03 8802 1519 [email protected]

Can you have period without ovulating?

ovulation egg and uterus

A normal ovulatory menstruation cycle a woman ovulates every cycle. After ovulation, the level of estrogen drops then raise again in the second part of period. At the same time progesterone raise and keep at a high level. Two weeks later, both hormones retreat and menstruation start. Usually after ovulation you will have period in two weeks unless pregnant.

However, can you have still period without ovulating?

Sometimes although follicles in the ovaries develop periodically, even with menstrual cramps but the follicles do not rupture to release mature eggs, and there is no formation of a corpus luteum in the ovaries. This phenomenon of menstruation without ovulation is called anovulatory menstruation, or anovulatory cycle.

Generally speaking, anovulatory menstruation is caused by hypothalamic hypoplasia, or delayed development, imperfect regulation between the hypothalamus, pituitary gland and ovarian axis, decreased ovarian reserve, hormonal disorders, or long-term emotional stress and fatigue. Those can all can cause abnormal uterine bleeding.

Symptoms of anovulatory menstruation are abnormal bleeding, variable amount, prolonged cycle or repeated irregular vaginal bleeding. Some people’s period seem to have certain time pattern and thinks that they have normal menstruation period. However no evidence of ovulation can be found through ultrasound or basal body temperature.

Typical anovulatory dysfunctional uterine bleeding may have several months of amenorrhea before menstruation, followed by heavy vaginal bleeding, which often changes to vaginal bleeding after a few days. The bleeding can last for a few days or for a couple of weeks. It may even cause anaemia.

The diagnosis of anovulatory menstruation can be judged mainly through clinical examination. It can be checked by observing the thickness of the endometrium and vaginal discharge. According to whether the menstruation has regularity and the symptoms and signs associated with menstrual period cycle, we can generally diagnose whether it is anovulatory menstruation.

To confirm the diagnosis of anovulatory menstruation, the diagnosis can be confirmed by color Doppler ultrasound or blood test for endocrine examination. You can do a ultrasound during ovulation to see if there is follicle development and mature follicle rupture. You can also have blood test to see if estrogen, luteinizing hormone, and progesterone have risen to determine whether it is anovulatory menstruation.

If the cycle length and flows are normal, the menstruation bleeding come and end in time, and it is usually ovulatory menstruation.

如何测量记录基础体温

作者:Dr. Richard Zeng 曾医生(中医师)

什么是基础体温 (BBT)

基础体温 (BBT) 是您在休息时的温度。这是您身体的最低温度。

为什么要测量基础体温 (BBT)

从月经开始到排卵,您的基础体温 (BBT) 一直保持在较低水平。一旦排卵,您的基础体温就会升高并保持高位,直到下一个月经开始。因此,通过测量和记录基础体温 (BBT),我们可以知道: 您在该周期是否有排卵;如果有排卵,什么时候排卵。

如果正确测量和记录基础体温,您的医生也可通过检测基础体温图表来反映的您的生育状况的变化。根据这些细微的变化,我们可以调整您的中药针灸,以取得最佳的治疗方案。

如何测量记录您的基础体温BBT

 基础体温

  • 在测量基础体温之前,您应该保证至少 3 小时的连续睡眠;
  • 您需要准备一个普通的数字温度计;
  • 最好有一个闹钟,并尽量在每天醒来时(而不是起床时)的同一时间进行测量。周末应该也一样;
  • 如果你起得太早或太晚,最好在当天的图表上做个标记;
  • 早上醒来时直接测量体温(在此之前不要做任何事情——比如去洗手间或给你丈夫一个拥抱……);
  • 测量体温的方法有两种:经口腔或经阴道;
  • 口腔:将温度计深入牙龈根部和面部之间。测量时确保嘴巴闭紧;
  • 经阴道:经阴道测量温度会更稳定,温度可能比经口腔略高;
  • 记录后立即记录温度;
  • 在适当的温度下画一个十字,连线制成折线图 – 如果是手动记录在纸质表上时;
  • 如果温度在玻璃温度计上的两个数字之间,请始终取较低的数字;
  • 你可记录其他任何的生活或身体变化比如同房,白带,睡眠,饮食,情绪,或疾病症状,如感冒、发烧,头痛,失眠等等。

目前大多数人选择下载手机应用程序,轻松记录。在这里我们推荐 fertility friend

BBT chart

如有任何问题请联系我们,或现在就拨打电话预约:

03 9378 9479 (Coburg 诊所)

Coburg 诊所地址:21 Bell St, Coburg, VIC 3058 诊所后有免费停车位。

03 8802 1519 (Ringwood 诊所)

Ringwood 诊所地址: 31 Wantirna Rd, Ringwood, VIC 3134 诊所后有免费停车位。

Postpartum Confinement Herbal Care 产后月子中药调理

Chinese herbs

Various physiological or pathological changes occur in the body of women during pregnancy and after labor. No matter it is a natural birth or a cesarean section, it will lead to the loss of Qi (means vital energy) and blood. Weak Qi and blood often means weakened immune function. At the same time, increased blood viscosity and coagulation make it is easy to aggregate into blood stasis. These lead to prolonged recovery or cause other postpartum issues. Hence it is important to prevent postpartum issues. Traditional Chinese medicine has been used to help new mothers to regulate and nourish Qi and blood, promote blood circulation. It can prevent or reduce various postpartum symptoms, quickly restore visceral functions, effectively balance yin and yang of your body.  It is helpful for your body to recover and good milk supply.

妇女产后机体出现各种生理或病理的变化。无论是自然生产或剖腹产都会导致气血流失,气血虚弱出现免疫功能低下,抗病能力弱。同时因为血液粘度增高,凝固性强,易聚集成瘀致恢复时间延长或引起其他相关产后诸病,因此产后病的防治相当重要。传统上中医药被用于帮助产妇调理,以益气养血、活血化淤。从而预防或减少产后各种症状,迅速恢复脏腑机能,有效地协调阴阳、平衡体质,防止皮肤老化,葆有肌肤弹性,恢复完美体形,使奶水充盈,确保新生儿更加健康。

It is a tradition in China for new mothers to take herbal medicine after giving birth. Some mothers with postpartum anaemia and sweating are easy to catch a cold, or have symptoms such as constipation, haemorrhoids,  prolonged bleeding (lochia), wound infection, joints pain,cold sores, lack of milk or poor milk flow, postpartum depression. Some mothers use them to promote the early recovery of the uterus and vagina, prevent uterine prolapse and quickly restore the body.

很多新妈妈产后经常会进行中药调理。有些妈妈产后贫血虚汗易感冒,或有恶露不尽、伤口感染、腰腹或关节疼痛、手足水肿、口舌生疮、乳汁缺少或排乳不畅、情绪低落抑郁、大便秘结或痔疮等症状。有些妈妈则想要促进子宫、阴道早日恢复,预防子宫脱垂和养颜美容,迅速恢复身材等。

There are some prescriptions and over-the-counter medicines on the market, but they must be used with caution. After giving birth there are some changes in the body. This stage will be different from normal and different from the time of pregnancy. As each mother’s physique and needs are different, the use of Chinese medicine should be different too. For example, it is necessary to remove blood stasis if there is congestion after childbirth. If there is no blood stasis, there is no need to do so. Some people will take ginseng to replenish deficiency. However, the mother may experience insomnia, irritability, restlessness and other adverse reactions. These could affect postpartum recovery.

市面上有一些药方和成药,但须谨慎使用。准妈妈分娩后,身体的机能会发生一些改变,这个阶段会不同于平常,与怀孕的时候也不同,每个妈妈体质和需求也不同,使用中药应有所讲究和禁忌。比如,产后有淤血的情况才要化瘀,没有淤血的情况不需要刻意地化瘀;有些会服用人参以补虚,结果产妇出现失眠、烦躁、心神不安等不良反应而影响产后恢复。

Therefore, confinement prescriptions cannot be the same. It is safe and reasonable to see a properly trained Chinese medicine doctor. He/she can make appropriate diagnosis according to your individual physical conditions, then make a personalised management plan.

所以坐月子所用药方不可一成不变,要让正规注册的中医师去根据不同产妇体质,不同时期,身体个人状况综合评估适当调整,然后制定个性化的调理方案才安全合理。

产前 Prenatal

A couple of weeks before labor you can visit our clinic. Have a consultation with our fully trained Chinese medicine doctors. We will gather your full health information based on Chinese medicine diagnosis approaches, such as observation, inquiring listening , inspection and pulse taking. According to your individual conditions, we give the most professional prescriptions and guidances.

产前1~2周左右孕妇可亲自到我们诊所由专家看诊,根据望、闻、问、切等方式,建立个人档案。根据孕妇自身的情况,给予最专业的生产指引和信心。

产后 Postpartum

Confinement after childbirth usually takes one month. According to your conditions, you may be given different herbs, including decoctions, granules or bath herbs.  After entering the fifth week, you can resume a light diet, or reduce the frequency of taking tonics. If take good care of yourselves during the whole confinement period, you may even notice some improvement of your past health issues, such as period pain, irregular period, cold hands and feet.

Should there is a need to withdraw milk, a special herbal formula is available too.

生产后坐月子通常以一个月为准,每周都有不同的中药根据不同的情况给产妇煎服或冲服,洗泡或煲汤料。进入第五周之后,产妇就可以恢复清淡、正常饮食,或者降低进补的频率。产妇在整个月子期间如能好好调养,通常原本有的一些妇女病和原发性经痛、生理期不顺,还有手脚冰冷的情况也会改善许多。
如有退奶需求者,则有专门汤方可供使用。

调理方案 Management Plan

At Almond Wellness Centre telephone or WeChat consultations is available. Afterwards we may prescribe the herbal formula. You may have family members come to our clinics to pick up the herbs.

If you have any questions during the confinement period, you can consult by telephone or WeChat.

杏林中医中心我们会通过辩证的方法,对产妇进行产后电话或微信问诊及看舌苔后开出药方,由家人到诊所领取煎服中草药包或冲泡浓缩药粉以及各种泡洗或煲汤的药包。

月子期间如有各种疑问,可通过电话或微信等咨询方式,足不出门就可以得到医师的专业回复,拥有你的私人中医师。

疗程:4 周

Course: 4 weeksAlmond Wellness Centre Wechat QR code

You can come to the clinic for a face-to-face consultation with a Chinese medicine practitioner before you give birth. After giving birth phone consultation is available.

Chinese medicine package

4 week’s dosage, including raw herbs, and/or concentrated granules, herbs for bath, etc.

产前可来诊所中医师当面作舌脉诊查,产后可电话或微信咨询。中药药包 – 4 周量,包括草药或浓缩粉,外洗泡澡方等。

Natural Ways to Decrease Oestrogen and Increase Progesterone

Author:Dr. Richard Zeng (Chinese medicine)

Natural Ways to Decrease Oestrogen

women's health

Eat cruciferous vegetables

  • broccoli is the star but eating plenty of green vegetables of the cruciferous family help the liver metabolise oestrogen.
  • Other cruciferous vegetables include: Bok-Choy, Brussels sprouts, Cabbage, Cauliflower, Chinese cabbage, Daikon radish, Horseradish, Kale, Radish, Turnip and Watercress.

Eat high fibre foods to help oestrogen bind in the bowel and assist elimination.

  • One source suggests that eating 1/2 cup of raw grated carrots can be enough fibre to assist in elimination

Decrease alcohol consumption

  • Assist the liver by drinking St Mary’s Thistle and Dandelion tea

Avoid soy

Eat a no sugar and no gluten diet

  • sugar and gluten are both highly inflammatory in susceptible people so should be avoided when possible

Be mindful of too many vitamins, supplements, medications and even caffeine that all need to be processed by the liver, where possible space them out through the day.

Chinese herbal medicine

Some Chinese herbal medicine /formula may help assist in balance your hormone. You may contact us for details.

 

Natural Ways to Increase Progesterone

Reduce stress

  • google progesterone steal if you are more interested in how stress affects progesterone levels

Supplements:

  • 750 mg vitamin C per day (increased progesterone 77% and improved fertility)
  • 600 mg vitamin E (increased progesterone in 67% of patients)
  • 6 g L-arginine (increased progesterone in 71% of patients)

Increasing beta carotene in your diet, as found in:

  • Apricots, Asparagus, Broccoli, Carrots, Chinese cabbage, Chives, Dandelion leaves, Grapefruit, Herbs and spices – chilli powder, oregano, paprika, parsley, Kale, Onions, Peas, Peppers, Plums, Pumpkin, Spinach, Squash, Sweet potatoes. So again, get onto those carrots!

Supplementing with

  • Vitex Agnus Castus 1000mg daily
  • Black Cohosh or as we call it in Chinese Medicine ‘Sheng ma’ on days 1 to 12 (increases progesterone and fertility).

Weight loss

Improving insulin sensitivity (for example metformin increases progesterone levels 246%, chromium supplementation can help in regulating blood sugar in combination with a low sugar and low carbohydrate diet)

  • Replacing saturated fat in the diet with unsaturated fat
  • Eating a high protein, low carbohydrate diet
  • Lowering TSH levels in subclinical hypothyroidism

Chinese herbal medicine

Some Chinese herbal medicine /formula may help assist in balance your hormone. Contact us for details.

Nutrients for Female fertility, Pregnancy, Breast feeding and beyond

Iron

This nutrient is important for the correct formation of foetal blood, brain, eyes, bones and an overall healthy growth rate. It is also vital for a healthy immune system, mucous membranes, for general health and fertility. However many women do not realise how important iron is very important in fertility health. Women with low iron stores could suffer anovulation (no ovulation). In a Harvard University study of 18,500 women, women supplementing iron were 40% less likely to suffer from fertility problems.

During pregnancy there is an increased need for iron due to greater red blood cell mass and plasma volume. Iron should be increased in the 2nd and 3rd trimesters as the foetus will draw on the mother’s iron stores to prepare itself for the 4-6 months after birth (because breast milk is low in iron). Deficiency increases the risk of anaemia, pre-term delivery and low birth weight

Women with low iron are suggested to supplement 10-20mcg daily, however if you are prone to constipation a liquid supplement is more gentle on the stomach; we suggest capsules by bio-ceuticals or liquid spatone.

Also note iron will not be absorbed with calcium, so if taking a supplement make sure to separate these. Inorganic iron supplements can bind up in the gut and cause constipation; they also destroy Vitamin E and compete for absorption with zinc; therefore, use of organic iron supplements and chelates are preferable. Vitamin C enhances the absorption of iron.

Natural sources include green leafy vegetables, dried beans, black strap molasses, lean meat (organic/chemical free), dried apricots, almonds, egg yolk, seaweed, wheat germ, parsley, pumpkin, sesame and sunflower seeds.

 

Folic acid (B9) and B vitamins

Essential for RNA & DNA formation, it is the most important pre-conception nutrient. Supplementation at least three months prior to conception is suggested, and the need doubles in the first trimester. This is especially so for women who have been on the Pill, as it depletes Vitamin B9 in the body. Prior to conception, make sure your Vitamin B9 intake is around 10mgs per day. During early pregnancy, 25-50mgs of B9 taken 3 times per day can reduce the risk of morning sickness.

Deficiency can lead to infertility and spina bifida. When increasing B9 please note the vitamin is water soluble means that the body only has a limited capacity to store B vitamins (except B12 and folic acid). A person with a poor diet can end up with a deficiency of B vitamins. Delicate means that cooking and processing can reduce amounts in foods; highly processed foods like white flour, have far less than wholegrain counterparts.

Natural sources include dark green leafy vegetables, i.e., uncooked spinach, kale, beet greens; asparagus, broccoli, corn, lima beans, parsnip, mung beans, soy beans; wheat germ; oranges, pineapple, banana. Most of these foods need to be eaten fresh and raw if possible, as B9 is destroyed by heat.

 

Vitamin D – The sunshine vitamin

I recently saw a new client who works in child care; I asked her if she had any known deficiencies of vitamins. She was not sure so I suggested a blood test with her GP testing all major vitamins including vitamin D, she assured me that her vitamin D would be fine since she spent part of her day outside with the children. Unfortunately she was low in Vitamin D.

Vitamin D has now been strongly linked with temporary infertility. Most of us work and play indoors especially during the colder months. We always advise clients to test their vitamin D levels since 23-49% of Australian’s have a deficiency, and obesity can increase the risk. 10 minutes a day in morning and afternoon sunlight can help correct a slight deficiency however supplements are advised for levels under 50. Supplement 100mcg or 4000iu daily.

 

Omega 3 fatty acids

Omega 3 is needed for the correct hormone balance; including prostaglandins, increases cervical mucus, helps to promote ovulation and increase the blood flow to the reproductive organs. In pregnancy it aids in the development of the foetal brain and nervous systems. Omega 3 fatty acids contain 2 acids that are essential to health; EPA and DHA. Low levels of DHA, has been linked to depression and other mental health issues.

One study where couples where given 1000mg of omega 3 had a 76.5% verses without omega 50.4% fertilisation rate. Considering that only half of all follicles collected commonly fertilise this could greatly improve the number of viable embryos for transfer.

During pregnancy, a lack of DHA may be associated with premature birth, low birth weight, chromosomal defects, spontaneous abortion, hyperactivity and asthma in children. A recommended daily dose of 500-1000mg daily should be supplemented.

Natural Sources include deep sea ocean/cold water fish (ie. salmon, cod, herring, trout), mono-unsaturated cold-pressed oils (flaxseed especially, walnuts, hemp and chia seeds.

 

Vitamin E

Assists with conception, a healthy pregnancy and regulates oestrogen levels, improves circulation and protects against varicose veins and haemorrhoids. Vitamin E also helps in the absorption of essential fatty acids and has antioxidant actions as well. Deficiency can lead to spontaneous abortion or cystic fibrosis (with selenium). In later pregnancy Vitamin E will help facilitate an easy delivery.

Sources include sunflower seeds, almonds, organic cold-pressed wheat germ oil, cold-pressed vegetable, seed and nut oils. Best not heated or cooked, i.e., use in salad dressing.

 

Protein/Amino Acids

Vital for the number and quality of the ovum (eggs) produced the fertilisation process, and the early development of the embryo.

Natural sources include deep sea fish, tofu, legumes ie. lentils, soy beans, kidney beans, eggs (free range), lean organic chemical-free meat and poultry, nuts and seeds, sprouted grains.

 

Calcium

Essential for the development of the baby’s bones, formulation of nerve tissue and muscles; necessary for controlling blood clotting; makes your fertility mucus ‘stretchy’ and therefore aids ability of sperm to swim through it; aids uterine muscle tone. The foetus requires roughly 30g of elemental calcium to be deposited in the skeleton by the time of delivery (200mg during the 3rd trimester).

If inadequate in the mother’s diet, the supply to the foetus will occur at the expense of the maternal skeleton. Therefore, insufficient calcium supplies during pregnancy and lactation may result in maternal bone loss, reduced breast milk calcium secretion, or impaired infant bone development. If the mother’s diet includes a high proportion of processed foods, soft drinks, high red meat intake, sugar, salt, and alcohol; if she smokes, does not exercise, and consumes caffeine and tea, this will reduce the absorption of calcium. Deficiency can lead to nervous tension, fluid retention, and hypertensive disorders and toxaemia in pregnancy.

Sources include broccoli, cauliflower, soy beans, almonds, sesame seeds, tofu, leafy greens, Brazil nuts, sunflower seeds, unhulled tahini, black strap molasses and kelp (other seaweeds). Dairy foods are another source of calcium; however, since they are not as easily absorbed, it is best to vary your sources of calcium as widely as possible. If you are prone to any sort of mucus congestion such as hayfever, sinus, asthma, recurrent colds/flu or other chest infections, it is best to avoid dairy foods as a source of calcium.

Royal jelly

Royal jelly is a natural bee product; it is rich in amino acids, contains high levels of vitamin D and E, calcium and iron. It is a super food for fertility and been used in Chinese culture for many years. Consider this; the queen bee is only feed royal jelly throughout her lifetime which she will need to lay millions of eggs up to 2000 per day.

Royal jelly has been shown to help balance hormones and increase propensity to mimic human oestrogen, which may help those that suffer from low oestrogen levels. Some evidence exists that royal jelly might also;

  • Improve egg and sperm health
  • Increase libido
  • Reduce inflammation
  • Support the immune system
  • Decrease signs of aging
  • Helps women with irregular cycles

PLEASE DO NOT TAKE IF ASTHMATIC OR ALLERGIES TO BEE’S

 

Co Q10

CoQ10 is a mitochondrial enzyme. It does multiple jobs in our cells; 1) anti-oxidant, 2) energy production and 3) gene regulation. CoQ10 is the most basic energy currency of our body. Our body makes a huge amount of its own CoQ10, but this ability decreases as we age beyond 35 years.

CoQ10 can be absorbed through supplements and evidence is slowly being accumulated that it could possibly boost a women’s egg health and IVF success rates. It is strongly suggested women older than 35 years wishing to conceive either through IVF or naturally supplement 100-200mg daily preferably in a gel capsule.

 

PCOS

Clients who have been diagnosed with PCOS can supplement with Chromium and magnesium to help maintain glycaemic control in addition to a low GI diet. Suggested chromium supplementation is between 200-800mcg daily and magnesium between 400-800 mcg daily.

 

FERTILITY FOODS AND OTHER IMPORTANT INFORMATION

Consume fresh foods that are in season. It is also important that most of your food is organic. If you find that getting organic food is difficult for you, wash all of your vegetables and fruit with a solution of 1/3 cup vinegar + 3/4 cup of water, to ensure that all pesticides and chemicals used in the soil are washed off. Limit the amount of dairy and wheat in your diet. A great company to get organic or fresh vegetables delivered to home is farmer’s direct; www.aussiefarmers.com.au

Protein – eat 60g (grams) daily equivalent to 2x100g portion of meat per day

Proteins Amount of protein per amount of food

  • Egg 6g per egg
  • Lean meat, fish, poultry 25-30g per 100g portion
  • Milk 8-9g per 250ml
  • Yoghurt 8-10g per 250ml
  • Cheddar cheese 7g per 25g
  • Nuts and seeds 2-3g per Tablespoon
  • Most fruits 1g per fruit
  • Kidney beans 15g per 200g
  • Tofu 10g per 100grams
  • Lentils 9g per 120g
  • Cooked soy beans 28.62g per cup
  • LSA mix, flaxseed oil, tablespoon pumpkin seeds, evening primrose oil, oily fish, salmon, herring, avocado, etc.
  • eat 4-5 servings daily

 

Fats – eat 40g daily

Vegetables and fruit

Dairy

Reduce dairy intake to 1 serving per day, yogurt is the best source of calcium from cow’s milk. Try coconut yogurt available from health foods stores; great for people sensitive to lactose. Consider using almond milk to replace regular milk. Other calcium sources include broccoli, cauliflower, soy beans, almonds, sesame seeds, tofu, leafy greens, Brazil nuts, sunflower seeds, unhulled tahini, black strap molasses and kelp (other seaweeds).

 

Herbal tea

Many women ask which herbal tea is ok during conception, pregnancy and breastfeeding. During conception women can use raspberry leaf tea and chaste berry to aid in conception. However during early pregnancy (1st trimester) it is recommended that women pick the following teas; Dandelion, ginger, peppermint, fruit teas (orange or lemon peel), Jasmine, lemon balm, rose hips, citrus, spearmint, or fennel.

During the last trimester after 35 weeks women should start raspberry leaf tea in preparation for labour. Raspberry leaf tea can also be drunk after birth to help restore uterine shape and encourage discharge of clots. Remember we can make you are personalised Chinese tea for helping with increasing breast milk and mastitis. Other options include dandelion tea.

 

Caffeine and alcohol

It is best to minimise both caffeine and alcohol consumption but not to cut out all together until pregnant. However caffeine has various different sources; black tea and green tea are much healthier sources than coffee. Minimise alcohol intake to 1-2 glasses per week.

Water

8 glasses of filtered water every day

Sleep

We recommend women achieve 8-9 hours of sleep per night. Ideally between the hours of 10pm and 7am for at least 3-4 days per week. Shift workers need to discuss extra nutritionals such as melatonin that will assist with your acupuncturist.

Suggested supplements for all women;

  • Multivitamin; In Natal by Bio Ceuticals
  • Fish oils; Ultraclean EPA/DHA by Bio Ceuticals

If deficiencies exist;

  • Vitamin D; D3 capsules or D3 forte drops by Bio Ceuticals
  • Iron; liquid iron
  • CoQ10 100mg by Bio Ceuticals
  • Royal jelly 1000mg daily preferably from an Australian source. Fresh royal jelly is available but must be refrigerated.
  • Chromium starting at 200mg daily
  • Magnesium starting at 400mg daily

For women on IVF or older age group;

PCOS;