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PCOS and acupuncture

6/17/2015

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As many of my patients undoubtedly know, polycystic ovarian syndrome (PCOS) is defined as irregular or even absent ovulation resulting in long stretches of time between menstrual cycles. Traditional Chinese medicine (TCM) sees PCOS in a few different ways, depending on how it presents in your body.  Western medicine tends to treat all PCOS patients in the same way, where TCM looks at each patient’s pattern of symptoms before making a diagnosis.  Often, women with irregular ovulation are given a diagnosis of PCOS, even if they are not insulin resistant. Below are the three most common types of PCOS patient that I treat.

The first type of PCOS is the most commonly seen, and it is caused by insulin resistance.  This patient typically presents as overweight, and she may or may not have acne on her jawline and neck.  She may also have excess hair on her face, and lower abdomen. This type of PCOS is called “damp stagnation”.  In basic terms, the excess weight is seen as “dampness”, and the unreleased follicles as “stagnation”.  It responds best to weight loss (to get rid of the “dampness”), exercise (to move the stagnation), and the supplement inositol, to help reduceinsulin resistance.  Important dietary changes to get rid of dampness include giving up dairy products, wheat, refined sugar and alcohol, which are all dampening foods.  Metformin can also be helpful in certain cases.

A second type of patient I see with a PCOS diagnosis has what is called “Qi and Blood stagnation” in TCM.  In this case, the patient is often very fit, has quite a bit of acne around the mouth, and on and under the chin and neck.  She may also have some hair under her chin.  She is stressed and easily frustrated, and uses frequent exercise as stress relief.  She is not insulin resistant, so Metformin doesn’t work for her.  Chinese herbs to move Qi and Blood stagnation work well to promote ovulation in this case.  Electroacupuncture is also very effective right before ovulation to encourage an egg to release.  

A final type of PCOS patient has a diagnosis of “Heart Qi stagnation”.  This doesn’t involve the Western heart organ, rather the Chinese concept of the Heart, a group of functions which when combined are called “Heart” (with a capital H).  One of the functions of the Heart is to open and close the cervix, ie: ovulation.  When the Heart energy is damaged by trauma, anxiety or chronic sleep disorders, it has a hard time regulating ovulation.  Acupuncture is quite effective in helping calm the Heart, and thus promoting ovulation.  This patient may have had a traumatic event in her life, have a very stressful job (one patient was a 911 operator), or a job which upsets her sleep patterns, such as a night shift worker. This patient may or may not be overweight, and may or may not have unruptured follicles in her ovary, but her cycle is irregular, and she has received a PCOS diagnosis.  Unless she is insulin resistant, Metformin will not help in this case.

Acupuncture regulates the hypothalamic/pituitary/ovarian axis, which regulates menstrual cycles.  Each of these patients is quite different, but acupuncture and Chinese herbs will still regulate her cycle.  



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My educated, above average patients

11/12/2014

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The fertility predictor company, First Response™  funded an unrestricted educational study through Yale School of Medicine. Its results were published in January (2014). Researchers surveyed 1,000 women ages 18-40 in the U.S. about reproductive health. Responses were covered widely in the media for a few weeks noting how little information women have about their own reproductive systems and how infrequently women discuss these issues with their healthcare providers.  Much hand wringing and head shaking followed about women and their apparent lack of information.
See more about the study here: http://www.prnewswire.com/news-releases/242205101.html

Reading these results, my thoughts were that the sample of women surveyed really do not reflect the knowledge and experience of the patients I see. It is probably true that many women don't know exactly how to get pregnant... until they start trying. But that's where the sample population and the women I serve in my practice diverge. 98% of my patients know about the misconceptions found in the study.
  They know when their ovulation occurs. 
  They know that sex right before ovulation is the recommended best practice for fertilization.
  The number of eggs their ovaries carry weighs heavily on their minds.
  They are aware that folic acid (I recommend L-5-methyfolate instead) is recommended to prevent birth defects. 
  They have already changed their lifestyles, diet, and dropped any potentially unhealthy habits that may inhibit fertility and healthy pregnancy. 

I think this study reflects attitudes and misperceptions about reproductive health that are too broad to truly lend meaning. I believe the articles that followed leaned heavily on shame (see HuffPo's take or Forbes or Google to find many other articles.
None of this is helpful to women who are trying to get pregnant. So, if you felt a little uncertain upon hearing the news that most women don't know what's what, don't sweat it. You are not most women.

Feel free to share this blog and my website with your friends. I love to help people have babies.

Yours in good health,
Rachel Blunk, L.Ac.

Rachel Blunk is a fellow of the American Board of Oriental Reproductive Medicine who has specialized in fertility since 2002. Her practice is located in Fort Collins, Colorado. See more at www.BabyByBlunk.com. 
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Guest blog post from a patient

8/22/2014

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This is perhaps the most important story I will ever tell. I say this because my two children are my most precious assets and this story is about how I brought them into this world. 

A highly respected doctor specializing in infertility treatments had convinced me that I would never conceive naturally. He said I had Polycystic Ovarian Syndrome (PCOS) a condition in which the ovaries grow many small cysts in a  classic ring-like structure, that lead to hormonal imbalances (mainly the overproduction of the male hormone, testosterone), and to fertility problems. The doctor said that my case was so extreme, the only way I could have children was through In-Vitro Fertilization (IVF.) I was in my late 20’s, in good health , from a stable home and married to an extremely caring man who also desperately wanted to be a father. We were ready to be parents and we knew we would do everything to have a baby. IVF, however, was just not an option - it was unaffordable and more importantly, it made me feel “barren.”  


I respected the doctor who tried to help us get pregnant over two years. I had gone through one and a half years of taking clomid - the first line of infertility treatment that helps the eggs mature and release on time - and failed.  I had switched doctors and gone to a university teaching hospital to try another method. This time I used a fail-proof injectable medication that  supposedly made the process more efficient - and failed. The last resort before IVF was In-Utero-Insemination (IUI) - a carefully controlled experiment in which the sperm is injected into the ovaries right before ovulation to increase the chances of fertilization. We failed even this one. By the end of two years, my uterine lining was so thin - a known side-effect of clomid - that I couldn’t have conceived naturally. I was very close to giving up. My days were so dark, I had the worst nightmares.I just couldn't bear the thought of not carrying the child of the man I so dearly loved. I couldn’t accept that I was infertile.


I had heard of Ayurveda, the ancient healing science originating in India, and about its effectiveness in overcoming infertility. As a last resort I decided to give it a try. Before I could go to India, however, I thought I’d inquire about Ayurvedic practitioners in my local community. Nobody had heard about Ayurveda but a friend, Kerri Diamant who headed AlterMed Research Foundation, an organization that  studied alternative medicine,  recommended Traditional Chinese Medicine (TCM) and acupuncture. For the first time, I heard about Rachel Blunk who practiced fertility acupuncture. I was extremely skeptical about needles inserted into various parts of my body helping me conceive a child. It just didn’t seem plausible. But I didn’t have a choice. It was either go to India, or give acupuncture an honest shot. The needles were definitely more cost-effective!


In my first meeting with Dr. Blunk, she asked me to call her Rachel. She sat down beside me and made sure I felt comfortable in her small but well appointed treatment room. She didn’t wear a doctor’s coat and had the most genial smile on her face. She looked at me with genuine interest and looked like someone who wanted to help. I felt like pouring out my sorrows. And I did without a pause. I shared with her the horror of how I tried to get pregnant using conventional methods - the drugs, the countless ultrasounds, the injections, the negative pregnancy tests, and anger, humiliation, helplessness and desperation. I told her about my PCOS and that I was made to feel “inferior” because of it.


After about 30 minutes, she took a deep breath and asked me to stick my tongue out. I thought it odd but did it nevertheless. She looked at my tongue for what felt like an eternity. Then she checked my pulse. In the end she said the most unexpected. In her professional opinion, I did not have PCOS at all, definitely not one that could result in infertility. She pointed out for example, that I didn’t have excessive facial hair or obesity - classic symptoms of the testosterone imbalance in patients with PCOS. I wondered why that hadn’t been brought to my attention before. She felt that all I needed was some relaxation. My “Chinese heart” was weak and need stabilization. She then told me that not only could I get pregnant naturally, it would happen within six months. All I had to do was come to a weekly session of acupuncture and take some Chinese herbs to help me relax. All that by looking at my tongue??!!


I just couldn't believe my ears, Did she really know what she was doing or was she just playing “doc doc.?” A part of me really wanted to believe her but the bigger part was extremely unsure.Of course the perennial self-doubt consumed me. I hadn’t questioned on Dr. Expert before? Was I making the same mistake again? How much did I really know about acupuncture? Would the needles hurt? Would the herbal medicines have any side-effects? Ultimately would this really help me mother a child? Was I asking for the moon here?


After discussing the situation with my husband, I decided to give Rachel the benefit of doubt.  I had nothing to lose after all and a lot to gain. The herbs were not expensive and Rachel had promised that the needles wouldn't hurt. She was also absolutely sure that I would have a baby within six months. The carrot she dangled was irresistible and that's how I began my weekly tryst with acupuncture.


The sessions always started with Rachel asking me how I felt. She was always personable and professional. She made me feel at ease. All sessions began with her checking my pulse and peering into my outstretched tongue. Then I had to lie down on a comfortable table, much like a massage table and she would insert the needles into strategic treatment points on my body - around the rim of my ears, my forehead, chest, wrists and ankles. Some around my navel too. The needles didn’t hurt at all - they were extremely fine and felt like small pin pricks. I had my eyes closed and in many a session even drifted off to sleep. After an hour, Rachel would come back and inquire about me. The needles came off and she gave me the herbs I was to take home that week. The herbs were in pill form and easy to take and had absolutely no side-effects. I started enjoying my weekly meetings with Rachel and felt much better. I was finally off the hook with ultrasounds and all-important doctors telling me how to treat my sex life. I was almost back to feeling like my old self again. Till I was six weeks into my acupuncture treatment.


At the end of the  sixth session, Rachel asked me to take a pregnancy test and report to her the following week. I thought Rachel must have been out of her mind to even consider that I may be expecting. It had only been six weeks!


I took the test the next week just to tell Rachel that I wasn't with child. I was so sure the test would be negative, I didn't even bother to look at it. I was pottering around the house and came back a few minutes later to discard the test. Lo and behold! There it was -  the second line that had eluded me for so long, I simply couldn't believe it was actually there and clearly visible. I was definitely pregnant. I was ecstatic. My husband was out of town and I wanted him to be the first one to know. I tried his number with trembling hands. It was busy. I tried again and again and again for a good 10 minutes when he finally picked up. I was bawling by then and am sure he must have been sick with worry when he picked up the 100th call. Of course he didn't believe that the home pregnancy test was positive. Just like me he had his hopes dashed so often that it took a lot to convince him that he was going to be father. To make matters worse, I just couldn't stop crying. We were going to a family, we would have a child of our very own. I wasn't a failure…


Rachel had known a week before that I had conceived and knew that a pregnancy test would bring home the good news. She had been right again just like with the other women. When I told her, she was genuinely happy for me. We hugged like friends - a woman to woman. She understood...


For the next three months, I took acupuncture treatments to make sure I gave my baby the best possible start. The treatments were designed to prevent a miscarriage and to help bolster my general health. I was perhaps the happiest during that time. And I finally believed in the power of acupuncture and in the power of positive thinking. Rachel was right - I didn't have PCOS after all. All I need was some TLC.


I had a healthy, uneventful pregnancy and a normal, full-term baby. He was the most beautiful newborn and when he opened his eyes to look at me, I knew I had met my destiny. A year and a half later, I conceived again. I didn't even know I was expecting till seven weeks later. His too was a full-term, uncomplicated pregnancy.  I had not been taking any medication, even prenatal vitamins. I was just happy being a mother and God rewarded me again…


My experience with Rachel was so positive that I told everyone I could. A friend who had also been given the “death sentence” of IVF due to PCOS got help from Rachel and got pregnant after four months of treatment. Yet another friend got help for her fibroids under Rachel’s treatment but couldn't conceive, unfortunately, because of other complications.  I am not advocating acupuncture as a cure-all for infertility. Several factors have to be considered before embarking on this path- age of the patient, correct diagnoses of the underlying problem, the academic credentials and successful track record of the acupuncture practitioner etc. The game changer, however, is faith. A strong belief that non-conventional treatments help the body do what it was designed to do naturally.


My children are thriving today and are as boisterous as children can be. I am an extremely happy and grateful mother. I learned an important lesson along the way: alternative medicine has an important place in restoring our body’s natural rhythm. Our bodies are capable of healing themselves with a little help. Western medicine definitely offers quick results but it also comes with a lot of excess baggage in the form of long-term side-effects. More and more women are finding that acupuncture can help them in their journey toward motherhood, either used alone or in conjunction with standard medical protocols.

I am posting this anonymously but am happy to answer any questions. Just email me by commenting on this post and I will try to answer your questions to the best of my ability. Thank you!
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How to Choose the Gender of Your Baby

7/7/2014

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Every so often, a patient comes in and asks if it’s possible to choose the gender of their baby.  While this method is not completely foolproof, it is possible to stack the odds in favor of having a boy or a girl. 

You probably already know that having sex just before ovulation is the recommended way to get pregnant. Since sperm live two to five days inside the woman's system, and eggs are only viable for 12 to 24 hours after ovulation, it is usually best to have the sperm right there waiting as the egg drops.

There are two types of sperm, male and female. The male sperm have an X chromosome and Y chromosome (which is actually a broken X without a tail – go girls!).  Female sperm contain a double X, which is slightly heavier. Thus, the male sperm swim faster. 
Think of sprinters versus marathon runners. 
The boy sprinters get right up to the ovaries and hang out in the fallopian tubes waiting for the egg to drop. This sprint to the egg uses up all their energy, so if they aren't able to quickly fertilize an egg, they die. The female sperm (our marathon runners) keep a slow and steady pace, reserving fuel as they make their way to the ovary. 

So, for a probable boy baby, intercourse should occur the day you ovulate. If you have sex a few days before you ovulate (and then not again), the boy sperm will have died by the time your egg appears, leaving room for the girls to get to work.

Of course, many factors complicate this issue, including maternal age and health of mother and father. Hardest of all is knowing the exact moment you ovulate. But, if you really have your heart set on one gender over another, this approach is worth a try.

Feel free to share this blog and my website with your friends. I love to help people have babies.
Yours in good health,
Rachel Blunk, L.Ac.

Rachel Blunk is a fellow of the American Board of Oriental Reproductive Medicine who has specialized in fertility since 2002. Her practice is located in Fort Collins, Colorado. See more at www.BabyByBlunk.com. 
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Share this with Your Mother-In-Law

6/16/2014

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Most of my daily work consists of providing acupuncture, Chinese herbs, and supplements to help get women's (and men's) bodies back into balance naturally, so that conception is possible. But there is a portion of every appointment that is emotional. I listen to women as they struggle mightily with the sadness, grief, and cautious hope that characterizes the journey through infertility. I believe it helps my patients to have a neutral person to unload to, who will encourage them and offer support. 

One of the top frustrations my female patients confide about is the pressure they are under. They feel the expectations of their family, their spouses, their friends, and commonly, their mothers and mothers-in-law. It's a persistent enough complaint that I am compelled to write this advice to future grandmas.

Don't alienate your daughters. Make friends with her. Deepen your friendship with her. Make seeing you a pleasant experience that brings happiness to you both. In the same way I suggest to my patients that they should make a bucket list of fun they would like to have before having a baby, I think future grandmas should find ways to bond with their adult children that will build a foundation of love and mutual respect. Seek out activities that work on your friendship.

Constantly asking how the treatments are going and checking in on the baby question adds great pressure and stress to your daughter. Leave it alone. Allow your children to give you the information they would like to as they feel comfortable sharing it. 

From my perspective as the shoulder to cry on, this approach would help everyone feel a little more grounded.

Feel free to share this blog and my website with your friends. I love to help people have babies.
Yours in good health,
Rachel Blunk, L.Ac.

Rachel Blunk is a fellow of the American Board of Oriental Reproductive Medicine who has specialized in fertility since 2002. Her practice is located in Fort Collins, Colorado. See more at www.BabyByBlunk.com. 

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Using Feedly

6/7/2014

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If you would like to read this blog with Feedly.com, please enter the following URL on the feedly home page: http://www.babybyblunk.com/blog/feed 
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Bucket List

6/6/2014

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As a fertility acupuncturist in Fort Collins, Colorado, I'm one of the only people doing this work in my region. So many women struggle with fertility issues. I want them to hear the message that acupuncture can help.
Infertility is hard. I see women every day who are despondent about their inability to have a baby. By far, the biggest issue women deal with is the stress of trying and failing to reach a goal. And yet, the message they seem to hear over and over is "Don't Stress". 

Stress does have an impact on fertility, but that message can be oversold. Yes, it impacts your sympathetic nervous system. Stress supercharges your fight or flight reflex; that's how women through the ages were able to get up and flee from a lion. 

But how do you tell someone to stop worrying about something? The message itself just adds more stress. That doesn't work. Instead here is what I tell patients:

Don't sit around waiting around and hoping, fretting, and worrying. Make a list of all the things that would be hard to do with a newborn. Wind surfing? Going to dinner and movies? International travel? Triathlon training? Make that bucket list, whatever it is, and then go do it.

The chances are very high that you will have a baby soon.  I estimate that 85% of all my patients go on to have a baby when using both Eastern and Western modalities. So, take all that effort you were putting into worrying, and channel it toward something that will make you happy in the meantime. By the end of the process you may have a killer passport or a race medal... AND a baby!

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Get Thee to a Doctor (Eastern or Western)

6/5/2014

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As an acupuncturist specializing in fertility, I am acutely tuned into the issues that women (and men) face when having trouble starting a family. This journey started for me when I, too, had trouble conceiving. I was determined to figure out a solution and knew from my education at Pacific College of Oriental Medicine, that acupuncture was a powerful tool. That journey was what ultimately gave me my own two children and helped me find my professional calling. 

Now that I have my two kids, it's very satisfying to help people who have been struggling with fertility. As a part of my practice in Fort Collins, Colorado, I work with reproductive endocrinologists (REs), OB/GYNs and nurse midwives to help their patients get pregnant. And it WORKS! 85 % of my patients go on to have babies. I feel incredibly fortunate to do the work I do. 

With over 12 years experience in fertility acupuncture, I have had many years to consider the advice I give to patients. When women first come to me, they are overwhelmed and frustrated with their efforts to get pregnant. Often, they are burdened with too much information from the internet and well-meaning friends or family. At the same time, ironically, they are suffering from a lack of solid data.

The one piece of advice I give to every single patient is get evaluated. You need to answer that “why” question before any other. If there are anatomical issues preventing you from conceiving, you need to know that.
Go see an acupuncturist if you have been trying to get pregnant for six months with no luck. If you have been trying for over a year, see a reproductive endocrinologist. And definitely, without question, go to an RE first if you are over age 35. There are things that I can't see as an acupuncturist, like blocked fallopian tubes or a uterine septum. At later ages, women don't have much time to waste trying out alternatives. 

More than advice from your girlfriends or inventive sex positions from women's magazines, what you need is data about your specific reproductive system. Without knowing exactly what is preventing you from conceiving, any solutions you may try will be blind.

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    ​Rachel Blunk, LAc, FABORM is an acupuncturist specializing in fertility issues.

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