All posts tagged pregnancy

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Recently, several of my readers have been asking me about women’s health issues — things like fertility, pregnancy, PCOS, balancing their hormones, etc.  It’s a big issue.  Women don’t have a lot of truthful information about their health.  Western medicine doesn’t understand how heavily hormones play into everything that happens with our health.

Why Track Fertility Signs?

It reminded me that I have never posted on tracking your fertility signs, which is a huge way for women to know what’s up with their bodies.  Believe me — this is not just for women who want to get pregnant.  Tracking these signs is a way to tell if your body is on track hormonally.  Women can tell (by sharing these signs with a qualified medical professional, who can interpret them in her particular case) whether she’s suffering from:

• PCOS
• Anovulatory cycles
• Insulin resistance
• Adrenal dysfunction
• Thyroid dysfunction
• Other issues of hormonal balance

This can provide a clue as to why you can’t lose weight, if you’re at risk for diabetes or metabolic syndrome, if you have a thyroid condition, and of course, help you conceive (if that’s what you’re after).  This is something all women should do!  This is one major reason I’ve got pregnant fairly quickly and easily each time — I carefully tracked all my signs.  Even when we were “struggling” for 6 months to conceive Jacob (I was still breastfeeding frequently around the clock and this naturally suppressed fertility), I could tell by tracking my signs that things just weren’t “right” yet.  This is a really important tool!

The “What”

Let’s take a quick look at which signs you should track, and what they mean:

• BBT — Basal Body Temperature, or your temperature as soon as you wake in the morning, before you even get out of bed.  This is your lowest temperature of the day.  A temperature below 98 is an indication that your metabolism is low and may indicate dysfunction in your adrenal or thyroid glands.  You should see a sustained shift upwards by .2 or .3 degrees mid-cycle, which indicates that ovulation has occurred.  Your BBT will drop again right before or when you begin your period.
• Other Temperatures — Take your temperature also at noon, 3 PM, 6 PM, and bedtime.  A low temperature and fatigue at 3 (which should be your highest of the day) indicates adrenal dysfunction, which can play a role in infertility as well as several other issues.
• Cervical mucus — At the beginning of your cycle (when you start your period), it should rather dry (except the bleeding).  After the first week, it should gradually change to creamy, then stringy, then clear/watery, and mid-cycle, “egg white.”  This means clear, thick, jelly-like and stretchy, like raw egg whites.  It indicates that ovulation is either about to occur, or that your body is attempting to ovulate.  If you see this “EWCM” multiple times in your cycle, especially if it is earlier or later than expected, it may mean your hormones are surging to try to ovulate but are unsuccessful.  (I saw this a lot during the 6 months prior to Jacob’s conception, and I’m seeing it again now.  I haven’t gotten my period back.)
• Cervical Position — Your cervix changes quite a lot in position and texture throughout your cycle.  At the beginning, it is low, hard, and mostly closed.  As you approach mid-cycle, it should rise higher, soften quite a bit, and open.  (It might take you a couple months to get the hang of what ‘hard’ and ‘soft’ feel like, but they are drastically different.)  The “high, soft, open” indicates ovulation is about to occur, or has recently occurred.  After ovulation, it should drop back down, firm, and close.  A cervix that doesn’t follow this pattern may indicate that ovulation isn’t occurring, if you look at it with the other signs.

Other Signs

• Spotting — Spotting may occur around implantation, if you get pregnant.  It can also occur at random times if something’s out of balance with your hormones, usually when progesterone is suppressed (I tend to see it 2 – 5 months PP every few weeks, as a first sign that my body is trying to re-balance).  If you are not ovulating based on the other signs, it’s probably a sign that your body is trying to heal, but could be a sign of another condition (see your doctor).
• Nausea — Many women say that pregnancy causes nausea early on because of spiking progesterone levels.  Progesterone also surges as you approach ovulation and stays higher in the second half of your cycle.  I have found that when my body is attempting to ovulate (but prolactin, in my case, is suppressing it), I feel nauseous and morning-sickness-like for a couple days in the middle of the month.  I believe it is because of progesterone and other hormones surging.
• Sore Breasts — Similar to pregnancy, you may feel breast tenderness when your hormones are surging.  It can be another indication that your body is trying to ovulate.
• “Mittelschmerz” — It means pain with ovulation, and is felt on the lower left or right side.  This can indicate that ovulation has occurred, or is occurring (I have felt this and used it as a guide to conceive).

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The “How”

Tracking BBT

To track your BBT, you’ll need a thermometer that is digital and reads to the hundredth of a degree (97.98, for example).  Each morning (ideally around the same time), take your temperature before rising.  This means before you go to the bathroom, before you take a drink of water, anything.  Record this temperature on a chart.  Ideally, your temperature will be around 98 to 98.6 in the morning, and will shift up .2 or .3 degrees post-ovulation (shift needs to be sustained at least 3 days to ‘prove’ ovulation really happened.  More than 18 days and pregnancy is highly likely).

Take your temperature also at 12 PM, 3 PM, 6 PM, and bed time.  3 PM should be your highest temperature.  A low temperature at this time can indicate adrenal dysfunction.

Cervical Mucus

When you use the bathroom, you can check for this.  Using clean hands, reach slightly into your vagina and touch the secretions there — this is cervical mucus.  Sometimes you will not notice much of anything; other times there will be so much that there will be a decent amount on the toilet paper when you wipe.  Note the texture of what you see — dry, sticky, creamy, watery, or egg white (thick and stretchy like raw egg whites).  It should progress from dry at the beginning of your cycle (after your period) to egg white in the middle (at ovulation) then back again as your period approaches.  It will move back towards dry initially even if you are pregnant, so this is not a sign.  Once you are further into your pregnancy, you will see a lot more creamy and stringy cervical mucus, but by the time you see this, you will have had a positive test.  If you don’t notice egg white or watery CM at all, or you notice it several times (along with a lack of temperature shift), this may mean you are not ovulating.

Cervical Position

This, too, you can check for when you use the bathroom.  Sometimes, it will be hard to reach, or even impossible.  Other times it will be easy.  With clean hands, reach up inside your vagina.  You will feel a small, knobby thing — it is very different from the surrounding soft tissues.  Your cervix will change quite a lot in both texture and position throughout your cycle.  At the beginning (during your period), it will be thin, hard, low (easy to reach) and mostly closed.  You may notice a small opening in it, and it will feel narrow (maybe like a thin marker in diameter).  As you approach the middle of your cycle and ovulation, it will rise up high (may not be able to reach), become thicker and wider, open, and very soft.  This indicates that you are fertile (especially with fertile CM and a temperature shift).

The important of tracking the cervix is that it lets you know when ovulation is coming, while a temperature shift lets you know ovulation has already occurred.  Conception occurs most easily in the 2 – 5 days pre-ovulation and 12 – 24 hours post-ovulation.  (After this the egg decays and cannot be fertilized.  A lot of women are simply missing this window.)

In pregnancy, the cervix shifts up high and becomes very soft, and may feel “open,” but it is blocked by a mucus plug to protect the baby.  (It especially will feel “open” if you have already had a baby.)  This won’t occur until 6 – 8 weeks, however, so cervical position and texture isn’t a reliable early pregnancy sign.

Other Signs

Simply note on a chart if you have any spotting, pain, headaches, nausea, sore breasts, or anything else out of the ordinary — no matter how minor.  It may or may not be related, but it’s good to note.

What Next?

The most important thing is to take your chart to a practitioner who is qualified to read these charts.  They can look at the combination of signs and will be able to tell if your hormones are off, why, and what to do next.  It’s likely that you will be prescribed a fertility diet (including lots of healthy fats).  Other treatments may include herbs, acupuncture, or other treatments that will help balance your body.

Be very wary of anyone who suggests using synthetic hormones to manipulate your body into a pregnancy.  This is not a good long-term solution.

Your practitioner may also recommend follow-up tests, like checking your blood sugar, or doing saliva tests for adrenal function and other hormones.  These can offer even more insight into what your body is doing, hormonally.  If pregnancy’s not your goal, then you may be recommended to use bioidentical hormones for certain conditions.  Ask your doctor.

For a lot of women, estrogen dominance is a big problem.  Removing any extra sources of estrogen from your diet can help. These include:

• Any type of plastic
• Soy
• Pesticides
• Cosmetics
• Pharmaceuticals

This is not an exhaustive list, and a qualified professional can let you know what to avoid (if needed).

Tracking your fertility signs is complicated, but can help you figure out what’s going on with your body, so that you can re-balance as needed, to achieve both general health and pregnancy!

Do you track your fertility signs?  Has it helped you?

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By Aimee Raupp, MS, LAc, Guest Writer

Many of you have requested information about hormonal imbalances, fertility, and other women’s health issues.  I’ve asked Aimee, who practices Chinese medicine and works in women’s health, to share a series of articles with you.  This is the first one — getting pregnant with PCOS.  Aimee has an excellent success rate — 100% so far!  Thanks for sharing, Aimee!

What is PCOS?

Dealing with fertility as much as I do in my Traditional Chinese Medicine (TCM) practice—I see patients with PCOS quite often.  Currently, it is estimated that 10% of women between the ages of 18 and 40 have this condition often characterized by hormonal imbalances, multiple ovarian cysts and an irregular menstrual cycle.  Generally speaking, PCOS women have too many androgens (male hormones) circulating in their body in conjunction with an imbalance of the female hormones estrogen and progesterone.   One thing you need to know if you have been diagnosed with PCOS: PCOS is NOT a disease, it is a hormonal imbalance condition and it is reversible.

Clinically there appears two different types of PCOS—the insulin dependent type and the non-insulin dependent type.  The first is the “classic” PCOS presentation: weight gain, acne, facial hair and hair loss on the scalp.  The PCOS type that is not insulin dependent usually presents as being fairly thin and “wiry” as we would say in TCM terms.  Although this is a generalization of the two types of PCOS, typically this is what I see in my clinic.

Upon ultrasound (one of the diagnostic tests completed to confirm PCOS) not all women will show with ovarian cysts.  To accurately diagnose PCOS a blood test must look at FSH (follicle-stimulating hormone), LH (luteinizing hormone), fasting glucose and insulin as well as testosterone and estrogen levels.  I also recommend these patients have a blood serum thyroid panel taken as this can be a cause of PCOS in some patients.  Typically all PCOS patients (insulin dependent and non-insulin dependent) will  have high testosterone levels and an LH to FSH ratio of 1:1.  The insulin-dependent types will have high fasting glucose levels and the non-insulin dependent types will have a normal glucose level.

Fertility Diet

Okay, so medical specifics out of the way, let’s talk about how best to get pregnant if you have PCOS.

One of the most important things to do is to clean up your diet.  By this I mean, eating foods that are organic and pesticide free.  Pesticides have what are called xeno-estrogens and can cause and or exacerbate any hormonal imbalance in your body.  As well, you must consume organic, grass fed and hormone free animal products.  The conventional (non-organic) farm animal is pumped up with hormones and PCOS women don’t need any more hormones in their bodies.

Eliminating any processed white flour and sugar is also imperative—not just for the insulin dependent types, as white flour and sugar increase circulating testosterone levels in the body and will worsen the PCOS condition.

Lastly, you must remove all soy from your diet.  Soy foods not only are highly processed and toxic but are also estrogenic and will further disrupt any hormonal imbalance.  With some patients, I even go so far as to remove gluten and dairy from their diet as both of these foods are very inflammatory and can exacerbate the PCOS condition.

As well, recent studies have also shown a link between BPA (bisphenol A) exposure and increased incidence of PCOS as BPA has estrogenic properties.  So watch your BPA exposure.

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Additional Fertility Help

In addition to dietary changes and weight loss (if needed), I treat my patients with acupuncture to encourage ovulation.  As long as you ovulate and attempt to conceive the right time—you can get pregnant.  For PCOS women timing is tricky as menstrual cycles can be long and erratic.  Often, I’ll have patients use a basal body temperature chart  to help us “catch” ovulation as the store bought ovulation predictor kits don’t always work for PCOS patients (due to their imbalanced hormone levels).

Scientific studies have shown that acupuncture plus electrical stimulation can help induce ovulation in PCOS patients and I see that as well in my clinic.

Most all my fertility patients, PCOS ones included, get prescribed individual Chinese herbal prescriptions to help regulate their hormone levels and menstrual cycles.  There is no one specific herb I can recommend here as each case is different.  See a NCCAOM certified Chinese herbalist for your case.

Lastly, most all PCOS patients show up with vitamin D deficiency.  So, get in some vitamin d daily—the best is through 10 minutes of unprotected sun exposure daily.  Second best is through taking a daily dose of cod liver oil (high in omega 3 fatty acids, vitamin d and vitamin a).  My favorite brand to recommend is Green Pastures fermented cod liver oil.  Typical dosage is 2 capsules/day of cod liver oil (which gives you about 3,000-5,000 iu’s of vitamin D).

Final Thoughts

To sum up—the best way to ensure pregnancy when suffering from PCOS:

1. Clean up your diet: No sugar, no soy, no white flour.  Eat only organic, grass-fed and hormone free animal products.  Focus on avoiding all environmental hormones.
2. Lose weight if necessary
3. Track your BBT daily to pinpoint ovulation
4. Get acupuncture to help induce ovulation
5. Get in a healthy dose of vitamin D daily

And, most importantly, stay optimistic. I’ve never had a PCOS patient not get pregnant in my clinic.  You WILL get pregnant!

Do you suffer from PCOS?  If you’ve successfully gotten pregnant, what has worked for you?

Aimee Raupp – acupuncturist, herbalist and author of Chill Out & Get Healthy (Penguin) – practices  Traditional Oriental Medicine to help her patients reclaim their health and prevent disease. An active public speaker, Aimee practices in Manhattan and Nyack, NY and is writing a book about fertility. For more information, visit www.AimeeRaupp.com.