Acupuncture Controls Overactive Bladder

Researchers have discovered that acupuncture is effective for controlling overactive bladder syndrome. The research team, a combination of Whipps Cross University Hospital and University College of London Hospital investigators, document that 79% of patients in the study showed clinically significant improvements. The researchers conclude that acupuncture is an effective treatment modality for patients with overactive bladder syndrome (OAB) and “is well tolerated with no side effects or complications.” As a result, the research team notes that acupuncture “should be considered as a potential alternative to our current therapeutic regimes” for patients with OAB.

Overactive bladder syndrome is a dysfunction of the bladder’s storage abilities that lead to a sudden urge to urinate. Symptoms include a sudden urge to urinate that is often difficult to control, involuntary loss of urine (urge incontinence), frequent urination (greater than 8 times per day) and waking at night 2 or more times to urinate (nocturia). Etiology varies and may include dysfunction of the kidneys, bladder nerve signals and muscle activity. Contributing and exacerbating factors of OAB include multiple sclerosis (MS), Parkinson’s disease, increased fluid intake, kidney and bladder organic disorders, diabetes, pharmaceutical medications and illicit drugs, urinary infections, enlarged prostate and increased consumption of caffeinated beverages.

The researchers note that acupuncture is safe and effective. All patients in the study had already tried conventional approaches to care: behavioral modifications and pharmaceutical medications including anticholinergics and beta agonists. Although surgical procedures are often part of conventional treatment regimes of care for OAB sufferers, all candidates were pre-surgical. The research team notes, “The aim of the study is to assess if acupuncture is effective in the treatment of patients with OAB in whom conservative measures and oral medications have failed, but are unwilling or unsuitable for invasive therapies.” 

This study focused on three acupuncture points. This protocolized approach is common in scientific investigations and varies from standard clinical practice in which customization of the acupuncture point prescription is applied for specific diagnostic considerations. Despite the limitations of a standardized set of acupuncture points across all patients in the study, 79% of all patients showed significant clinical improvements. In a real-life situation, a licensed acupuncturist has the ability to adjust the protocol to meet the specific individual needs of the patients. As a result, a licensed acupuncturist can potentially exceed the success rate achieved in this protocolized approach to care. 

Acupuncture was applied at a rate of once per week for a total of 10 weeks. Each acupuncture treatment session was 30 minutes in length. Acupuncture points SP6, CV4 (RN4) and KI3 were applied. SP6 and KI3 were needled bilaterally on the lower leg and ankle. CV4 (RN4) was needled on the midline and is depicted in the image at top of the article. The researchers note that the study began with the use of traditional manual acupuncture and later electroacupuncture was applied to the needles. Urodynamic studies and evaluations confirm that this regime of care is both safe and effective for the treatment of overactive bladder syndrome.

The researchers note that acupuncture has several benefits. It can be used for patients who cannot tolerate medications, acupuncture does not cause the adverse effects associated with OAB medications, acupuncture demonstrated efficacy where medications and behavioral therapy failed and acupuncture may avert the need for surgery as a corrective measure. Acupuncture provides an effective option to patients who have tried medications without success. In this way, acupuncture can potentially reduce the number of patients requiring surgery for OAB.

References:
Post-treatment, Pre-treatment, and ICIQ-UI Short Form. "ACUPUNCTURE IN THE MANAGEMENT OF OVERACTIVE BLADDER SYNDROME." 2014.

Philp T, Shah PJR, Worth PHL. Acupuncture in the treatment of bladder instability. British Journal of Urology 1988 Jun: 61(6); 490-493.

Acupuncture in Stroke Treatment

by Russ Erickson, MD
Acupuncture therapy for stroke-caused conditions such as paralysis, speech and swallowing problems, and depression is commonly used in the Orient. In China and Japan, an acupuncturist is likely to start therapy as soon as possible after a stroke. However, my recommendation is a delay of 2 weeks before acupuncture for strokes caused by bleeding in the brain, 10 to 20% of strokes (instead of the usual blood vessel block or clot). The wait is due to studies showing that acupuncture opens blood vessels for better flow and decreases clotting and inflammation. These effects are desired early when arteries are blocked, but after a stroke caused by bleeding has occurred, it is safer to wait until the bleeding blood vessel has clotted and is unlikely to bleed further before providing the acupuncture.

Acupuncture is done on a daily basis in China. Uncertain as to whether daily acupuncture is essential, even in Western countries, some acupuncturists with experience in treating stroke with acupuncture believe treatment 3 times a week is optimal. Several different approaches have been used to treat stroke, demonstrating that acupuncture for this disorder remains a healthcare art: Traditional Chinese Yang meridian point therapy, Chinese scalp acupuncture,

Dr. Yamamoto's YNSA Japanese scalp therapy, Korean Koryo Chim hand acupuncture, supplemental ear (auricular) acupuncture, and Xingnao KaiQiao (a newer therapy by Professor Shi Xuemin) are each advocated by a number of treatment centers in Oriental countries. One need not know in depth the approach of each, but it is important to know that more than one approach is available and used.

Does acupuncture really work to help stroke victims improve? Many studies involving thousands of patients have been published in China and Japan, and 2 of 3 studies from Scandinavia, demonstrated significant help. These studies indicate that patients get well faster, perform better in self-care, require less nursing and rehabilitation therapy, and use less healthcare dollars. However, since most studies come from China, they get little credence from the Western medical community because researchers in China do not appear to be published unless their results are highly positive, so publication bias is possible. And, no money has been made available in the United States for studies needed to confirm the claims of experts in China and Japan of indeed helping stroke patients. Such studies, if done well, demand significant funding; sources of such money are difficult to find. Most physicians, including rehabilitation experts, have appeared unwilling to consider acupuncture therapy, not due to bias but because the published studies do not necessarily meet research study criteria for the United States.

Acupuncture is a safe therapy, and my experience has taught that this is especially true when helping stroke victims. Even discomfort is generally minimal. If one compares the possible positive help to be obtained with the risks associated with acupuncture, my contention is that acupuncture is worthy to attempt for stroke therapy. Studies are needed in the United States to prove this to medical skeptics. It will be important for such studies to involve skilled acupuncturists with experience in stroke therapy.

Adding acupuncture to rehabilitation therapy obviously increases the cost; daily-to-3 times-weekly treatment is needed for 2-4 weeks or longer. Concern for added cost would perhaps disappear if the end result demonstrates more self-care and less dependence on family and health providers.

IBS due to Liver/Spleen disharmony

The Liver and Spleen disharmony, the most common cause of IBS that there is.

Liver/Spleen disharmony is really just using traditional Chinese medicine terms to describe what we in the west might refer to as a stress induced digestive disorder. That's the simple explanation. If you want, you can scroll down this page a bit to learn more about how this is treated. Or, you can read on and learn a little bit more about the specific condition and the logic behind the diagnosis of "Liver/Spleen disharmony."

In Chinese medicine the Liver is not the liver. Well in this case it really isn't. This Chinese concept of the Liver (with the capital "L") is more like the nervous system. The nervous system is very important for the proper workings of the digestion. It has been recently noted by the practitioners in the burgeoning Western medical field of gastro-neurology, that there are actually more neural connections made in the digestive system than there are in the brain. This is a rather amazing discovery, though perhaps about 2,000 years behind the times when compared to Chinese medicine, but enough of my soap box, let's talk about your digestion.

The Liver/Spleen disharmony tongue may not actually show any indications of problems. It could look totally normal. However, given time, it can develop a thick coating as the Spleen's function is compromised and gives rise to internal dampness. Or, if the Liver really starts to become a problem, it can begin to generate some heat which can manifest as the red dots on the left side of the illustration shown here.

Because the nervous system is designed to respond to danger, stressors in our lives will constantly be exciting our nerves. There are two basic nervous systems in our body. One is the conscious stuff like the nerves that make my fingers type this article. Then there is all the unconscious stuff like the beating of my heart, the glandular secretions to keep my eyes moist, the digestion that is currently wrestling with a overly marinated chicken sandwich from a deli on Melrose in West Hollywood.

Now this nervous system that works without our having to think about it is called the autonomic nervous system. And it too, is broken up into two components. One is called the sympathetic and the other is called the parasympathetic. The sympathetic doesn't make you kind to little birds, but it is sympathetic in its ability to read the environment correctly and get you up and running if you should perchance suddenly discover a lion stalking you. The sympathetic nervous system is among other things, our fight or flight response. It is all those things that activate those organ systems in charge of keeping us alive in the event of an emergency.

The other half of the autonomic nervous system is called the parasympathetic nervous system. It is the nervous system in charge of allowing us to be relaxed, doing everything that the sympathetic nervous system doesn't do and that includes digestion.

Usually, these two nervous systems get along just fine. But since our lives became more and more civilized and the modern world has become more and more emotionally stressful, the sympathetic nervous system is in a constant state of excitation. Our blood pressure is higher, our heart rate is higher, our incidence of insomnia is higher and we develop digestive disorders secondary to stress. The way that this works is simple.

The digestion is reliant upon the parasympathetic nervous system to do its job. If we're being chased by a bear in the forest, it would be prudent for our blood supply to be used for the muscles in the legs so that we can run away. So, in the event of over stimulation of the sympathetic nervous system, blood and other factors are sent away from the digestive organs toward the organs that are needed in the case of an emergency.

When we are under stress, our body responds as if we're being chased by a bear and so the digestion shuts down until such time that we feel safe and we can begin to digest our food again.

Simply put, this is the stress induced digestive disorder. The Liver in Chinese medicine is that nervous system and the Spleen is the entire digestion. Or job in Chinese medicine is to calm the Liver and strengthen the Spleen. In fact, most stress induced or stress aggravated pathology are viewed in Chinese medicine as the Liver beating up on one organ or another. The Liver is called the angry organ in Chinese medicine. I guess we can all see why now.

So, IBS is what happens when you're Liver is responding to stress in your life. If the stress is associated with being chased by a tiger or something, then once the tiger is gone, you can relax a bit and eat in peace and more importantly you can digest your food in peace. But if you live in a state of constant stress where corporate tigers are hiding in every bush or whatever stressor may be effecting you, then the digestion never really gets a chance to do its job. The end result is IBS. The stress in your life may not be that great to begin with, but you may have begun this path with a deficient Spleen to begin with, in which case, it wouldn't take much stress to cause a problem anyway.

There are a few ways to handle this. Of course coming up with a better way to handle stress is the first thing and probably the last thing you'll want to look at. In between those two points, we'd look to acupuncture and Chinese herbal medicines to really get this digestive problem under control.

Acupuncture is really good at treating anything that is stress induced. Acupuncture has a particular affinity for neurological conditions of any nature. That includes sedating the Liver as we say, or simply calming you down. On the other hand, there are herbal formulas that target this same problem from the inside out. One herbal formula often used as a base formula for further modification by a trained TCM herbalist is called Tong Xie Yao Fang. That translates to "Important Formula for Painful Diarrhea". Not a name that you'll likely find on any bottles in the English speaking world, but you gotta admit it certainly does get to the point.

This formula is made up of four herbs that have a particular relationship that strengthens the appropriate functions within them to both sedate the Liver (calm the stress) as well as firm up the stools by drying up the water and strengthening the digestion's ability to adequately digest the food.

Everybody is a little bit different and this formula is often times modified to treat the unique expressions of this condition within the individual.

Other symptoms of a Liver/Spleen disharmony include:

• Diarrhea aggravated by stress
• Diarrhea alternating with constipation 
• Constipation with pellet sized stools 
• Constipation aggravated by stress 
• Gas aggravated by stress

Here is a peer-reviewed meta-study of research done on Tong Xie Yao Fang

All of the formulas mentioned in this article are widely available at Chinese medicine pharmacies, though the so-called patent medicines that you'll find there aren't always as strong as they could be. These formulas come in a variety of different forms and strengths and your friendly neighborhood herbalist can assist you in obtaining them as is appropriate.

You can purchase any of the formulas mentioned in this article by simply clicking on their names. Another option is to obtain this formula modified for your unique situation from Beyond Well Being.

Be Well.

Why Go Veg?

People are drawn to vegetarianism by all sorts of motives. Some of us want to live longer, healthier lives or do our part to reduce pollution. Others have made the switch because we want to preserve Earth’’s natural resources or because we’’ve always loved animals and are ethically opposed to eating them.

Thanks to an abundance of scientific research that demonstrates the health and environmental benefits of a plant-based diet, even the federal government recommends that we consume most of our calories from grain products, vegetables and fruits. And no wonder: An estimated 70 percent of all diseases, including one-third of all cancers, are related to diet. A vegetarian diet reduces the risk for chronic degenerative diseases such as obesity, coronary artery disease, high blood pressure, diabetes and certain types of cancer including colon, breast, prostate, stomach, lung and esophageal cancer.

Why go veg? Chew on these reasons:

You’ll ward off disease. Vegetarian diets are more healthful than the average American diet, particularly in preventing, treating or reversing heart disease and reducing the risk of cancer. A low-fat vegetarian diet is the single most effective way to stop the progression of coronary artery disease or prevent it entirely. Cardiovascular disease kills 1 million Americans annually and is the leading cause of death in the United States. But the mortality rate for cardiovascular disease is lower in vegetarians than in nonvegetarians, says Joel Fuhrman, MD, author ofEat to Live: The Revolutionary Formula for Fast and Sustained Weight Loss. A vegetarian diet is inherently healthful because vegetarians consume less animal fat and cholesterol (vegans consume no animal fat or cholesterol) and instead consume more fiber and more antioxidant-rich produce——another great reason to listen to Mom and eat your veggies!

You’ll keep your weight down. The standard American diet—high in saturated fats and processed foods and low in plant-based foods and complex carbohydrates——is making us fat and killing us slowly. According to the Centers for Disease Control and Prevention (CDC) and a division of the CDC, the National Center for Health Statistics, 64 percent of adults and 15 percent of children aged 6 to 19 are overweight and are at risk of weight-related ailments including heart disease, stroke and diabetes. A study conducted from 1986 to 1992 by Dean Ornish, MD, president and director of the Preventive Medicine Research Institute in Sausalito, California, found that overweight people who followed a low-fat, vegetarian diet lost an average of 24 pounds in the first year and kept off that weight 5 years later. They lost the weight without counting calories or carbs and without measuring portions or feeling hungry.

You’ll live longer. If you switch from the standard American diet to a vegetarian diet, you can add about 13 healthy years to your life, says Michael F. Roizen, MD, author of The RealAge Diet: Make Yourself Younger with What You Eat. ”People who consume saturated, four-legged fat have a shorter life span and more disability at the end of their lives. Animal products clog your arteries, zap your energy and slow down your immune system. Meat eaters also experience accelerated cognitive and sexual dysfunction at a younger age.”

Want more proof of longevity? Residents of Okinawa, Japan, have the longest life expectancy of any Japanese and likely the longest life expectancy of anyone in the world, according to a 30-year study of more than 600 Okinawan centenarians. Their secret: a low-calorie diet of unrefined complex carbohydrates, fiber-rich fruits and vegetables, and soy.

You’ll build strong bones. When there isn’’t enough calcium in the bloodstream, our bodies will leach it from existing bone. The metabolic result is that our skeletons will become porous and lose strength over time. Most health care practitioners recommend that we increase our intake of calcium the way nature intended——through foods. Foods also supply other nutrients such as phosphorus, magnesium and vitamin D that are necessary for the body to absorb and use calcium.

People who are mildly lactose-intolerant can often enjoy small amounts of dairy products such as yogurt, cheese and lactose-free milk. But if you avoid dairy altogether, you can still get a healthful dose of calcium from dry beans, tofu, soymilk and dark green vegetables such as broccoli, kale, collards and turnip greens.

You’ll reduce your risk of food-borne illnesses. The CDC reports that food-borne illnesses of all kinds account for 76 million illnesses a year, resulting in 325,000 hospitalizations and 5,000 deaths in the United States. According to the US Food and Drug Administration (FDA), foods rich in protein such as meat, poultry, fish and seafood are frequently involved in food-borne illness outbreaks.

You’ll ease the symptoms of menopause. Many foods contain nutrients beneficial to perimenopausal and menopausal women. Certain foods are rich in phytoestrogens, the plant-based chemical compounds that mimic the behavior of estrogen. Since phytoestrogens can increase and decrease estrogen and progesterone levels, maintaining a balance of them in your diet helps ensure a more comfortable passage through menopause. Soy is by far the most abundant natural source of phytoestrogens, but these compounds also can be found in hundreds of other foods such as apples, beets, cherries, dates, garlic, olives, plums, raspberries, squash and yams. Because menopause is also associated with weight gain and a slowed metabolism, a low-fat, high-fiber vegetarian diet can help ward off extra pounds.

You’ll have more energy. Good nutrition generates more usable energy——energy to keep pace with the kids, tackle that home improvement project or have better sex more often, Michael F. Roizen, MD, says in The RealAge Diet. Too much fat in your bloodstream means that arteries won’’t open properly and that your muscles won’’t get enough oxygen. The result? You feel zapped. Balanced vegetarian diets are naturally free of cholesterol-laden, artery-clogging animal products that physically slow us down and keep us hitting the snooze button morning after morning. And because whole grains, legumes, fruits and vegetables are so high in complex carbohydrates, they supply the body with plenty of energizing fuel.

You’ll be more ‘regular.’ Eating a lot of vegetables necessarily means consuming more fiber, which pushes waste out of the body. Meat contains no fiber. People who eat lower on the food chain tend to have fewer instances of constipation, hemorrhoids and diverticulitis.

You’ll help reduce pollution. Some people become vegetarians after realizing the devastation that the meat industry is having on the environment. According to the US Environmental Protection Agency (EPA), chemical and animal waste runoff from factory farms is responsible for more than 173,000 miles of polluted rivers and streams. Runoff from farmlands is one of the greatest threats to water quality today. Agricultural activities that cause pollution include confined animal facilities, plowing, pesticide spraying, irrigation, fertilizing and harvesting.

You’ll avoid toxic chemicals. The EPA estimates that nearly 95 percent of the pesticide residue in the typical American diet comes from meat, fish and dairy products. Fish, in particular, contain carcinogens (PCBs, DDT) and heavy metals (mercury, arsenic, lead, cadmium) that can’’t be removed through cooking or freezing. Meat and dairy products can also be laced with steroids and hormones, so be sure to read the labels on the dairy products you purchase.

You’ll help reduce famine. About 70 percent of all grain produced in the United States is fed to animals raised for slaughter. The 7 billion livestock animals in the United States consume five times as much grain as is consumed directly by the American population. “If all the grain currently fed to livestock were consumed directly by people, the number of people who could be fed would be nearly 800 million,” says David Pimentel, professor of ecology at Cornell University. If the grain were exported, it would boost the US trade balance by $80 billion a year.

You’ll spare animals. Many vegetarians give up meat because of their concern for animals. Ten billion animals are slaughtered for human consumption each year. And, unlike the farms of yesteryear where animals roamed freely, today most animals are factory farmed: —crammed into cages where they can barely move and fed a diet tainted with pesticides and antibiotics. These animals spend their entire lives in crates or stalls so small that they can’’t even turn around. Farmed animals are not protected from cruelty under the law——in fact, the majority of state anticruelty laws specifically exempt farm animals from basic humane protection.

You’ll save money. Meat accounts for 10 percent of Americans’’ food spending. Eating vegetables, grains and fruits in place of the 200 pounds of beef, chicken and fish each nonvegetarian eats annually would cut individual food bills by an average of $4,000 a year.

Your dinner plate will be full of color. Disease-fighting phytochemicals give fruits and vegetables their rich, varied hues. They come in two main classes: carotenoids and anthocyanins. All rich yellow and orange fruits and vegetables——carrots, oranges, sweet potatoes, mangoes, pumpkins, corn—owe their color to carotenoids. Leafy green vegetables also are rich in carotenoids but get their green color from chlorophyll. Red, blue and purple fruits and vegetables——plums, cherries, red bell peppers——contain anthocyanins. Cooking by color is a good way to ensure you’re eating a variety of naturally occurring substances that boost immunity and prevent a range of illnesses.

It’’s a breeze. It’’s almost effortless these days to find great-tasting and good-for-you vegetarian foods, whether you’re strolling the aisles of your local supermarket or walking down the street at lunchtime. If you need inspiration in the kitchen, look no further than the internet, your favorite bookseller or your local vegetarian society’’s newsletter for culinary tips and great recipes. And if you’’re eating out, almost any ethnic restaurant will offer vegetarian selections. In a hurry? Most fast food and fast casual restaurants now include healthful and inventive salads, sandwiches and entrees on their menus. So rather than asking yourself why go vegetarian, the real question is: Why haven’’t you gone vegetarian?

Eating Disorder Quiz

How can I tell if I have a problem with food or eating? Here’s a simple Self Scoring Assessment Tool. This is not meant to be used as a clinical diagnosis, but as a tool to help determine if it’s possible that you could improve your relationship with food.

Answer these 6 questions honestly:

1. Do you feel like you sometimes lose or have lost control over how you eat?
2. Do you ever make yourself sick because you feel uncomfortably full?
3. Do you believe yourself to be fat, even when others say you are too thin?
4. Does food or thoughts about food dominate your life?
5. Do thoughts about changing your body or your weight dominate your life?
6. Have others become worried about your weight?

In this informal survey, 2 or more “yes” answers strongly indicate the presence of disordered eating. Adapted from the Scoff Questionnaire by Morgan, Reid & Lacy-BMJ, 1999.

We strongly encourage those who answer 2 or more “yes” answers to get a professional opinion. Eating disorders are serious illnesses, but with the right treatment people can, and do, recover.

Acupuncture for Nerve Damage

Nerve damage is a highly variable condition that can present with pain, numbness, tingling, loss of range of motion, and a multitude of other problems depending on what nerves are affected. A common treatment often involves working with a neurologist to find appropriate physical therapy, surgery, drugs (either oral or nerve blocks), and electrical stimulation methods. As with stroke, prognosis for recovery is better the sooner treatment beings.

East Asian Medicine classifies nerve damage based on the primary symptoms, and these classifications are often given names of things similar to things we observe in nature. Some common presentations in East Asian medical language are:

• Wind – for damage presenting as muscle twitching, spasm, uncontrolled movement or stiffness
• Damp – for damage resulting in tingling, dull or severe achy pain, swelling, or quick fatigue
• Cold – for damage that is worse seasonally, with sharp & throbbing pain, and muscle & sinew contraction
• Phlegm – for damage resulting in numbness & growths

Treatments for nerve damage vary just about as much as the presentation, and go beyond the simple insertion of acupunctureneedles. For example, electroacupuncture (where electrodes are placed on the handles of needles) is one therapy used for loss of range of motion, sensation problems, and very stubborn pain. It is a very heavy treatment that helps steer or promote nerve growth, and can be used for neuralgia or chronic neuropathy in any peripheral nerve. Moxabustion – a heat-based therapy involving the burning of herbs – is often used for spasm, fatigue, or tingling to help break inflammatory cycles and fluid congestion that impede nerve activity. Another possible treatment is the use of a plum blossom needle, pictured at left, which is a small hammer with blunt metal ends that is tapped against the skin. This treatment promotes sensory nerve regrowth in small areas and can reduce the pain from inflammation or febrile-based conditions, like post-herpetic neuralgia.

Dealing with nerve damage and nervous system disorders can be a challenge, and these cases often take a long time to resolve if they have been left alone for many years. Typically, those who seek treatment immediately from both East Asian and Western approaches see the fastest and most complete recovery, since an acupuncturist can use the knowledge of East Asian medicine to support the entire constitution of a person, while both specialties can work on the problem at hand.

Why I Became Vegetarian

moxibustion for breech baby

Chinese Meditation music

The Practice of Chinese Medicine: What is Moxibustion?

How to Use Moxa at Home for Joint Pain

moxibustion - English substitle

moxibustion

https://www.youtube.com/watch?v=fNePdPzXzPk

Preparing for Conception Over 40

Dalene Barton-Schuster, CH, Doula

More women than ever are trying to conceive over the age of 40, that is a fact. In most developed countries the world over we are finding that women have more freedoms and equalities than past times. There is no denying this is wonderful. This gives us the freedom to focus on career goals, travel, making our creative dreams a possibility, rather than feeling like we have to have children right away in our 20’s. We are no longer as stuck as we once were, but what about that nagging fear of fertility decline as we age?

I hear the doubt daily, “Should I have waited so long to have children?” I find that women over 40 come to us with a huge amount of fear surrounding their fertility journey. Where does this fear stem from? Society? Media? Science? Where? As long as humans have existed, there have been deep emotions, opinions, the “right and wrong” ways to do just about everything in life. So why would we expect it to be any different for those desiring to have children over 40? I am not here to pick sides, but I do think it is very important to be realistic and to listen to your gut. When has any decision that started off in fear been a step in the right direction? Let your journey begin with confidence and belief in your body. If you doubt your body or the health of your future child to begin with, how can you expect to be successful? Even if you don’t succeed, at least you will know you gave it your best shot.

I figure that if you are reading this article, you are all in, ready to have a child over the age of 40. Because of that, I am not here to list statistics on the likelihood of conception for women over 40, or the risks to mother and child. You can find that information elsewhere. We are here to let you know the importance of smart preparation. There are important key areas that need to be focused on. These key areas can help to give you and your baby the best chance at a healthy first 9 months in the womb and beyond!

Understanding Female Fertility for Women 40 and Over

What happens to my fertility as I age?

The Menstrual Cycle: Menarche to the Beginning of Climacteric
Menarche is the beginning of the childbearing years, when the first menstruation begins. Climacteric is the long phase in which hormone production and ovarian function declines, allowing the body to adapt to the natural changes in which menstruation ends. Menopause occurs within the climacteric years of a woman’s life. Climacteric lasts for about 15-20 years, typically beginning at the age of 40.

The Menstrual Cycle in the Childbearing Years of a Healthy Woman
Approximate age of 11-40 years

In very simple terms the hypothalamus produces GnRH (gonadotrophin-releasing hormone) which signals to the pituitary to produce LH luteinising hormone and FSH follicle stimulating hormone. The release of GnRH is pulsatile in women with regular menstrual cycles. This normal pulsatile release of GnRh signals some of the follicles in the ovary to begin maturing and for the ovaries to release estrogen and progesterone. This estrogen/progesterone signal is recognized by the pituitary gland. As the follicles begin maturing they release and increase the hormone estrogen over time. The rising estrogen level signals the pituitary gland to curb release of FSH.

In a normal functioning follicle, the estrogen levels rise and signal the pituitary gland to release Luteinizing Hormone (LH). LH signals the follicle to open and release the mature egg, this is ovulation.

Ovulation is followed by the luteal phase. With LH present the corpus luteum begins to secrete increasing quantities of progesterone and fairly constant levels of estrogen.
The endometrium is now influenced by progesterone causing it to develop to be capable of nourishing a developing embryo.

If fertilization does not occur, the decline of the hormones causes the endometrium to shed, which is dependent on hormones at all times for its health, maintenance and development. When estrogen reaches a low enough point the hypothalamus releases GnRH and the cycle starts over again.

This cycle lasts on average 28 days, though it may vary some from woman to woman.

The Menstrual Cycle in the Climacteric and Menopause Years of a Healthy Woman
Approximate age of 40-60 years for climacteric, age 40-55 for menopause, with menopause occurring within the climacteric years.

Now this may seem very confusing because most of us have very little education on what happens during “the change of life” a woman goes through as fertility declines. Most women begin the natural phase known as climacteric around the age of 40. Remember this is what is supposed to happen, it is part of the natural processes of life. At this time the menstrual cycle length begins to shorten from about 28 days to around 26 days, this is because the ovaries begin to lose their ability to produce mature follicles, estrogen and progesterone. Cycle length may be different for each woman, these numbers are just averages.

Over the next many years the decline in hormone release and mature follicle production causes even more menstrual cycle changes. Cycles may become shorter, longer, or the cycle may be skipped. Ovulation may or may not occur during any given cycle as a woman approaches menopause. Menopause is confirmed once a woman has not had her menstrual cycle for at least one full year, and is between the ages of 40-55. Menopause may take 1-7 years to complete. The changing hormone levels continue until climacteric is complete, which may last until around the age of 60.

There are 3 distinct phases of change for women in the climacteric phase of life.

Phase 1 Perimenopause: 2 to 8 years leading up to cessation of menstruation

• Menstrual cycles become irregular
• Hormone levels change
• It is still possible to conceive naturally and carry a baby to term
• Doctor’s may suggest medical assistance options like Clomid, IUI or IVF

Phase 2 Menopause: Defined by absence of menstruation for one year. Doctor’s may also use certain hormone testing to indicate menopause, they are as follows:

• Elevated FSH level between 60 to 100mL/L on two tests done at least 1 month apart may indicate menopause
• LH level greater than 50mIU/L and estradiol less than 50pg/mL
• Some reproductive endocrinologists are willing to do IVF with an egg donor for women in menopause

Phase 3 Post-menopause: the first stage typically lasts about 4 years of continued physical symptoms of hormonal changes, with the second stage lasting for years until all symptoms of hormonal changes end. This last stage is different for each woman, but usually ends by age 58-60.

The human female body is designed to go through these changes very slowly over time. Sudden change in a short period of time may cause more severe symptoms in the body. This great shift in fertility, though it is long and drawn out, may produce many unwanted physical symptoms including:

• Muscles of the vagina, cervix, uterus and ovaries atrophy
• Muscles in the pelvic floor and surrounding supportive tissues lose tone
• Lack of cervical mucous
• Bone mass declines
• Metabolic rate slows down
• Breast shape, firmness and size changes
• Hot flashes
• Mood changes, depression, insomnia and anxiety
• Mild incontinence due to weakening and shrinking of pelvic tissues
• Heart palpitations

Though these symptoms can be uncomfortable, this process is completely natural and is what is supposed to happen to the body. It is a “rite of passage”. I know, this may not be comforting to hear, but it is the truth. Research has shown that other cultures that are notWesternized do not report severe symptoms of menopause and are not medically managed. Menopause is not a disease that needs to be treated, but in the United States we have come to believe it does.

Knowing what is happening to your body gives you an advantage. It helps you to know key areas you need to focus on to give yourself the best possible chance at a healthy pregnancy.

Preparing for Conception Over 40

Healthy fertility over 40 is probably going to take a bit more effort on your part. It is vital you eat well, exercise regularly, reduce poor lifestyle choices and consider seeing a fertility specialist. If you have been trying to get pregnant for over 6 months it is important to see a doctor. Having a full hormone test panel run will help you to know where your hormone levels are at and what hormones may need to be supported. Seeing a doctor can help you to know if there are other fertility issues that may be hindering conception and pregnancy as well.

Because of normal life changes women over 40 need to focus on the following key areas:

Tools for your fertility tool box!

• Improving egg health
• Improving uterine health
• Supporting hormonal balance
• Strengthening pelvic floor muscles
• Supporting cervical mucous production
• Managing stress
• Timing ovulation and sexual intercourse

In addition, typically the older we are, the more time we have been exposed to the negative effects of stress, environmental toxins, poor dietary and lifestyle habits. These can contribute to fertility issues which may decrease healthy fertility at all ages, but especially for women over 40.

Medical Options

If you have been trying for a child naturally for 6 months or longer with no success, it is time to get in to see a doctor. Many women over the age of 40 will find they have diminished ovarian reserve (DOR). This is completely natural and normal. Regardless of what your test results are, a natural therapy plan may greatly increase your chances of a successful pregnancy. It does not matter if you are going for IUI or IVF or using a donor egg, simple natural preparation can still be done. A natural therapy plan may increase your chances of a successful medical procedure as well.

What will your medical options be if you find out you do have low ovarian reserve? Depending what your ovarian reserve is determined as, they may suggest Clomid to stimulate ovulation, intrauterine insemination (IUI), in vitro fertilization (IVF), or an egg donor (if your reserve is extremely low), or suggest hormonal medications. If you are planning to do any of the medical options I just mentioned, you can still follow a natural therapy plan prior to beginning any hormonal medications for those procedures. For example you could prepare naturally for an upcoming IVF. We always encourage couples to continue eating well and exercising through any type of fertility plan regardless if it is natural or medical.

Natural Therapy Plan for Women Trying to Conceive Over 40

Note: If you have been diagnosed with a fertility issue please also see one of our guides related to that particular issue.

There are many key areas that need to be focused on. I am briefly going to cover each of them below. At the bottom of each section is a link to more information specific to that subject.

Fertility Diet

The single most important thing you can do, if you do not already eat a whole food diet, is switch to one! I have seen the most dramatic improvement in egg health through diet changes alone, specifically by switching to a nutrient dense fertility diet that includesfertility superfoods like spirulina, maca, and royal jelly. Also, supplementing with key nutrients such as antioxidants, CoQ10 Ubiquinol, and folic acid have been shown to increase egg health.

Exercise

If you are not sweating regularly, your body is not going to be able to detoxify itself! Sweating helps the body to remove excess toxins, especially xenohormones, which are human-made chemical toxins shown to cause hormonal imbalance through endocrine system disruption. Exercise also helps to reduce fat in the body, quell depression, increase a sense of wellbeing, increase stamina and strength for the hard work of labor and early motherhood!

Most toxins are stored in our liver, kidneys and fat cells. If you plan on breastfeeding your baby, it is important to try to cleanse toxins from your body as much as possible prior to conception and breastfeeding. Your body will use fat stores during pregnancy and breastfeeding, which go directly to your baby, exercise is an essential way to cleanse the body of toxins in preparation for pregnancy!

Great Ideas for Exercise:

• Walking
• Fertility Yoga
• Biking
• Dancing
• Swimming Laps
• Pilates

Be sure you are exercising for 30 minutes a day, 5 times a week.

Kegel Exercise
Learn to make Kegels a part of your daily routine! What are Kegels? Daily Kegels strengthen the pelvic floor muscles. Contracting and relaxing the pelvic floor muscles repeatedly will help to keep the reproductive organs in place, support vaginal, cervical and uterine strength, as well as help to prevent uterine prolapse and incontinence after childbirth and post-menopause.

Fertility Cleansing

Women over 40 have had more time to be exposed to environmental toxins and are more likely to have an accumulation of toxins in the body. If there are poor diet and lifestyle choices involved such as drinking alcohol or smoking, being sedentary, etc., there is an even greater need for fertility cleansing prior trying to conceive.

The number one complaint we get from women over 40, is that fertility cleansing requires the couple to take one month off of trying to conceive. We understand that it can feel as though time is running out and that one cycle may be your missed opportunity for conception. Stop and think about this for a minute: Do you want to give your baby the best chance at a healthy beginning? Your body will use fat stores during pregnancy and breastfeeding, which go directly to your baby, regular exercise and cleansing is an essential way to rid the body of toxins in preparation for pregnancy!

Improve Egg Health

Egg health and count begins to dramatically decline on average around the age of 37-40. It is imperative you work to preserve and increase your egg health now. We suggest working on this for at least 3 months prior to beginning to try to conceive, whether naturally, through IUI or IVF. The cycle of an egg in preparation for ovulation is around 90 days. This is why we suggest taking 3 months to focus on increasing the health of your eggs.

To help improve egg health we like to focus on increasing circulation, boosting nutritional levels and supporting hormonal balance with fertility superfoods and vital nutrients.

Key tips for improving egg health:

• Eat a fertility diet
• Exercise
• Fertility Superfoods like maca, royal jelly and green foods
• Fertility cleansing
• Stress reduction
• Key nutrient supplementation with a whole food multivitamin, antioxidant blend, CoQ10 Ubiquinol, & L-Arginine

Improve Uterine Health

Due to the gradual changes in hormone levels after the age of 40, the uterus slowly begins to lose muscle tone. All women need to have a strong uterus for pregnancy and the hard work of labor. If you have a sedentary lifestyle it is even more important to work to improve uterine health. We already discussed how Kegel exercise can help to improve and preserve muscle tone of the pelvic floor muscles and uterus. Fertility massage and castor oil packs done externally over the lower abdomen helps to strengthen the uterus, improve hormonal balance, detoxify the tissues of the reproductive organs and surrounding tissues, and increase circulation to the reproductive organs. There are also specific herbs that have a direct action on uterine tone.

Key tips for improving uterine health:

• Daily fertility yoga, walking, and Kegels
• Fertility massage
• Castor Oil packs
• Herbs

Cervical Mucous

Cervical mucous production naturally declines with hormonal changes as well. It is important to support healthy cervical mucous production over the age of 40. For women that have low or no cervical fluid, it is harder for the sperm to reach the awaiting egg for conception.

Key tips for supporting cervical mucous production:

• Drink plenty of clean, filtered water daily, about 8 full glasses
• Take a complete omega essential fatty acid supplement daily
• Consider herbs that support cervical mucous production

When having sexual intercourse use a sperm friendly lubricant if CM is scant. This will help get the sperm where they need to go!

Chart Your Cycle

If you do not already chart your cycle, begin now. I know I said I wouldn’t throw any statistics out there, but let’s be realistic, women over 40 only have about a 5% chance per cycle of conceiving. If you do not have your timing down, it is going to be extremely difficult to get pregnant.

You have a 6 day window to get pregnant, with only 2 peak days. So begin trying to conceive 3 days prior to ovulation, the day of ovulation and 2 days after that. If your male partner has low sperm count or poor sperm health, try to have sex only on the day of ovulation. Abstaining from sexual intercourse for the days prior to ovulation will help to build up his sperm count.

Most women ovulate 2 weeks before menstruation begins. Charting helps you to know if and when you may be ovulating, which will help you to know when to try to conceive.

Support Hormonal Balance

The entire menstrual cycle relies on hormonal balance. Ovulation, conception and a healthy pregnancy cannot occur without hormonal balance! We know that hormone changes occur as we age, if hormone levels specific to fertility are too high or too low it may prevent conception or cause miscarriage.

Key hormones to learn about and support for a healthy pregnancy:

• Estradiol (E2)
• Progesterone
• Follicle stimulating hormone (FSH)

You may find that as you age, your changing hormone levels may interfere with conception or maintaining pregnancy. It is imperative to support the endocrine system at this time, as it is responsible for hormonal balance. We find that most women over 40 will need to support hormonal balance in some way. We like to utilize herbs and specific herbal formulas to help women encourage fertile hormone levels. Here are some herbs to consider:

• FertiliCare Phase 1 & 2 (a liquid herbal blend)
• Vitex (Vitex agnus-castus)
• Maca (Lepidium meyenii)
• Shatavari (Asparagus racemosus)

Other Important Considerations

Your Male Partner
We have focused so much on you, but what about your male partner? If he is also over 40, it is a good idea to get him in for some testing to determine sperm count and quality. There are many great natural ways to support healthy male fertility, you can learn about them here…

Support
Make sure you have a support network to help you out. Having a baby over 40 may bring more challenges and opinions from others, having a solid support network is going to give you more confidence and provide a cushion for days that may be tough!

Summary

Conception, pregnancy and having a healthy child over 40 is possible. Having a natural therapy plan in place may increase your chances of success by improving egg health, uterine health and maintaining hormonal balance. Natural therapies take time to be effective, we suggest you give yourself 3 months to implement a natural fertility therapy plan prior to beginning to try to conceive. This will give you the best possible chance at success.

Continue your natural fertility therapy plan throughout the time you are trying for natural conception. If you are planning on trying medicated cycles to achieve pregnancy such as Clomid, HRT, IUI or IVF, please discontinue any herbs or supplements you have been taking to improve your fertility.

Here is a quick summary of important key tips for preparing for conception over 40:

1. Eat a nutrient dense fertility diet, which will contribute to improving fertility overall.

2. Improve your egg health, uterine health and pelvic floor muscles with diet, exercise, herbs and supplements.

3. Support hormonal balance with stress management, herbs and supplements.

4. Support cervical mucous production by staying hydrated, supplementing with omega EFAs, herbs and possibly using a sperm friendly natural lubricant during intercourse.

5. Learn to chart your cycle so you can correctly time ovulation and sexual intercourse.

References:
1. Hoffmann, David , FNIMH, AHG, (2003) Medical Herbalism: The Science and Practice of Herbal Medicine, Healing Arts Press: Rochester, Vermont.
2. Romm, Aviva (2010) Botanical Medicine for Women’s Health, Churchill Livingstone: St. Louis, Missouri.
3. Fertility After Age 40 – IVF in the 40s. (n.d). Advanced Fertility Center of Chicago. Retrieved online at: http://www.advancedfertility.com/fertility-after-age-40-ivf.htm