It is important to educate the public on this condition because it is so prevalent world wide. It is generally acknowledged that an estimated 10% of all women during their reproductive years are affected by endometriosis. This is a condition where tissue similar to the lining of the uterus is found elsewhere in the body, which can lead to extreme pain and reproductive complications.

The following is an excerpt from my upcoming book on fertility enhancement:

The most common signs and symptoms of endometriosis include:

• Painful periods
• Intense cramping may start 1-2 days prior to menstruation and can be so severe that it causes vomiting, diarrhea and fainting.
• Pain at the end of or just AFTER menses
• Irregular cycles
• Annovulatory cycles
• Premenstrual spotting
• Painful intercourse

Risk factors:

• History of sexual abuse
• High levels of stress
• High serum levels of prolactin, cortisol and/or the presence of autoantibodies
• Prior use of intra-uterine devices (IUDs)
• Close female relative with endometriosis
• Infertility
• Basal Body Temperature graph abnormalities
• The temperature does not drop significantly at the beginning of the period, or it may drop but then rises during the menstrual bleeding.
• At ovulation time the temperature takes several days to rise, or it rises but then falls again in a few days

What does Oriental Medicine have to offer for Endometriosis?

The most common symptom of endometriosis is pelvic pain. The pain often correlates to the menstrual cycle, but a woman with endometriosis may also experience pain that doesn’t correlate to her cycle – this is what makes this disease/condition so unpredictable and frustrating. For many women, the pain of endometriosis is so severe and debilitating that it impacts their lives in significant ways.

Endometriosis can also cause scar tissue and adhesions to develop that can distort a woman’s internal anatomy. It is estimated that 30-40% of women with endometriosis may not be able to have children.

The most common symptoms of endometriosis include fatigue, infertility, painful sexual intercourse, intense pain before and during the menstrual cycle, painful urination and bowel movements during menstrual cycle, diarrhea, constipation, nausea, allergies, chemical sensitivities and frequent yeast infections.

In general, women can achieve healthier breasts (less pain and lower cancer rates) by limiting several environmental pollutants:

• PAHS (Polycyclic Aromatic Hydrocarbons)
  Present in:cigarette smoke, air pollution, auto exhaust, diesel fuel, smoked and grilled foods.
• PBCs ((Polycholorinated biphenyls)
  Banned in the US in 1979, we are still exposed to this through accumulation in rivers and industrial areas, fish and HUMAN BREAST MILK!
• BPA (Bishenol A)
  Present in plastic and epoxy resins, plastic wrap, plastic bags, storage containers, canned foods.
• Dioxin
  Produced through chemical processes involving chlorine such as pulp and paper manufacturing, dioxin has now contaminated many food sources such as milk, fish and meat.

So, what can you do? Not eat, breath or sleep (mattresses commonly contain pollutants as well)?

This is a sound, but not practical solution. You can avoid canned foods, know where your food is coming from, adjust some habits and be proactive. For example, use glass containers to store food, avoid canned foods, always bring a reusable bag to the grocery store. When at the grocery store be mindful of where your food came from. Is it organic? Was it imported from Mexico or other places where there are fewer laws and regulations regarding the use of chemicals in agriculture? Is it local, or did it come here from from across the country on a diesel truck? Get involved, support environmental groups.

Keep your liver healthy!. Your liver is responsible for breaking down and excreting toxins. There are specific breast support formulas available to support breast health, endocrine balance (which these chemicals disrupt) and provide antioxidants.

GET HELP!

Acupuncture & Oriental Medicine has a long history of successfully treating breast pain! From cyclical breast pain to cancer related breast issues, you can feel better!

When working with menstrual cycle induced breast pain or cysts I combine dietary therapy with acupuncture (no, the needles do not go in the breasts) and herbal prescriptions. Often, when women get up off the treatment table, their pain is alleviated. Liver support is essential for these individuals, along with herbs that promotes circulation through the breasts and discourage the formation of fibrous tissue. Many women with this problem also find their menstrual cycles also improve. Common side effects of treatment are: a reduction or eradication of PMS, regular menstrual cycles, more energy, better sleep and an increase in well being and quality of life.

Here are just a couple of studies showing the benefits of acupuncture on breast health and cancer recovery:

Acupuncture in breast diseases. How, when and why?

Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes.

Afraid of needles?

How many times have you tried to refer a friend for Oriental medicine treatment and they cut you off with, “Oh no, I’m terrified of needles!” You try to explain to them that acupuncture needles are like hairs but it doesn’t matter. Maybe they have had a bad experience with shots as a kid. Maybe they had a negative experience with acupuncture as we are not all created alike!

If they are concerned about their breast health, suggest lymphatic massage! They can receive this treatment from Sarah, then receive a nutritional/herbal/lifestyle consultation with me!

Lymphatic massage for breast health

“Lymphatic massage is a gentle and therapeutic form of soft tissue mobilization that enhances lymph formation and promotes drainage within the superficial and deep systems of the vascular network.  My use of lymphatic massage is to specifically enhance the immune system, treat post-surgical edema and medically uncomplicated lymphedema, general detoxification, and to work gently with cancer patients at risk for lyphedema.  Especially for clients with a history of breast cancer or lymph node removal, lymphatic massage is an excellent way to promote lymph decongestion and support detoxification of the tissues.”–Sarah

If you or someone you know is experiencing breast health issues or wants to do all they can to prevent problems, make an appointment so we can talk about specific strategies and breast support formulas.Online Appointment Booking

My first clinical class was with Sharon. It was my first day, and she scared the hell out of me. This tiny 5’3″ woman who was twice my age and 1/2 my weight was terrifying. Her directness, no “B.S.” attitude and inability to tolerate anything less than perfection from her students was legendary. Over the years, I attended the first gynecology-only class she offered at Five Branches, took one-on-one clinic supervision hours with her and chose her as my acupuncturist. Years later, in my Doctoral Program, she taught a wonderful fertility module that deeply influenced the way I treat infertility.

I can still hear Sharon’s favorite sayings, “Tong ze bu tong, bu tong, ze tong” which roughly translates to “Pain there is no flow, no pain, there is flow.” and “Spleen 6, three birds, one needle! Spleen 6 (Sanyinjiao) is called “three yin crossing” in Chinese. This acupuncture point is used to treat many health conditions but is ESPECIALLY useful in gynecology as the three yin meridians that innervate the reproductive organs cross here.

Dr. Feng, in the clinic. "Feng" means wind in Chinese. I can not conceive of a better name for Sharon. She moved like the wind, treating four people on her one-hour lunch break.

I am greatly indebted to Dr. Sharon Feng. It is with sadness and great appreciation that I write of her. And now, over a year after her passing, her patients continue to come through my door seeking treatment. They present with a wide variety of issues: painful/irregular periods, infertility, menopause, past due date/breech, cyclic acne and PMS….but they all have a deep reverence for Sharon in common.

Sharon was a Medical Doctor in China and a strict Traditional Chinese Medicine (TCM) practitioner.  I wrap TCM, Classical Chinese medicine, Japanese acupuncture and other holistic approaches into my treatment of gynecological disorders, so my practice differs from Sharon’s style. However, Dr. Sharon Feng was my first OB/GYN teacher. She shaped my perspective on treating Women’s Health and I will forever be grateful to her.

This is an excellent example of the type of inquiries I get weekly. The following excerpt of our communication is posted with her permission and request to remain anonymous. Her email is in italics and my response is bolded.

Hello, I am searching for a practitioner with knowledge, patience, and a history of success in treating women with PCOS.

I am hoping you would answer a few questions for me to help me decide if I should come to your office for treatment…A little bit about me:I am 34 next month. I was diagnosed with PCOS about 6 months ago after having trouble trying to conceive. I started acupuncture treatment in July to help regulate my cycles (before by diagnosis of PCOS). I went for weekly appointments from July through Mid October. Although at times it seemed to help, my cycles were still not regulated. I think I might not have given acupuncture a fair chance. For one, I did not know enough about my condition to explain my needs to the practitioner. Now that I have been charting my CM and BBT, I can bring these charts to a practitioner for a better understanding of my needs. Although the acupuncturists I saw at Five Branches were very knowledgeable, the environment seemed much too rushed. I am afraid I did not get the focused attention I was looking for.

Can you answer these few questions for me?How many women have you treated with PCOS?What were your results treating PCOS?How do you believe diet effects PCOS?Have you treated women who were taking Clomid? Did any become pregnant after treatment?Have you used women’s charts to aid in treatment?Have you read the Infertility Cure by Dr. Randine Lewis Ph.D? (this book was what convinced me to try acupuncture again, now that I am more aware of my cycle through FAM charting).

Thank you so much for taking the time to answer these questions,Sincerely looking forward to reading your response.

My Response:

First of all, I’d like to say I appreciate the time you are putting out in terms of these thoughtful questions in an effort to find the best practitioner for you. I will try to answer them to the best of my ability. I have treated several with a PCOS diagnosis, and many more who I believe had PCOS but went undiagnosed.

What were your results treating PCOS? This is a difficult condition, NOT impossible to treat, but it takes diligence on the part of the patient. To answer this question, two patient histories come to mind:

1. I treated one patient several years ago for three months with acupuncture, herbs and dietary suggestions. In this time her cycles regulated, she lost weight and reached her health goal which was to have regular periods.

2. I treated one patient about 3 years ago who came at the urging of her girlfriend. She had a lot of psychological challenges around weight and her eating habits and would not entertain the idea of dietary/lifestyle changes. She also did not want to take herbs. I saw her twice a month for 2 months and then we both decided that this was not the ideal path for her at the time.

How do you believe diet effects PCOS? This is a very interesting and complicated question. In short, I think it is pivotal. I have done a lot of work with insulin resistance and believe it plays a huge role in this disease.

Have you treated women who were taking Clomid? Many.

Have you used women’s charts to aid in treatment? Yes, they are a less expensive way to follow hormonal shifts than salivary hormone panels, though sometimes these are helpful too.

Have you read the Infertility Cure by Dr. Randine Lewis Ph.D? (this book was what convinced me to try acupuncture again, now that I am more aware of my cycle through FAM charting). Funny that you ask me that. I think this is a great laywoman’s guide to fertility. You may also enjoy Fertile Soul Cycle Companion Journal by the same author. I just ordered two copies of this book for the library at the Fertility Physicians of Northern California.

So, I’d like to give you a little background on me, my practice and how I work with Women’s Health. I attained my doctorate in Acupuncture and Oriental Medicine (DAOM) with a dual specialization in Women’s Health and Pain Management. I am continuing on to do research with the Fertility Physicians of Northern California for my PhD in Integrated Chinese and Western Medicine. I am also the only certified specialist in Oriental Reproductive Medicine in Santa Cruz county. The majority of my patients are women and it brings me great joy to help them shift their health and achieve their goals. During your initial visit we will go over your medical history in detail, go over the herbs/drugs/supplements you may be taking and your typical diet. I’ll do an assessment using Chinese and Japanese methods of diagnosis and and acupuncture treatment. The session will conclude with a treatment plan detailing appropriate modalities for treatment such as acupuncture, specific herbal formulas, dietary suggestions and other self care measures.

Hope I answered your questions and gave you the information you are looking for. Take care and good luck to you!

Nothing makes me happier than following up with a patient who became pregnant under my care. For example, yesterday Isaw a patient who I haven’t seen since her first trimester. Now she is in her 36th week. She wrote of her experience during her first trimester:

I am research scientist, and I have always been a little skeptical about acupuncture and other non-western medical practices.  After my experience with Dr. Rozenn, however, I enthusiastically recommend her for the treatment of fertility issues. My husband and I were trying to conceive for the second time and after a year, we saw an M.D. specialist in infertility.  He explained that Western medicine had no easy answer for my particular issue (my cycles were  short and he suspected I was ovulating before my eggs were mature), and recommended that I try meditation or yoga as a first strategy.  He also mentioned that there was a program available that combined standard infertility treatment with acupuncture.  After talking to a friend of mine (who recommended Dr. Rozenn), I decided to try acupuncture alone for three months and then reassess my options. Dr. Rozenn was willing to work with me either with or without parallel treatment from my M.D. and was positive but realistic about my chances of conceiving.  I appreciated that she did not discount the role of Western medicine in infertility treatment, but I opted for a non-parallel approach.  I decided to follow all of her recommendations to the letter so that I would have no doubts at the end of three months that I had given the process my all.  I changed my diet, took herbal and other supplements, saw Dr. Rozenn on a weekly basis and opted for abdominal massages from Brianna Brownfield (Dr. Rozenn’s assistant, whom I also enthusiastically recommend).  I noticed changes in my cycle within one month of starting my treatments, and within two cycles my standard headache (a hallmark for 12 years), did not accompany my period.  During my third cycle since start of treatment, I ovulated on day 14 for the first time in 7 years, and I am now thrilled to say that I am 11 weeks pregnant.  I am entirely convinced that it was the treatment program that I pursued with Dr. Rozenn that enabled my husband and I to conceive this baby. If you are in a similar situation, I encourage you to consider Dr. Rozenn and acupuncture as a treatment option.  I am so grateful that I was able to conceive without risking multiple births or spending enormous sums on IVF.  This experience has convinced me to consider acupuncture among the practices I typically pursue to maintain my general health. Thank you, Dr. Rozenn and Brianna!

Now, in her 36th week, she is beginning a cycle of 4 “Pre-Birth” acupuncture treatments. This is a specific protocol routinely practiced in Germany. The practice was incorporated by midwives in Germany because of research showing that these four treatments can:

• Promote an easier delivery
• Reduce the duration of labor
• Reduce the pain of labor

When my fertility patients get pregnant, it is so exciting! But that is only part of the journey. Depending on their circumstances they may come in during their first trimester for morning sickness or to help hold the pregnancy. Later on, they may receive treatment for back or stomach pain. Then, at the end of the third trimester they begin the Pre-Birth acupuncture series. Occasionally patients will seek to promote the onset of labor or strengthen/regulate contractions.

I have had several patients bring their children in for treatment for colds, colic, pre/post immunization care, etc. It is such a joy to be a family doctor.

* How a person’s constitution plants the seeds that can give rise to symptoms and ill health

* The importance of strengthening the constitution first to facilitate deeper healing and the true resolution of symptoms

* Factors that slow or interfere with the body’s ability to heal, thus turning an acute problem into a chronic one such as: hormonal factors, poor digestion, structural issues, toxicity from drugs or environmental influences, stress and nervous system/adrenal gland imbalances

* The specific relationship between structural issues and gynecological problems

Would it surprise you to know that high heels may contribute to painful periods and infertility? Or that the chronic shoulder pain you suffer from may be caused by constriction in your lower back and pelvis? Or that your headaches and sinus congestion can affect your pituitary (the master glad that controls all of your hormones)?

The best part is that there are specific treatment strategies to address all of these issues!

Given that my clinical doctorate is in Women’s Health and Pain Management and I’m pursuing a PhD in Integrated Chinese and Western Medicine, this powerful seminar on holistic gynecology was based in line with my training and philosophy of healing AND expanded my knowledge base.

I feel so excited to share this information and experience with my patients!

I am so excited to be attending the seminar, ”Gynecology, Fertility and Promoting an Easy Labor” in Costa Rica. It will be taught by one of my esteemed Japanese Acupuncture teachers, David Euler. Topics will include:

• Menopause Support
• Infertility Causes and Solutions
• Endometriosis, Ovarian Cysts
• Irregular Cycles, PMS
• Healthy Pregnancy and Delivery

The timing couldn’t be better, given that this month is National Women’s Health Month. While I am away, Jessica Parker, LAC, MTCM will be seeing patients on Thursdays, Fridays and Saturdays. I will be back in the office on Saturday, August 21st and look forward to sharing my experiences with you!

Infertility and Miscarriage

 It is imperative to keep in mind that ultimate goal. The holistic Chinese medical view of fertility includes not only a confirmed pregnancy, but a healthy pregnancy, smooth delivery and parents with the energy and stamina to take care of a newborn baby. All of these steps can be influenced before conception by bolstering the health of the mother and father to be, thus setting the stage for a healthy sperm and egg to unite, a plush environment for implantation and the foundation for a strong pregnancy.

I told Becky that I understood how she felt; that undergoing a surgical technique to accomplish what her body should naturally do on its own did not feel right to her. I also suggested she go through with the D&C. While strong manipulation of specific acupuncture points can cause miscarriage, it is not commonly done because of the risk of incomplete miscarriage which can result in infection or hemorrhage.

While I did encourage her to pursue the Western route first and afterwards to use acupuncture and herbal formulas to nourish her depleted qi and blood, regulate her hormones and prepare her for another pregnancy.

Becky and I worked together for several months until she felt secure in her health and ready to try again. She conceived her first month of trying and is now happily in her second trimester.

Case study—Becky

Below is an excerpt from my book, Practical Fertility.

Thyroid Questions and Answers

So far we’ve talked about the pituitary, ovaries, fallopian tubes, cervix and of course the UTERUS in regards to fertility, but what about that unsung hero, the thyroid? The thyroid gland sits in the front of your throat. It controls your whole body’s metabolism—the metabolic activity of EVERY CELL! Because of this, thyroid disease affects every organ in the body, including your reproductive organs.

Like the ovaries, the thyroid is controlled by the pituitary and hypothalamus. When levels of thyroid hormone in the body drop, the pituitary sends a message to the thyroid via thyroid stimulating hormone (TSH) to make more thyroid hormone, thyroxine (T4).. Like all of the hormonal pathways in the body this is complicated!!! The plot thickens as T4 has to be converted into a more active hormone, triiodothyronine (T3) to affect your cells and actually get anything accomplished. This conversion of T4 to T3 happens all over the body but especially in the liver. So, having optimal liver function is imperative when talking about thyroid health.

The endocrine system is one big balancing act so it stands to reason that if it is possible to have too little of a hormone it is also possible to have too much. You can have too much estrogen, too much FSH, not enough progesterone, etc. Thyroid hormones are no exception. Having too little thyroid hormone causes hypothyroidism, while having too much results in hyperthyroidism. Both hypothyroidism and hyperthyroidism can cause unpleasant symptoms and abnormal basal body temperature graphs that can tip you off to the fact that something is not quite right. However, both of these conditions can also be totally asymptomatic which is why fertility specialists often include thyroid tests in an initial fertility workup.

Hypothyroid

• Weight gain
• Tendency to be cold
• High cholesterol
• Hair loss
• Depression
• Dry skin
• Memory and Concentration difficulties
• Constipation
• Menstrual irregularities such as: unpredictable cycles, heavy bleeding and a history of miscarriage or stillbirths. 
• Basal body temperature readings will be low; you may not even register on the chart. You may not show the peaks and valleys showing of normal hormonal functioning and ovulation.

Hyperthyroid

• Weight loss
• Anxiety
• Insomnia
• Restlessness
• Shaking
• Thirst
• Exopthalmos (an eye condition resulting in bulging and irritation)
• Shortness of breath
• Basal body temperatures will be chronically elevated. Temperature shifts showing ovulation may also be absent.

While hypothyroidism and hyperthyroidism are opposite sides of the spectrum, both of these conditions may present with fatigue and muscle pain or weakness.

Impact on fertility

Now for the part you have been waiting for. Yes, this is all very interesting information, but how is taking care of your thyroid going to help you GET PREGNANT!?

Both hyper and hypothyroidism can result in anovulation. Of course if you are not ovulating, you won’t be getting pregnant. Plus, if you do get pregnant and have one of these conditions the baby could suffer, becoming either hypothyroid or hyperthyroid itself. Hypothyroidism in early pregnancy can negatively affect the developing baby’s brain and nervous system development. On the other hand, hyperthyroidism can cause toxicity to the baby, or if the mother’s thyroid condition is caused by an autoimmune problem the mother could be hyperthyroid while the baby is hypothyroid!

What should you do?

First adopt lifestyle and dietary habits that support health thyroid function. As we discussed earlier, pesticides have components that alter endocrine function as do certain, chemicals and even some drugs such as aspirin can disrupt iodine levels in the body. Fertility enhancing diets help regulate endocrine function thus also help thyroid function avoid chemical pollutants in cleaning products, don’t buy a new car, don’t go to the public swimming pool every day (chlorine), don’t use bleach, avoid plastic water bottles or cooking in plastic containers, and avoid foods with oleic acid (margarine is a common source of these). Eat a balanced diet and take your prenatal vitamins. The body needs certain nutrients such as iodine, vitamin E, A zinc, copper and selenium to manufacture and utilize thyroid hormone properly. Supplementing your diet with sea vegetables such as kelp and hijiki with provide you with good quality iodine.

            In addition you want to avoid foods that can keep the thyroid from using iodine (goiterogenic) such as uncooked turnips, cabbage, mustard greens, broccoli, pine nuts, peanuts, millet and soy. These foods are not BAD for you, but uncooked they can contribute to an underactive thyroid. So, keep eating these foods just cook them first (the Chinese believe cooked foods are better for you anyways) and individuals with confirmed low thyroid hormone should avoid daily soy intake.

            So, if you have hyperthyroidism you should eat lots of margarine, right? Not exactly. In general you should avoid iodine rich foods such as dairy and flour products as these can contain high amounts of iodine.

Because thyroid disease can easily go undiagnosed and can have serious effects on fertility and a developing baby, if you suspect that you have a thyroid problem, either because of your BBT or you have more than 3 symptoms of thyroid disturbance contact your primary healthcare provider and request a thyroid test. An initial screening test is an inexpensive simple blood test that measures the amount of TSH. Depending on your symptoms your physician may also order tests that directly measure levels of thyroid hormones and thyroid antibodies. There is an art and science to interpreting these tests, as sometimes tests will be borderline rather than obviously conclusive. The diet and lifestyle changes previously discussed several Western herbs as well as acupuncture and Chinese herbal formulas, nutritional supplements and thyroid hormone may be used to normalize your thyroid and improve fertility. A well versed holistic physician well versed in fertility should be able to guide you in choosing the best treatment for you.