by Beth Heller, M.S.

Recurrent Pregnancy Loss (RPL) is one of the most frustrating fertility challenges a woman can experience.   One loss is devastating enough but the cycle of  expectation and disappointment that accompanies RPL can create feelings of despair.  But from both a medical and a holistic perspective, though, couples who experience RPL have plenty of reason to be hopeful.

“In practice we will initiate a work-up for RPL after two losses in a row,” says Reproductive Endocrinologist Dr. Christopher Sipe of Fertility Centers of Illinois.   A medical work-up is important since common conditions such as hyper/hypothyroid, PCOS, luteal phase defect , infection and diabetes can cause RPL.  Once there is a better understanding of the causes of miscarriage, steps can be taken to choose a treatment plan that will optimize the chance of a healthy pregnancy.

There are also holistic strategies for addressing potential root causes of miscarriage.

1.   Acupuncture and Traditional Chinese Medicine

From the Traditional Chinese Medicine perspective much of miscarriage prevention occurs in the months leading up to pregnancy. Regular fertility acupuncture treatment prior to conception can help to manage stress, potentially regulate the menstrual cycle and improve the uterine environment  by increasing blood flow – key elements promoting a healthy uterine environment and pregnancy.   In cases of  threatened abortion, several studies show that treatment with TCM herbs has been shown to be beneficial and may relate to an impact on endocrine hormones and abnormal maternal-fetal immune interaction.  While herbs are NOT appropriate during a medicated fertility cycle,  woman who are not using ART may wish to explore acupuncture and herbal therapy.  However, if you choose to consider this route, we recommend that you check with your OB before beginning any herbal regimen and ALWAYS work with a licensed TCM practitioner who specializes in fertility and pregnancy.

2.  Nutritional Support

Studies have linked conditions like hyper/hypothyroid, obesity, PCOS and oxidative stress to early pregnancy loss and each of these conditions has a nutrition connection.  Assuring that a woman’s diet is rich in antioxidant nutrients like Vitamin A, C, E and selenium can reduce oxidative stress.   In some cases, food allergy or intolerance may be causing gastro-intestinal inflammation which in turn may negatively impact the uterine environment or impair the absorption of nutrients that are vital to reproductive function, as in the case of celiac disease.  RPL is also more prevalent in women with  diabetes and PCOS. Working with a nutritionist to learn how to eat an anti-inflammatory diet that is rich in antioxidant nutrients, and supports good blood sugar regulation and  GI function not only supports overall fertility but may address root causes of pregnancy loss.

3.  Stress Reduction

Giving yourself time to grieve, finding community and surrounding yourself with positive people can make a huge difference for a woman who has experienced RPL and is “trying again.”  Researchers hypothesize a link between stress and poor pregnancy outcomes , so techniques like support groups, yoga and meditation not only help you feel better but may help you stay pregnant.

If you would like more information about holistic support for miscarriage or would like to meet with a Pulling Down the Moon Patient Advocate to discuss your particular experience, please call us at 312-321-0004 (Chicago-Area) or 301-610-7755 (DC Metro) or email us at info@pullingdownthemoon.com.

By Breea Johnson, MS RD

It’s the end of the holiday season and most people are already looking towards next year saying to themselves “This will be the year that I _______.” Whatever it is that this next year will be about, cleansing on an emotional, physical and nutritional level is a great way to clear your head and start working towards achieving your goal. Because being in your best health in your best body with your best mind opens you up to achieving anything you set out to accomplish.

Over the past year I have gotten many requests for us to do our ART Recovery/Prep cleanse as a group cleanse as many women like the peer and emotional support that group meetings provide. So, for the New Year, yoga teacher Jenilyn Gilbert and I are working together to offer a joint nutrition and Kundalini yoga cleanse for 4 weeks starting in January 2011. The nutritional cleanse will be a slightly modified version of our ART Recovery/Prep Cleanse which is sure to move your diet to a more clean and green fertility-friendly place. Every week we will split our time between an interactive nutrition lecture and a yoga class that focuses on cleansing a specific area of our body.

What you need to know:

Start the New Year with a special yoga and nutrition combo cleanse! This cleanse will combine nutrition guidelines and Kundalini yoga to focus on restoring digestion, supporting liver detoxification and cleansing both physically and emotionally. Peer support will help you find greater success and even enjoy the process of cleaning up body, mind and spirit!

This class is not for women currently on a medicated fertility cycle or who are pregnant. No prior yoga experience required. The class fee of $200 includes four combined nutrition and yoga sessions, teas and snacks. Any related nutrition supplements are extra.

Co-taught by senior PDtM yoga instructor Jenilyn Gilbert and nutritionist Breea Johnson at the Chicago River North location this is the right class to help you meet your goals for health and wellbeing in 2011!

To sign up or if you have any questions, call Pulling Down the Moon at (312) 321-0004 or visit our web registration page.

Beth Heller M.S.

A  recent study examined the prevalence of eating disorders in women preparing for their first IUI at a private fertility clinic and found that an astounding 21% met the criteria for a past or present eating disorder.    The researchers who conducted this study recommend that the infertility screening process include an eating disorder assessment as part of the overall intake.

When I read this study I was thrilled that the medical community is moving toward an active assessment of not only what a woman is eating, but also the psychological factors that play in to many women’s relationship with food, exercise and body image.   At the Moon we see a lot of women who do not have a full-fledged eating disorder but who work quite hard to maintain a fashionably thin figure.  It’s not uncommon for a normal weight/svelte woman to struggle to remain five pounds below her ideal body weight.  It’s so common that we even have a name for it:  the “final five syndrome” (or FFS) and I’ve long wondered about the role FFS may play in a woman’s ability to conceive.

From a nutrition standpoint, the concept of  Energy Balance is critical for fertility.  When Energy In (the food we eat) is greater than Energy Out (our metabolism + activity) we gain weight, which can be a problem for fertility.  Excess fat tissue can disrupt estrogen metabolism and too many calories-in can impair blood sugar regulation, with the result that overweight and obese women have a harder time getting/staying pregnant than women at a healthy body weight. On the flip side, when Energy In is less than Energy Out, women also struggle to conceive.  The body has a very precise, evolutionarily defined priority for the way it uses its calories (energy).  First “served” are the functions that are absolutely essential for life – nerve transmission, cellular metabolism, respiration/circulation.  Once these processes are secured, energy is diverted to less-critical but still essential body functions including locomotion, immune function and growth.  Last served are non-essential functions like reproduction, which can essentially be “turned off” during lean times without harming the individual.   Reproductive function doesn’t necessarily shut off all at once, either.  Cycles can lengthen,  the luteal phase can shorten and menstruation can become scant prior to complete loss of periods.  Clearly, none of these conditions is optimal for conception.

When Energy In = Energy Out there is balance, healthy body weight and healthy appetite.  Yet for many women energy balance can be a difficult, and at times scary, place to find.  Our society promotes a version of athletic thin-ness that is nearly impossible to emulate.  This unattainable image means that women who are naturally svelte are still spending hours at the gym, counting calories and worrying that they will become fat if they release this state of constant vigilance.  While not a full-fledged eating disorder, it wouldn’t be surprising, at least from the holistic perspective of Pulling Down the Moon, if reproductive function suffered in women struggling for the perfect figure.

So how do we address the FFS at the Moon?  Well, one of the amazing things we’ve found over the years is that techniques that work with the body, mind and spirit – like yoga, acupuncture and psychotherapy – can be very effective in healing the FFS.  As women begin to “fill up” their body with life energy, it becomes harder to deplete and deny themselves.  The fear of “letting themselves go” transmutes into a desire to simply “let themselves be.”  Exercise doesn’t go away – it simply becomes less grueling and more fun.  Including more nourishing foods and fats in the diet leaves women feeling more satisfied and stronger.  Interestingly, for most women these changes take place without any change in actual physical weight.

If you are interested in learning more about the ways the good nutrition, stress reduction and other holistic techniques can support fertility, visit www.pullingdownthemoon.com.

Tami’s got a smoking hot blog on PDtM’s Fertility Authority blog today – check it out!

In addition to the tantric tips Tami provides, the simple act of relaxing and being present can make a huge difference in your sex life.   If you’re stressed and find it hard to be “in the moment” you may want to enroll yourself  (and maybe even your partner, too) in our four-week long iRest (r) for Fertility class at PDtM in Chicago.  This deeply restorative class can help you release negative patterns of stress and sooth your over-tired and over-emotional mind.

We feel so much better when we are able to love.  Reserarch shows that people in community tend to live longer and enjoy better health than those who live in isolation.  Yet fertility challenges can be deeply isolating. This simple meditation can open and energize the heart center, rekindling our ability to give and receive love:

Bring your awareness to the heart center and notice any sensation there.  Perhaps there’s a sense of constriction, or alternatively, a feeling of warmth and expansion.  Observe without judging.

The meditation continues in three phases:

May I dwell in the awakened heart.
As you repeat these words silently to yourself, feel your heart center waking up.  Visualize a wheel of the brightest green glowing in your chest.  Sit with this phrase for several minutes, breathing into the heart, feeling it wake and glow with a fertile, radiant green light.

May I attend to what clouds the heart.
As you repeat this phrase, you may want to silently chant it on the exhale and “see” the clouds of your pain, disappointment, loss and anger dissolving in the radiant green glow of the heart.  Sit with this phrase for several minutes, until you feel that the heart is unobstructed and bright.

May my awakened heart be extended to all beings.
As you now silently repeat this phrase, feel the radiant light of your heart extending out beyond your body, wrapping the world in a huge loving hug.  Rest for a few minutes and allow a free give and take – offering the world this love and receiving love in return.

To end the meditation, join your hands in front of your heart in a gesture of reverence and gently bow to your own loving heart.

Beth Heller, M.S.

Has your fertility journey caused you to ask your mother questions about her experience trying to conceive?  Many women at Pulling Down the Moon report that their challenges have prompted their mothers to reveal  previously untold stories of struggles to conceive, miscarriages and losses.  Others learned for the first time that their mothers had irregular cycles or experienced strong menstrual cramps.

Unfortunately, modern society has lost touch with the value of this transmission of “woman-wisdom.”  I am not advocating a return back to “the red tent,” but I do lament that the menstrual cycle has arguably been demoted in our world.   As a holistic fertility practitioner, I am trained to view the menstrual cycle as a fountain of valuable information about the physical and even emotional health of a woman.  The shedding of menstrual blood is an important detoxification process.  The downward flow of energy that governs the menses (called apana in yoga physiology) can be strengthened with yoga poses and other lifestyle practices.  This same energy channel also allows us to excrete bodily wastes and let go of negative thoughts and emotions.  From a yoga perspective, when apana is blocked or impeded overall health (and fertility and emotional well-being in particular) suffer.

The very idea that there are now birth control pills that advocate limiting menses to four times a year makes my teeth itch.

Medical research is now revealing that some fertility challenges may be hereditary.  Many women are not aware that Polycystic Ovarian Syndrome (PCOS) has a hereditary component.   Sisters and daughters of women diagnosed with PCOS have a 50% chance of developing this syndrome.  If a young woman knows that her mother experienced irregular cycles or had difficulty getting pregnant, she may be more aware and proactive about her own reproductive health.  An early diagnosis of PCOS can help a young woman enormously.  Some of the external manifestations of PCOS – acne, hirsutism, weight gain – can be mistakenly attributed to normal adolescent changes.   However, these  symptoms are not necessarily an “inevitable” part of growing up and if PCOS is present they may be treated with diet, lifestyle and pharmaceutical methods.

So, while  mom may not be able to diagnose our PCOS or other fertility issues, her menstrual history, her experiences of trying to conceive, and other reproductive wisdom can prompt us to be more aware of our own bodies.  Opening a line of communication early on with young women to discuss their cycles – even the gritty details of flow, cramps, PMS and cycle length – should be an important pulbic health issue.

by Ellen MacGran

Each of us has great inner wealth – an abundance of wisdom, joy and peace.  How can we become more present to this in our daily lives?

After years of exploring meditation practices in search of greater access to this inner treasure, I found Beth Heller’s weekly iRest class at my gym.  The practice brought a deep sense of peace and relaxation from the very beginning.  iRest is short for Integrative Restoration and is based on the ancient practice of yoga nidra.

As I experienced the benefits of the practice, my commitment deepened and I decided to make iRest a bigger part of my life.  I enrolled in the certification process led by Richard Miller, the developer of the protocol and Beth’s teacher.  Richard, a clinical psychologist and spiritual teacher, has demonstrated the benefits of iRest in numerous clinical studies, showing its effectiveness in addressing various conditions such as PTSD, anxiety and sleep disorders. Participants using the iRest protocol have reported many benefits including decreased insomnia, reduced depression and anxiety, improved interpersonal relationships and a greater sense of ease in daily life.

In the two-hour workshop at Pulling Down the Moon, you will receive a brief history and overview of the iRest protocol, and a 60-minute iRest practice session giving participants a real sense of the practice’s power.  Bringing this practice to your community, which is already committed to holistic health and well-being, is an honor and a privilege.

Here’s what to expect from an iRest practice:

• The practice is done lying down in a comfortable position on a yoga mat, with blankets and bolsters to support your body
• The teacher will guide you through an exploration of your physical body, breath and thought patterns
• The process is deeply relaxing and restorative – and you may even fall asleep!
• Perfect for folks who think they can’t meditate
• The practice is a wonderful way for partners to share a program of relaxation together
• iRest has been shown to reduce the severity of Post-Traumatic Stress Disorder in military vets.  Experiences like miscarriage, child loss and even failed cycles can create lasting emotional scars and iRest can help manage and release these negative experiences.

Learn more about iRest research here.

iRest and Fertility

Click to register for the free iRest workshop at Pulling Down the Moon workshop on September 26 1-3 p.m.

I look forward to the workshop on Saturday, September 26.

Namaste,
Ellen

Last Friday I was riding home from work with our wise-beyond-her-years Chicago admin/receptionist Jenny when our conversation turned to coping with loss.  This had not been an easy winter for Jenny, who had lost most of her earthly belongings in an apartment fire that left her homeless in February.  During the catastrophic event and the aftermath, Jenny remained steady and positive, giving support and compassion to our patients while maintaining an impressively professional demeanor in her work.  Everyone at the Moon was inspired.

Since I had been noodling a blog about loss around in my head, I thought it would be useful to ask Jenny about the fire and the strategies she used for recovery.  I thought it would provide a foil for the losses I could write about from personal experience (miscarriages and a stillbirth) and for the kinds of losses we encounter at the Moon.  These are largely emotional losses – hopes and dreams of pregnancy, failed cycles, miscarriages and stillbirth.  At times these losses are coupled with the loss of resources, in cases where couples have paid out of pocket for unsuccessful treatments, but they are largely emotional.   Jenny’s loss was concrete – literally valuable possessions as well as priceless mementos that were completely destroyed by a bolt from the blue.

“I kept telling myself that there is a bigger picture,” she said.  ”It was the old saying that ‘things happen for a reason’ that gave me strength.  I really focused on staying positive and looking for the good that might come.”

If you smell a cliche here, keep reading.  Jenny’s next words were profound.

“I think it’s human nature to contract when we experience loss.  We contract around the pain, we avoid situations that remind us of our loss and we try to avoid the emotions – sadness, anger and envy- that come when our life seems to be in shambles compared to those around us.  More than anything I tried to remain open.  To emotions, to help from others and even to situations that could be painful.”

As Jenny shared her experiences of loss and healing, I was instantly struck by their similarity to my own journey. When my first full term pregnancy ended in a stillbirth of a little girl at 38 weeks, I received one strong message from the universe:  STAY OPEN.   Take every condolence call, accept every offer of comfort from friends, eat every casserole that was delivered and, above all, cry every tear that I needed to cry.  For a very introverted and private person (at least before the creation of Pulling Down the Moon) this was indeed a radical strategy.  My entire being wanted to crawl in a hole and avoid contact with others and with my pain.

In Jenny’s case, this call to open was an intuition.  In my own case, I believe the message came through my yoga practice.  The simple practice of stretching that has been part of my life for so many years kept calling to me to use the same techniques that keep my body healthy to heal my mind.  If you’ve ever been a beginning yogi, you know it can be an uncomfortable business at first to stretch tight muscles.  Yet, with practice, the discomfort eventually releases and gives way to spaciousness and calm.  This holds true for emotional challenges, too.  When we choose to stay open and experience our loss we can actually release pain and suffering.  When we “close” around these painful emotions we may not ever let them go.  In fact, we will often consciously or unconsciously go to great lengths to avoid the aspects of life that trigger past trauma and in doing so greatly circumscribe the scope of our experience.

There seems to be an energetic rule in play here, and the similarity of Jenny’s and my experience drove this home.  In the face of loss, rather than constrict, we must look for ways to open.  Begin with a simple physical practice of stretching and breathing.  Find support where you can tell your story and cry tears with people who understand.  Eat the casserole.  Like George Costanza from Seinfeld, do the opposite of what feels comfortable and stretch instead of hunker.

These are not easy words of advice.  Yet, there is a promise of courage and self-discovery in them.  And if you need help getting there our classes, teachers and gifted practitioners are here to help.  Have you experienced loss?  What worked for you?

A couple years ago, Tami and I spent a wonderful week studying yoga nidra with an amazing teacher and yogi, Richard Miller.  At the retreat we spent a lot of time exploring the nature of our mind.  Richard shared this hilarious piece by Zen writer Kim Boykin, Meditation Hints from the Colorado Division of Wildlife.  Whether you’re a seasoned practitioner or mind/body beginner, this is worth a read.

Do any of the following statements apply to you?  If so, you may want to read further to learn why joining a fertility yoga class would be a good first step for you on the fertility journey. 

1. I feel completely out of control of my fertility journey.
2. All my friends are pregnant or have children so I feel very isolated from my peers.
3. I experience mood swings as a result of the hormonal medications I am taking.
4. I’m having trouble sleeping.
5. I am struggling to find a way to be healthy and active while trying to conceive.
6. I’ve been diagnosed with endometriosis or PCOS.

If you answered “yes” to any of the questions above,  joining a fertility yoga class is a great way for you to enter the world of holistic fertility treatments.   Read the reasons why below:

1.  I feel completely out of control of my fertility journey.

Studies show that stress is the number one reason that women drop out of insurance-paid medical fertility treatment.  In our yoga classes we use non-religious philosophical teachings from yoga to re-frame the fertility journey, focusing on tools to release stress and doubt, and emphasizing your innate ability to heal.  Studies have also shown that women who use a yoga-like coping mechanism of “letting go” of control have higher rates of IVF success. 

2.  All my friends are pregnant or have children so I feel very isolated from my peers.

There is something magical that happens when women come together and share their experiences.  We call this magic our “sacred sauce,” but it’s no secret.  Research consistenly shows that being part of a community improves both mental and physical health outcomes, and specifically, research has shown that women who participate in mind/body support groups have better IVF success outcomes.* Yoga has also been shown to reduce anxiety.

3.  I experience mood swings as a result of the hormonal medications I am taking.

Yoga can combat the side-effects of hormonal medication in a number of ways.  First, many women complain of bloating, discomfort and weight gain as a result of fertility meds.  The gentle stretching of a yoga routine encourages the movement of fluids out of bodily tissues into lymph vessels for excretion.  Also, yoga has been shown to increase levels of “feel good” neurochemicals that can combat stress and depression. 

4.  I’m having trouble sleeping.

Sleeplessness has many causes, including lack of physical exercise, caffeine/alcohol intake and stress.  During the day we can control our “monkey-mind” by distracting ourselves with work and activity.  At night, when the lights go out, our mind is free to play the “fertility-nightmare-theater.”  What-if’s, regrets and nightmare scenarios loom spring to life when we close our eyes.  Insufficient sleep can also raise cortisol (stress hormone) levels and has been associated with infertility.  Yoga’s gentle movement, breathing and mindfulness techniques stimulate our body’s “rest, digest and nest” (parasympathetic) hormonal response.

5.  I’m struggling to find a way to be healthy and active while trying to conceive.

When you’re trying to conceive, strenuous exercise is not recommended.  This means that many women who control their stress with high impact, high intensity exercise are left feeling stuck.  Yoga, because it involves a blend of movement, strength and balance can provide a vigorous workout that is low impact but has a high impact on fitness.  Unlike other forms of exercise which primarily promote blood flow to the large skeletal muscles, yoga promotes blood flow to the internal organs of digestion, reproduction and elimination. 

6.  I’ve been diagnosed with endometriosis or PCOS.

Both endometriosis and PCOS are associated with inflammation, a condition that can be harmful to our body tissues, our immune system, and potentially our oocytes.  Stress exacerbates inflammation and new research suggests that women who practice yoga regularly may be more resistant to the physiological impacts of stress.   Women with PCOS have also been shown to have higher levels of sympathetic tone (the hormones associated with the “fight or flight” stress response). 

Fertility yoga is also easy on the pocket book.  If you join a fertility yoga class at Pulling Down the Moon you will learn techniques that will serve you well over the course of your fertility journey and beyond.  If the class is too expensive or not geographically possible, you can always check out a book or video and begin practice on your own. 

As always, if you have any questions regarding fertility yoga, please post your comments here.  Experts are standing by!  Be present, be positive…become a fertility yogini!   

*Domar et al.  Presented at the American Society for Repro Medicine conference