by Beth Heller, MS RYT

Chicago has had an amazing winter and a very early spring.  This past week has found us meditating on flip-flops…in March!

 While it’s super fun to slip on a pair of summery wedges and paint our toenails pink, open toed shoes and flip-flops aren’t the only reason to pay attention to our piggies.  When it comes to the holistic view of fertility  feet occupy a place of honor.  If you’ve ever had fertility acupuncture you know that many of the points that support the reproductive system are located in the feet and ankles.  Reflexologists assert that the feet literally provide a map of the body and that we can use foot manipulation to impact different physical organs.  Yoga, too, teaches that healthy feet are important for better menstrual function, dispelling toxins and improving immunity.

So what’s so special about our feet?  In yoga, the feet are seen as the foundation of our being that is connected with the earth.  The most basic of yoga poses, mountain pose, challenges us to simply stand and find balance from our feet to the top of our head.  If we close our eyes in mountain pose, we can visualize the outlines of our feet on our yoga mat…literally our footprint in the world.  One of the strangest things for the new yoga practitioner is exercising in bare feet rather than sneakers.   Postures are practiced barefoot to maximize our awareness of our feet.  Yoga postures also stretch and stimulate different points on the feet that are associated with different organ systems in the body.

Symbolically, the challenges of fertility lead us away from our feet into our head as we spin our mental wheels searching for the silver bullet that will blast us past “trying” time into mommy time.  Our feet, particularly when we practice yoga asana, bring us home from our imaginings and projections to the here and now.

On an energetic level, the feet are associated with our first chakra.  Chakras are energy wheels located along our spine and each chakra is associated with both physiological functions and spiritual life-lessons.  On a psycho-spiritual level the first chakra is associated with security, trust and our sense of belonging.  Physically, the first chakra governs our immune system, gut health and lower back.  The feet are also very important for the flow of apana energy, the energy current in our body that moves downward from the pelvis to the soles of the feet, governs the menstrual cycle and the ability for our body to dispel toxins.

So, be kind to your feet.   Try not to cram them into uncomfortable shoes and make sure they  are frequently touched or nurtured.   Here are some tips for fertility-friendly feet:

1.  Shake hands with your feet once a day.  To do this, take your fingers and thread them between your toes (pinky finger between pinky and second toe, ring finger between second and middle toe, etc.).  Once your fingers are threaded, gently squeeze and massage the ball of the foot.   Repeat on the other side.
2. Keep your feet warm.  Cold feet mean decreased circulation.  With summer coming we face “air conditioner freeze syndrome.”  Keep a pair of fuzzy socks in your bag or desk for the days when you feel like you work in a refrigerator!
3. Experiment with reflexology, the science of foot massage.  Either see a professional reflexologist or try out “reflexology socks,” that actually outline the different areas of the foot and their associated organ system.
4. Try yoga.  If you’re a runner or walker, your feet may need a good stretch.  Time spent in yoga class in bare feet can help feet become more flexible and improve circulation to these important fertility “organs.”  Click here to view our upcoming Yoga for Fertility schedule for DC Metro and Chicagoland.

by Beth Heller, MS, RYT

Research published in the journal Obstetrics and Gynecology reports that women who exercised 4 hours or more times per week for 1-9 years were 40% less likely to have a live birth and were almost three times more likely to experience IVF cycle cancellation.  They were also twice as likely to have an implantation failure or pregnancy loss than women who did not report exercise.  This research reinforces previous data showing that strenuous exercise can disrupt reproductive hormone regulation.

A common question that arises at Pulling Down the Moon is whether or not women should give up exercise when trying to conceive (ttc) and/or undergoing A.R.T.  For many, exercise is an important tool for relieving depression, controlling stress and regulating body weight.  Putting the message out there that women who are “ttc” should abstain from exercise could be dangerous – we’re already a highly sedentary society – but data such as the study referenced above suggest that we should look closer at the ways in which exercise can interact with our reproductive system.  An understanding of the mechanisms at work may help us make more intelligent exercise choices.

Another recent study dove into this question by comparing the menstrual cycles of sedentary and exercising women who were matched for age, body weight, BMI and age of menarch.  The results were astounding.  In the sedentary group, only 4% of women had menstrual dysfunction.  In the exercise group only 50% of cycles were ovulatory and 50% were abnormal.  Within the abnormal cycles,  29% demonstrated Luteal Phase Defect (a short luteal phase) and 20% were anovulatry.  In a further study of this same sample of women, the researchers found a correlation with “high-DT “(high drive for thinness) and menstrual dysfunction and found that REE (resting energy expenditure) was decreased in these women, a sign that they were experiencing negative metabolic effects of chronic negative energy balance.

So What Is Energy Balance?

Energy balance is a simple equation that nutritionists and exercise physiologists use to conceptualize the factors at work in weight loss and weight gain.  The energy balance equation is:

When Energy In = Energy Out, body weight is stable

When Energy In > Energy Out, there is weight gain

When Energy In < Energy Out, there is weight loss

Long-term negative energy balance in females is associated with decreases in circulating metabolic hormones (like thyroid hormone) that regulate overall metabolic rate, and with increases in baseline stress hormone levels like cortisol.  Often, shifts in energy balance can occur without weight loss, especially in long-term exercisers.  Call to mind that trim gal at the health club who spends 60 minutes a day on the elliptical trainer but never gets thinner.  While she may view the exercise session as justification for a candy bar, her body perceives it as a major “fight or flight event.”  Although her weight does not change, hormonal and metabolic shifts like the ones described above can still occur as the body slows down non-essential systems (like reproduction) to preserve energy.  Signs that a woman may be in negative energy balance are anovulatory cycles or the absence of menstrual periods.

Should Women Give Up Exercise when Trying to Conceive?

The answer to this question is a resounding “no!”  Exercise has also been shown to relieve depression, control stress and regulate a healthy body weight – all very important elements for conception.  What women do need to consider, however, is how to exercise in a way that is “fertility friendly.”

Intensity:  When we talk about exercise intensity we are talking about how HARD your body works during a particular exercise activity.  Intensity of an exercise determines its energy requirement, or how many calories you burn while exercising.  Thus, excessive intense exercise can create  a negative energy balance.  This may be a good thing when a woman has significant weight to lose but it is not a good thing when she is at a healthy weight.

Impact:  Exercise can be either low- or high-impact.  High impact activity is and exercise in which both feet leave the ground.  Examples of high impact exercise are running, aerobic dance that involves jumping and jumping rope.  Spinning is also high impact, although this form of cycling exercise does not involve jumping, the intense resistance and sprinting used in spin classes can place enormous impact on joints and muscles.

In general, high impact exercise can be detrimental to fertility in one of two ways.  The first is through the production of endorphins.  Endorphins “natural pain killers” produced by the body in response to strenuous exercise.  While these chemicals serve to mask pain signals and allow us to enjoy long-duration, strenuous exercise, they can also disrupt reproductive hormone regulation.  Second, high impact exercise is generally more intense than low impact exercise, causing the excessive energy drain described above.

What’s the Right Exercise Mix for Fertility?

Fertility-Friendly Exercise: Fertility-friendly exercise is moderate-intensity (heart rate at 60-65% of maximum), low-impact and of medium duration (30-45 minutes, 3-4 times per week).

Good Exercise Modalities:  walking, swimming, recreational bike riding, resistance training and hatha yoga

Relaxation Training: Learning to relax through practices like breathing and meditation are an important part of any fitness program.  Taking 20 minutes a day to meditate or just breathe can help to reduce stress and lower circulating stress hormones.  In addition, cross-training and including rest days where the body can rebuild and restore is also very important.

Nourish Up through Diet: In two recent blogs, Nourishing Up for Fertility and Energy Balance for Fertility – A Holistic View we explore the idea of creating a nourishing lifestyle that changes the paradigm of daily life.

For many women, letting go of an intense exercise program can be difficult.  Services like acupuncture, massage and nutrition counseling available at Pulling Down the Moon can be very helpful in making the transition to a more nourishing and fertile lifestyle.  Click here to learn more/book an appointment.

Sources

1.  Morris SN Obstet Gynecol. 2006 Oct;108(4):938-45.

2.  De Souza MJ Hum Reprod. 2010 Feb;25(2):491-503. Epub 2009 Nov 26.

3.  Gibbs JC Int J Sport Nutr Exerc Metab. 2011 Aug;21(4):280-90.

by Beth Heller, M.S.

Nutrition was a big topic at this year’s American Society for Reproductive Medicine conference.  Concepts under discussion included the potential role of inflammation in both male and female fertility and the possible value of antioxidants like resveratrol and omega-3 fatty acids in reversing damage done by environmental toxins.  Another very simple yet compelling idea was presented by Dr. Gil Wilshire from Missouri.  Dr. Wilshire contends that many women, even obese women, are not getting sufficient nutrition for good fertility.  Put simply, the typical low-fat, USDA Food Guide diet that we have all been programmed to eat, is low in essential nutrients like omega-3 fatty acids and fat-soluble vitamins that are essential for our body’s health and reproduction.

Dr. Wilshire was preaching to the choir on this one.  That the poor quality of our modern diet – from the over consumption of fast foods and overly processed meals, to the belief that “low-fat means healthy” – puts all of us at risk for less than optimal nutritional status  is a cornerstone of our fertility nutrition programming at Pulling Down the Moon.  What was especially compelling, though, was Dr. Gil’s use of the concept of “feeding up” in his discussion.  This idea is old as the hills but almost universally accepted in the medical community:  women get pregnant when they are “feeding up” rather than paring down.

The female body is keenly aware of “energy balance,” an evolutionary mechanism that ensures the survival of the human species.  When calories are scarce, bodies begin to shut down non-essential body functions…like reproduction.  Food, however, is much more than calories.  It is also the way our body gets essential nutrients like vitamins, minerals and fats needed for healthy body function.  If a woman is consuming a diet rich in calories but poor in nutrients, she can become malnourished.  Hence an obese woman who lives on processed foods can have plenty of calories but still be “starving.”  And the slender woman who has been told by her fertility doctor to gain some weight in order to conceive may benefit more from shifting to a highly nutritious diet and lowering the intensity of her activity than from simply packing on pounds.

Rather than “feeding up,” we like to say that women get pregnant when they are “nourishing up.”  Importantly, the process of nourishing up can take place without the gain or loss of a single pound.  It begins with a very healthy diet and  good digestion so that essential nutrients are not only present, they are being absorbed and assimilated.  Calorie counting is secondary to this objective, even for the obese woman who needs to lose weight.  In general we believe that certain nutritional supplements  (including a high-quality prenatal vitamin, a probiotic to support digestion and omega-3 fats) can help support the objective of “nourishing up” but the focus should be a diet rich in fruits, vegetables, lean protein, minimally processed grains and healthy fats.

We also know that nourishment can come in many ways – including the nourishment of true relaxation that comes with yoga practice, nourishment through channeling chi throughout the body during an acupuncture session or the healing touch of massage and reiki.  Changing the intensity and intention of our exercise program from “burning and racing” to “energizing and strengthening” can also make a difference.

At a high-tech conference like ASRM it was encouraging to see nutrition on the table, so to speak.  It was clear, however, that nutrition will never get the attention of research dollars.  Many more people attended the class on Pre-Implantation Genetic Diagnosis (PGD) than the class about nutrition.  Doing nutrition research is complicated and funding is scarce because unlike drug research, where there’s potential to patent and produce a pharmaceutical drug that will make billions of dollars, a healthy diet can’t be patented and won’t make anyone rich.  Conflicts of interest are everywhere.   Governmental agencies that are charged with making nutritional recommendations are also charged with protecting the economic interests of food manufacturers.   Our national nutrition association, the American Dietetic Association, is partnering with companies like Coca Cola to get women to drink more Diet Coke in order to prevent heart disease.  Yikes!

So what are we to do?  In the face of misinformation we must begin to live the truth and spread the word.  Have you made changes to your diet that fly in the face of the Dietary Guidelines for America?  Have you switched to full fat dairy and sworn off fat-free yogurt?  Have you switched to a more nourishing lifestyle through yoga, acupuncture or other practice?  If you have, please share your stories and we will feature them in our blog and on via social media.  Send your storied to beth@pullingdownthemoon.com subject line:  Nourishing Up.  You can include your name or let me know that you’d like to remain anonymous.

Anna Pyne, LAc, MSOM, FABORM

Inflammation is a common disorder which can be a contributing factor or sole cause of infertility.  Traditional Chinese Medicine (TCM) has many treatment options that may be used exclusively or in conjunction with Western medical therapy.  Inflammation of the pelvic organs can occur in diseases such as pelvic inflammatory disease (PID), endometriosis, and salpingitis (inflammation of the fallopian tubes).  I have successfully treated many patients with these conditions that are in the middle of or are about to go through a medicated fertility treatment cycle, as well as those trying to conceive naturally.

According to TCM there can be a number of different causes for inflammation to occur in the body and each can manifest in very individual ways.  Not only will PID, endometriosis, and salpingitis be identified and treated separately, but each one on its own has a number of different potential causes.  I will be able to assess the specific cause of the disorder by observing the tongue, feeling both wrist pulses, and reviewing the intake form with the patient.  By gathering all this information together I am able to then discern the TCM pattern and treatment plan going forward.  If you have any questions about TCM’s treatment options in regards to inflammation hindering fertility, please feel free to email us or if would like to make an appointment please call the office.

by Pam Policastro, L. Ac.

Eastern medicine views the individual as a whole being with body, mind, and spirit interconnected and supported by an underlying energy system.  Good health depends on a balanced circulation of Qi, or vital life energy, throughout the body.  Keeping this concept in mind, I will now discuss the TCM(Traditional Chinese Medicine) view on physical exercise.

First of all, there’s the sweat.  In Chinese medicine one of the functions of the Heart is to control body fluids.  Sweat is considered the “fluid” of the Heart, if you sweat a lot you are actually unbalancing the Qi, or energy, of your Heart.  In the case of perspiring too much and losing too much fluid, you are creating a deficiency of the Heart, which can prevent this organ system from functioning well.  What does this mean in terms of fertility?  The Heart and Kidney energies control the process necessary for female fertility.  The Heart “governs” the blood and is an integral part of the production of blood, therefore contributing to nourishment of the endometrium and embryo.

Then there’s the issue of the tendons and ligaments.  These areas of your body are dependent upon sufficient blood from the Liver to nourish them.  Strenuous and excessive exercise, such as intense aerobic and running workouts, is hard on the joints(tendons and ligaments).  When you overwork your joints, the Liver must send more blood to help restore them, and on a continual basis this depletes the Liver’s energy.  The Liver is a very important organ in terms of women’s fertile health.  This is because blood is stored in the Liver, especially when the body is at rest.  Some of this blood must be passed onto the uterus before preparation for pregnancy or menstruation can occur.  If the Liver Blood is deficient, then menstruation may be scanty, infrequent, or missing…compromising fertility.

Chinese medicine sees intense physical exercise as spending precious internal energy that is very difficult to replace, and not creating true health.  It is also detrimental to fertility. Wouldn’t  it make sense then, to pursue a form of “exercise” that actually increases life-enhancing energy instead of using it up?  Meditation, Qigong, Taiji, and Yoga have been shown to create positive changes in the areas of the brain linked with emotion as well as increase immune function and blood flow as well as decrease blood pressure.  PS…these more holistic forms of exercise support healthy fertility.

by Anna Pyne LAc FABORM

One aspect of medical theory in Traditional Chinese Medicine (TCM) includes the system of the five elements; wood, fire, earth, metal, and water. They can be used to differentiate TCM physiology, pathology, and treatment plan.  Each element corresponds to a specific emotion and an individual TCM organ.  The Earth element is affiliated with the worry or rumination emotion.  When our minds are busy over-thinking it hinders us from being grounded and impairs harmony between the mind-body connection.  The earth element is also associated with the spleen (not the same as Western medical spleen), which has to do in part with the digestive system.  A person with a poor digestive system usually cannot think clearly, hence the importance of a well functioning spleen.   When the spleen is working properly it means the earth element is being sufficiently nourished so that the mind can remain grounded.   This enables us to reduce stress, keep life in perspective when it gets tough, and can help maintain optimal physical health.

At Pulling Down the Moon we have numerous treatment modalities to ensure that the earth element comes into and stays in balance.  The therapies offered are acupuncture, herbal therapy, yoga, meditation, diaphragmatic breathing exercises, reiki, massage, and nutrition all of which can be used either individually or in combination.  If you have any questions regarding the earth element according to TCM, feel free to contact me via email (anna@pullingdownthemoon.com) or make an appointment for acupuncture/herbal therapy by calling the office.

by Beth Heller, M.S., RYT

On April 26 we are offering a free Laughter Yoga class at Pulling Down the Moon in honor of National Infertility Awareness Week .  I can imagine that some people might be offended by the idea.  Infertility is no laughing matter.

On some level that’s true – but on another it couldn’t be farther from the truth.  I can remember sitting out on the steps in front of my RE’s office after a bad ultrasound the day before Mother’s Day early on in my fertility journey.  I ran into my friend Heather at the office – she was starting her second IVF cycle – and she sat with me as I cried.

“On the bright side, Beth,” she said.  ”We can go out together on Mother’s Day and drink martinis and eat raw fish!”   The need to avoid sushi was something that had concerned both of us about being pregnant back in the days when we thought pregnancy would be easy to achieve.  Now raw fish was our consolation prize.  I don’t know why but that struck us both as enormously funny at the time and we laughed until we could barely breathe.  Sad as I was that my cycle had failed, I felt worlds better after that laugh.

The ability to laugh is one of our most profound self-healing skills.  Little kids laugh simply because it feels good and it makes them happy.  As adults we lose this spontaneity and, in turn, lose connection to the well-spring of physical, emotional and even spiritual benefits of laughter.  ”Mirthful laughter” has been shown to help reduce chronic pain, improve immune response, alleviate depression and improve cardio-vascular health.  To thicken the plot, it seems that laughter may improve IVF outcomes.  Researchers in Israel followed 229 women and found that a 15 minute visit from a trained “medical clown” immediately after embryo transfer increased the  pregnancy rate to 36%, compared with 20% for women whose embryo transfer was comedy free.

So how might laughter help fertility?   Perhaps by stimulating the relaxation response.   When people are stressed they tend to take shallow breaths. Extending the exhale (which is exactly what laughter is –  HA HA HA HA – gasp for breath – HA HA HA HA) has a profound effect on blood chemistry.  Breathing patterns that emphasize the exhale increase blood CO2 levels.  This change in blood chemistry relaxes blood vessels and promotes blood flow to the brain as well as the release of oxygen from the hemoglobin into the tissues.   In addition, laughter stimulates beta-endoprhins, our feel-good chemicals.  Interestingly, these are similar benefits to those believed to result from acupuncture treatment that is also associated with improved success of IVF cycles.

From the yogic perspective, laughter plays an equally important role.  Inside each of us, yoga teaches, is a core of joy.  This core is clouded by negative thought patterns and what we have allowed to become the daily grind of our existence.  If we can connect to that spark of  joy, yoga teaches, it can begin to transform – even “burn away” – the negativity that has grown up around it.  Laughter sparks that joy.  It begins a profound process of coming back to our own innate radiance.

So, come and join us for Laughter Yoga on Tuesday April 26 from 7 to 8 p.m.  The class is free.  This class will combine breathing and spontaneous laughter that will create an amazing shift in the chemistry of your body and brain.  We provide a silly, safe and nurturing environment for you to explore this wonderful practice and leave smiling.

Click here to register!

http://clients.mindbodyonline.com/ws.asp?studioid=3556&stype=-8&sTG=23&sVT=169&sView=day&sLoc=0

We hope you will take the time to read this wonderful article by Jenny Rough from Bethesda Magazine.   In the article Jenny shares her personal journey, interviews Reproductive Endocrinologists and speaks to women who used techniques like yoga, nutrition and Traditional Chinese Medicine to support their fertility journey.

We’re also excited to share that Jenny will be offering a FREE writing workshop at Pulling Down the Moon in Rockville on Saturday March 26 from 1 to 4 p.m.  Read more about this event here.