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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
