Practically Fertile

Episode 2 - What TCM Tells You About Hormone Balance Without Bloodwork

• Dr. Adrienne Wei, DACM, FABORM, CFN, L.Ac.

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Traditional Chinese Medicine (TCM) has been around for thousands of years.  Have you ever wondered how doctors were able to help women get pregnant without actually knowing anything about blood chemistry or how hormones work as we understand it in the present day?  

In this episode, you'll learn the perspective of Chinese medicine on fertility.  We uncover how the four vital substances—Qi, blood, yin, and yang—interact through the menstrual cycle and impact hormonal balance, and ultimately, fertility.

• Explanation of the four vital substances and their roles in the body
• Overview of the four phases of the menstrual cycle in TCM
• Introduction of the 10 Parameters of a Fertile Cycle
• Key insights into why a regular cycle isn't always a fertile cycle

To download the fertile cycle checklist, please click HERE.

Follow me on instagram @dradriennewei

Website: www.adriennewei.com

Speaker 1:

Welcome to the Practically Fertile Podcast. I'm Adrienne Wee, doctor of acupuncture and Chinese medicine, functional medicine practitioner and functional nutritionist. I specialize in using an evidence-based method, blending principles of East Asian medicine and modern functional medicine to help women optimize fertility and get pregnant. I believe in a world where every woman who wants to be a mother becomes one. If you're tired of being told that you're infertile and you want to take the right steps to get pregnant naturally and quickly, this podcast is for you. Hey, fertile friend, before I get started, I want to let you know that I have prepared a fertile cycle checklist for you as today's downloadable resource. Make sure that you stay tuned to find out what it is and how to get your hands on it.

Speaker 1:

In the last episode, we learned about the key hormones that are crucial for fertility. I hope you learned a thing or two about the interconnectedness of all the major players and supporting actors and see how it's never one specific imbalance that's the issue. There's always a cause further upstream. Conventional medicine is great we need it for sure, but I will say, when it comes to hormones, what it measures is one data point in time and it doesn't give you the complete picture. For example, if your cycle day three blood work shows that your FSH is high, it's great you got that information. But what you're wondering about this is how does this impact my fertility and how does this impact my body? Or if your blood work shows that your hormone levels are normal, then why are you not getting pregnant? None of these numbers really tell you anything beyond just a number. It's also super impractical to get blood work done every single month to see what your numbers are, unless you're doing fertility treatments. But if you're trying to conceive naturally, you don't have that luxury. Everything seems okay, but are they optimal? And how would you know without getting blood work? That's why I integrate the two medical systems together.

Speaker 1:

Modern and traditional Chinese medicine has such a different way of evaluating the body because thousands of years ago there was no biomedical understanding of the body. No one knew anything about blood chemistry, hormones or anything like that. The entire medical system was developed based on observations of signs and symptoms and a lot of trial and error to resolve these imbalances over thousands of years. So what you get is a medical system that is tried and true, proven to work and still used by billions of people today. I always joke with my patients when they ask me does TCM or traditional Chinese medicine work? And I always say if it didn't work, chinese people wouldn't be alive today.

Speaker 1:

The reason why TCM is still relevant today is because it's really sophisticated. Of course, it has limitations, for sure, but it can absolutely determine the root causes of disease without needing blood work. That is actually one of its limitations. Also, tcm is not going to be able to tell you that you're vitamin D deficient or you're vitamin B12 deficient. It can tell you that you have certain patterns of imbalances that's causing symptoms like fatigue, hair loss, pale skin feeling, cold light periods, but it won't be able to pinpoint the blood chemistry markers that are out of range. The thing is, though, even without blood chemistry knowledge, using the TCM diagnostic system, once your pattern of imbalance is identified and you start implementing appropriate treatments based on your specific pattern, you'll feel better. You'll start to see more fertile signs, but it's faster if we incorporate modern medicine, and that's why I developed a protocol that incorporates both. Anyway, how does TCM tell you that your hormones are off balance each month without blood work? I'm a fairly modern TCM practitioner, which means I've fully embraced modern interpretations of TCM principles and how they correlate with present day understanding of the body. As you follow me on social media and on this podcast, you'll see what I mean by that. What I've developed is what's known as the 10 parameters of a fertile cycle. These are 10 data points that evaluate your cycle every month and gives you information based on the principles of TCM and how they might correlate to possible hormone imbalances.

Speaker 1:

So to get started, though, I need to teach you the concept of the four vital substances. According to Chinese medicine, these are the crucial components that make it possible for us to be alive and healthy. When they're off balance, our health is not optimal. They're like friends unhealthy. When they're off balance, our health is not optimal. They're like friends Also, just like our hormones are all friends. Sometimes they fight, sometimes they're besties. These four substances are brace yourself, these are the terms that you might have never heard about before Qi, blood, yin and yang.

Speaker 1:

Let's talk about each of these. Qi, spelled q-I and pronounced like chi, c-h-e-e, it's the vital energy circulating through the body. The way to look at this is think of it like the electricity that's powering your house. You can't see it, but you know it's there. Qi is very important because it gets things moving. It moves the blood, for example. It also keeps your body strong and it protects you from getting sick. If you don't have enough qi, you might feel tired or weak. If it doesn't flow well, things can get stuck like a traffic jam on a busy road.

Speaker 1:

Next up we have blood Self-explanatory Turns out. Blood in Chinese medicine is the same as blood in Western medicine. It nourishes the body. It nourishes the organs. Blood also nourishes the mind. If you don't have enough blood, you can feel anxious, dizzy, tired.

Speaker 1:

Then we have yin and yang. Yang is Y-A-n-g. It's pronounced yang, not yang. Yin is the cooling energy. It keeps the body cool, hydrated and prevents overheating. Without enough yin energy, you might feel dry, overheated and have trouble relaxing. It directly counterbalances the yang energy, which is the warm and activating energy. Yang energy is like the fire that keeps the body going. It gives you energy to get through the day and it keeps you warm. Without enough yang, you'll feel very cold and very sluggish. So you might notice that blood and yin seem to have similar functions, and qi and yang do the same things.

Speaker 1:

Here is one way of looking at this Yin energy and blood they provide actual resources for the body. And qi and yang. They provide energy and activity. All of the four substances have to work together and balance each other in order for us to be healthy. Of course, in reality, no one is ever 100% balanced, but that's always the goal is to achieve balance. A lot of Chinese medicine principles that I'll be discussing on this podcast and wherever you might find me. Finding balance is what you'll hear a lot. Finding balance is what you'll hear a lot. So the yin and yang energies are a bit more abstract. I'm not sure if you're familiar with the yin and yang symbol. One side is black and one side is white. On the black side there's a white dot and on the white side there's a black dot. This symbol shows how we maintain balance and optimal health. There's a constant transfer of energy from one form to another. So now let's get on with how these four substances and hormone status are all related.

Speaker 1:

In Chinese medicine, the menstrual cycle is divided into four phases the bleeding phase, the cooling phase, the moving phase and the warming phase. I came up with these names as an easy way to understand what is happening in each of the phases. So, depending on what resource and what sources you come across, the names might be different. Some sources would call the second phase the yin phase, the third phase the qi phase, but when you and I are talking, the four phases are bleeding, cooling, moving and warming. The bleeding phase is again self-explanatory You're having your period. There is blood. The second phase is the cooling phase. If you remember, a minute ago I talked about how the yin energy is cooling and lubricating. What else is cooling and lubricating? How the yin energy is cooling and lubricating? What else is cooling and lubricating? Estrogen right From the last episode we talked about estrogen.

Speaker 1:

The second phase of the cycle is also known as the follicular phase. That's when the follicle is developing Well. The yin energy is therefore most abundant during this phase. The third phase is the moving phase. During this time the body is preparing for ovulation, which means that you need abundant vital energy or qi, to make sure nothing gets stuck, to make sure that the follicle ruptures on time, to make sure that the egg travels down the tube appropriately, to make sure that, if there's fibrillation, the embryo travels down to the tube at the right speed to implant in the uterus. If the embryo gets stuck, you might end up with an ectopic pregnancy. Usually if there's late ovulation or delayed ovulation, the vital energy, or qi, is typically the culprit. It's either stuck or sluggish. The last phase of the cycle is when the embryo should be implanting.

Speaker 1:

That is the warming phase and during this phase your body temperature rises. If you take the BBT, you'll see a spike in your body temperature. In Chinese medicine that's due to the actions of the yang energy, because it's warming and protecting. It's making the uterus a nice and cushy home for the embryo. What else do we know? Raises the body temperature and prepares the lining for implantation Progesterone, right. So the yang energy is very much like the progesterone. So knowing this now is very much like the progesterone. So knowing this now, you can see why.

Speaker 1:

If there's any imbalance between these energetics, there will be telltale signs of hormone imbalance as well. That, my friend, is how I created what I call the 10 parameters of a fertile cycle. What I realized a long time ago was that just having a regular cycle is not the same as having a fertile cycle. Even if the blood work is normal, it still doesn't reflect the actual hormone interactions inside your body. And this tool the 10 parameters of a fertile cycle has proven to be invaluable in giving me feedback about my patient's fertility potential on a monthly basis and also actually to see if my treatments are working. These 10 parameters are cycle length, days of period flow, color of the flow, amount of the flow, consistency of the flow, texture of the flow, continuity of the flow, pain level, uterine lining stability, whether you're experiencing spotting before your period, cervical mucus and PMS.

Speaker 1:

I'm not going to get into the entire 10 parameters right now. I just want to give you this overview today. I promise I'll have another episode to go into more detail about them, but let me give you a couple of examples of what the parameters can indicate. You might have experienced a very light period flow that lasts one to three days. If the flow itself is quite heavy, I don't tend to worry as much as the situation where the period lasts two to three days and the period is very light, like barely needing to use a pad or tampon, and the blood might be very dark. Maybe you read that this isn't an issue Doctors don't seem to worry but this might be an indication of not having enough blood, and I don't mean that you're anemic, I mean you don't have of the substance that's blood. If there isn't enough blood, there isn't enough nourishment going to the organs, including the ovaries and uterus. That could mean a poor quality egg, causing thin lining. There is evidence that show us a period flow of less than four days decreases your chances of getting pregnant. To be fair, this wasn't a clinical trial or anything, but by evaluating over 50,000 women's menstrual cycle characteristics, the researchers were able to identify this correlation we talked about. Poor eye quality could be caused by small follicle size, causing low progesterone. It might not be a big deal in Western medicine, but it is a big and huge deal in Chinese medicine.

Speaker 1:

Another example the cervical mucus egg white cervical mucus. Again, there's actually evidence that having at least three days of egg white cervical mucus means this will increase your chances of getting pregnant. Cervical mucus has an important job to filter out bad sperm and to carry the good sperm to meet the egg. Without this fertile mucus, the vagina becomes a hostile environment to sperm and sperm can die within minutes. If there isn't enough yin energy, you'll experience signs of dryness. If there isn't enough yin energy, you'll experience signs of dryness. Not only very little egg white cervical mucus, but you could also have vaginal dryness, making intercourse painful. This correlates to an estrogen imbalance.

Speaker 1:

Either the estrogen level isn't optimal or your body's not responding appropriately to estrogen. One of the most exciting achievements that we celebrate in my clinic is when a patient starts to see three days of egg white cervical mucus. We don't get champagne or cake or anything like that, but we high five, we hug, we jump up and down because having egg white cervical mucus is so huge. It's a big deal. It's a sign that the estrogen is doing what it's supposed to do. Again, there's a large range of what is considered normal for estrogen. Your blood work might indicate that the levels are fine, but fine is not fantastic. Fine doesn't mean your body is responding appropriately to that hormone.

Speaker 1:

Let me tell you how to get your hands on this Fertile Cycle checklist. You can go to adrienneweecom slash Fertile Cycle to download this checklist. What should you do with this information Now that you've downloaded the Fertile Cycle checklist? Go through the checklist and get your baseline Fertile Cycle score and use it on a monthly basis to see if what you're doing is working, to see if your score improves. Keep this in mind. Your score will improve and it'll also decrease sometimes. Don't worry about that. If your score decreases one month. Look at your lifestyle environment whether you've experienced more stress than usual, make any necessary adjustments and see if it returns to normal. If your cycle score does not improve after two or three months, then you'll need to dig deeper to find out what else is going on.

Speaker 1:

A question I get a lot is this hey, I have a super high fertile cycle score. It's a 9 or a 10. Why am I not pregnant? It's not when I get to a score of 10, I should be pregnant. This is one piece of the puzzle. It's one tool to help you get feedback about your fertility. There are many other variables that determine whether you get pregnant this month or next month. If you achieve a 10 on the fertile cycle score, that is absolutely fantastic. You have to maintain it. I will say that when my patients reach high scores like 8, 9, or 10, number one it doesn't just drop back down to a 5 or 6. It usually stays there. And number two within a few months they do get pregnant.

Speaker 1:

With my protocols, three to six months is usually when we see major changes, whether it's improvement to the cycle or pregnancy. When it comes to hormones and fertility, you can't just snap your fingers and expect something dramatically to be different. If you worked hard to improve your cycle. Kudos. Keep up the good work. Okay, we're nearing the end of the episode. If you still feel like you don't have a good grasp on the four substances and the TCM perspective on the menstrual cycle, do not worry one bit. You're going to hear a lot more of them throughout this podcast and if you follow me on social, we'll talk about them over and over again. I recommend that you use this Fertile Cycle Checklist monthly and be proactive about making changes that'll have a positive impact on your fertility. Use it like a feedback tool. I'm wrapping up here. If you found this episode helpful, please subscribe and share it with someone who might benefit. Until next time, beautiful friend, take care of yourself and your amazing body. You're one fertile cycle away from getting pregnant.