I don’t know about you, but when I was in high school nothing would put me to sleep faster than trying to memorize the series of hormonal fluctuations in the menstrual cycle. In college, my boredom turned to mixed interest and confusion as I tried to piece together the complex interconnected feedback loops of the neuro-endocrine system. Now, I am in a state of utter fascination and awe as I look at women’s reproductive cycles not just in a Western sense, but from a Chinese medical perspective as well.

The Basics Western & Eastern:

Most women have approximately a 28 day menstrual cycle. The cycle begins with the first day of menstrual bleeding. In Western medicine the cycle is divided into two phases, the follicular and lutial phase. Now don’t go to sleep yet! Basically, the first part of your cycle (follicular) is when estrogen helps with egg maturation, then ovulation occurs and the last part of your cycle (lutial) progesterone dominates as your body prepares for implantation of a fertilized egg. If there is no fertilized egg, your progesterone levels drop, you start your period and the process begins all over again.  In Chinese medicine the menstrual cycle is divided into yin (follicular phase) and yang (lutial phase). During the yin phase we want to nourish yin and blood to assist in the production of healthy, mature eggs. Then when the egg is released from the ovary the yang takes over. In this phase it is crucial to support yang and gently promote blood circulation to the pelvic organs to ensure that if there is a fertilized egg present, it can implant in the uterine lining and the body can hold the pregnancy rather than releasing it with a period. Approximately 25% of pregnancies miscarry during this crucial time because the yang (progesterone) is not strong enough to hold the pregnancy.

A Little More Than The Basics—Western  

Now that we have mastered that aspect of this complex hormonal event lets go a little deeper. How does the ovary know when to release an egg? In fact, how does it know when to start maturing eggs so you have one to release at ovulation time? To answer these questions we have to back one step farther and talk about the pituitary gland.  The pituitary is a very interesting little part of the brain that gives the ovaries orders to mature and release eggs. It does this by sending out hormones to the ovaries. Follicle stimulating hormone (FSH) is the hormone the pituitary sends to the ovaries to signal them to start maturing eggs. Lutinizing hormone (LH) is the hormone the pituitary releases to signal the ovaries that it is time to release the egg, i.e. ovulate.  Now some of your ears are starting to perk up. Those of you who have started the process of trying to conceive probably recognize LH. This is the hormone that is easily tested by urine strips in LH surge prediction kits available at your local pharmacy to determine the time of ovulation. The idea is that if the ovary reacts properly to the LH signal from the pituitary, an egg should be released within a 40 hour window. The catch is that those strips only measure the LH surge. They do not determine the health of the eggs or uterine lining or if the ovary is going to respond appropriately to LH and actually release an egg.

And who tells the pituitary what to do anyway–yet another part of the brain, the hypothalamus. What about the adrenal and thyroid glands, don’t they affect fertility too? Yes, absolutely. What roles does stress play in this process? So many, it affects the nervous system, hormone balance and blood flow to the pelvic organs.  

Now we are just brushing the surface of the complex interplay between the nervous system and endocrine organs that govern ovulation. In my next post I’ll talk more about ovulation and a healthy menstrual cycle from a Chinese medical perspective, but now let’s discuss research showing that acupuncture can influence hormone levels and promote ovulation.

Acupuncture & Ovulation  

In 1997 Dr. Chen published an important piece of research, Acupuncture Normalizes Dysfunction of Hypothalamic-Pituitary-Ovarian Axis in which he states that in China the success rate of acupuncture in inducing ovulation is 80%. He wanted to know why. In this landmark paper he discusses studies on both humans and animals showing that acupuncture can regulate the key fertility hormones such as estrogen and LH. He also showed that acupuncture can regulate the nervous system and adrenal hormones to support hormonal balance and optimal reproductive functioning.

Santa Cruz private practice I have used this research along with acupuncture treatments that I have developed through my own clinical experience and had the honor of learning from many experienced Chinese and Japanese acupuncturists. I see many women with irregular menstrual cycles and trouble ovulating. I use specific acupuncture treatments in the yin phase of the cycle to enhance blood circulation to the ovaries and uterus and promote pituitary-ovary communication and egg growth. In the yang phase treatments are geared towards balancing estrogen and progesterone levels and gently circulating qi and blood to encourage embryo implantation—and pregnancy!