Clinical Experiences - Stuart Zoll
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Addressing Two Common Infertility
Causes with Honso Herbal Formulas Infertility can be caused by a number of factors making it difficult
for practitioners of both conventional and TCM medicine In my practice I primarily treat reproductive disorders and
infertility with acupuncture and herbal medicine. TCM offers one of the
most effective therapies when used solely on its own for infertility or
when used in conjunction with IVF or assisted reproductive technology,
ART. Premature Ovarian Failure (POF) is defined as menopause that occurs before the age of 40, FSH is greater than 25, and no menstrual cycle for 6 months or longer. Most women have between 400-500 thousand eggs at the time of their first period. By the time menopause occurs that supply of eggs has dwindled down to a handful. This gradual loss of eggs during a woman's fertile years is normal. However, in premature ovarian failure for some reason, either the loss of the eggs is accelerated or the follicles themselves become unresponsive to hormonal stimulation (of course, these conditions can contribute to each other). Unfortunately, POF is one of the most common conditions affecting a women's fertility, occurring in one in every thousand women (0.10%) between the age of fifteen and twenty-nine and one in every hundred women (1.0%) between the ages of thirty and thirty-nine.2 Most women diagnosed with Premature Ovarian Failure are given one option, donor egg. A number of cases of POF have been reported with autoimmune disorders. Other than hypothyroidism, it is uncommon to encounter other autoimmune disorders associated with premature ovarian failure.3 There is a similar disease which mimics POF, Lymphocytic Oophoritis. Because of low estrogen levels, patients experience symptoms similar to those of menopause: atrophy of the reproductive organs (including the breast), hot flashes, irritability, and mood changes, among others. Except for replacement estrogen and progesterone, there are no available treatments in biomedicine. 4 To begin with, most cases of POF that I have seen clinically are due to Kidney Yin deficiency leading to internal heat and Blood deficiency, which include infrequent or no menstruation, little if any fertile mucus, night sweats, hot flashes, low back pain, thirst and irritability. The pulse is often rapid and thin, the tongue red. As for the treatment I prescribe Honso K001, Liu Wei Di Huang (Rehmannia Six Formula), which is available in softgel form. Patient compliance is excellent when taking the softgels and granule packs, and I find they work better than tablets. Many of my fertility patients are so overwhelmed by the whole process of trying to get pregnant they often need simple and easy ways to take Chinese herbs, Honso meets the modern needs of women on the go as they can easily carry the herbs with them. If Kidney Yin deficiency is compounded with Heart and Liver Blood deficiency it may cause irritability, constipation, and restless sleep. Also, if there is inadequate blood circulation to the uterus the endometrium lining may be too thin and therefore affect implantation. For treatment of Kidney Yin and Blood deficiency I would prescribe Honso K001, Liu Wei Di Huang (Rehmannia Six Formula), 3 gel caps twice a day, and H71 (Si Wu Tang, Tangkuei Four Combination), 1 packet twice a day. Kidney Yin and Blood deficiency may be combined with Spleen Qi deficiency. The spleen nourishes the Blood; a good formula would be Ba Zhen Tang, (Tangkuei Ginseng Eight Combination), it's the classic formula for treating dual vacuity of Blood and Qi and can be taken with Honso K001. Pelvic Inflammatory Disease is one of the most challenging and serious infections of young women in the United States. It has been estimated that about 1.2 million women develop PID each year in the United States. Chronic pelvic infections can adversely affect fertility. Pelvic infection, most commonly caused by Chlamydia trachomatis, results in severe tubal damage in 10-30% of the women after the first attack, 30-60% after the second and 50-90% after the third. 5 Chlamydia pelvic inflammatory disease (PID) is often "silent," with the patient having no symptoms until severe adhesions and pelvic damage are noted at laparoscopy during infertility investigation. Various tests can be performed to confirm the diagnosis of this disease, of these, a laparoscopy is the most useful, and it confirms the diagnosis in two thirds of the patients. From a traditional perspective, PID may fall into one of several categories: Heat penetrating the womb, abdominal mass, leucorrhoea, or menstrual pain. It usually results from dampness and heat toxins remaining in the womb, and in the conception and penetrating vessels, causing stagnation of Qi and Blood. Later a mass may develop possibly interfering with pregnancy.5 A 21-year-old woman came to my office for treatment of persistent lower abdominal pain, she complained about breast tenderness and irritability. Her menses are irregular and she has headaches, dizziness, and fatigue. I considered the diagnosis of pelvic inflammatory disease. Her tongue is pale red on the sides, pulses are deficient and wiry. I recommended Xiao Yao San, (Tangkuei Bupleurum), for Liver Qi stagnation and a disharmony of the Liver and Spleen and Blood deficiency. When the pattern has more heat signs such as red eyes, excessive or early menses, a fast and wiry pulse, then I suggest Honso, H24 (Jia Wei Xiao Yao San) and Bupleurum Peony Formula. A 28-year-old woman visited my office for infertility. She experienced marked lower right quadrant abdominal pain, which was worse around menstruation. Her pelvic pain is worse with pressure and relieved by warmth. She has persistent spotting and the blood is purple or dark and contains clot, her tongue is purple, pulses are choppy. The Honso formula I recommend is H25 (Gui Zhi Fu Ling Wan), and Cinnamon Poria Formula, to transform blood stasis, quicken the blood, and disperse abdominal masses. After taking H25 (Gui Zhi Fu Ling Wan) for 4 months she stopped spotting, and the menstrual pain and clotting was eliminated. PID can damage the inner lining of the fallopian tubes, pregnancy rates can be at least 10 times lower than average even when fertility medications and or IUI are used, therefore, I referred her to a reproductive endocrinologist. She had an HSG, Hysterosalpingrogram, which confirmed that both her fallopian tubes were completely blocked. I highly recommend that if you are treating patients for infertility that they be seen by a reproductive endocrinologist for a fertility work-up. This patient would not get pregnant with just acupuncture and herbs. She decided to use acupuncture and herbal medicine in conjunction with IVF. On her first attempt with IVF she achieved pregnancy and took home a healthy baby boy. This case demonstrates a more holistic approach to treating reproductive disorders and infertility with Chinese Medicine and western reproductive intervention. References: The above contents are only for the purpose of professional exchange of information. They do not necessarily represent Honso USA's opinions. All above mentioned products are not for sale on this website or without a licensed practitioner's consultatoin. *These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. |
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to treat. Women suffering from Premature Ovarian Failure and Pelvic
Inflammatory Disease, two commonly seen problems associated with
difficulties in conceiving, often have limited treatment options. This
article examines these two conditions and how Honso herbal formulas can
be used to treat underlying infertility issues.