Herbal therapeutics in female infertility

Herbal practitioner:

Carole Guyette MNIMH

History Taking for Fertility Problems 2

• Menstrual History

• Menarche - age & how it was experienced

• Menstrual cycle - length/regularity/changes ,

• Dysmenorrhoea - self help?

• Premenstrual symptoms

• Blood: colour/f1ow/clots/ease LMP

•. Use of pads/tampons - how many? Symptoms related to ovulation -

History Taking for Fertility Problems 4

• Reproductive History

• Previous pregnancies

• Same/different partners

• Time taken to conceive

• Health during pregnancy

• Outcome - incl terminations, miscarriages

• Residual feelings/body/cycle changes

• Labour & delivery, term/pre-term

History Taking for Fertility Problems 1

• De/ay in conception

• Duration

• Previous investigations/treatments

• Effect on client's life

History Taking for Fertility Problems 3 • MittelschmelZ

.Mucus changes, bleeding .Bleeding irregularities - post coital, stress ...

.Feelings/comments re cycle & others' perceptions

History Taking for Fertility Problems 5

• Sexual History

• Intercourse

• Frequency

• Enjoyment

• Lubricants

• Dyspareunia

• Difficulties

1

History Taking for Fertility Problems 6

• Past contraceptive history

• Preference, changes, "failures"

• Oral contraception - Duration, time of cessation, resumption of menses, side effects

• IUD - symptoms of infection

History Taking for Fertility Problems 8

• Past Medical History • Pelvic inflammation .STDs

• Peritonitis

• Pelvic operations

• Tubal pregnancy

• Appendectomy

• Drug therapy

• Endocrine

• Weight change

• Galactorrhoea

• Hirsutism

• Acne

• Smears

History Taking for Fertility Problems 10

• Psychological history

• Reasons for wishing conception

• Conflict reo conception

• Depression

• Previous psychiatric problems

History Taking for Fertility Problems 7

• History of Mothers and Grandmothers

• May reveal interesting patterns/attitudes

History Taking for Fertility Problems 9

• Social History

• Occupation & intentions

• Domestic circumstances

• Relationship with partner

• Diet

• Smoking

• Alcohol

• Stress

• Exercise

Female Infertility/ Sub-fertility

• What is cause? physical/emotional/mental /spiritual

• What block/s prevents successful pregnancy?

2

Case History Taking

• Ideally see both parties

• Fully assess nutritional statusl alcohol, cigarette or drug usel exercisel stressl lifestylel environmental factors

• Further investigations?

• Treat underlying pathology e.g. Endo, PID, PCOS, Infections such as Chlamydia, low thyroid function ...

Diet/supp/ementsllifestyJe

• Foresight 99% success - hair mineral analysis

• Exercise aerobic 3-4 x weekly • Yoga, Tai Chi

Herbs contraindicated in pregnancy

• [f:.r:.s:. 1;f;/:!r.:J'='::!nu,:;s,:aJk,,,=~ :'J:'ftl1Iitfll)

(6,.,,,_ an be IIMIfuI In dllltlblrtb). r"trlm.IIIA of __ I oll!J dll,. '" high rI5Ir of oven/OMge (.",.11 ,1II1n_S fine hi fltJVlHlrhl,S)

• 0tIJe, herb.,

• A_'ie" sin. -notlnbt_,

• A_spp.- nomonthilnSDOmIl/day

• Ciluklphyllum· only bike In 11m: 6 _5

• Chelidonium - fig more /:han lOOOm,/day

• Datura - #II$pOCixId _,."

• _pule,.

• Petrosellnum - due '" IIplDl ,.ntent (negligible In Apium)

• PeUfI'IUSbtlldo

• Ruts

• SIIfDl:INJmnU6

• T_tum pTfhenium - no men /:han SDOmIl/day

• T6fMCetum vulgaris

• Thu}8

• V/oc .... -onIyblkeln_6_

• Zlnfllber - no more/:han 2DOOmIl/tktr

• plllJllX gI".."g - only lit deI/oery

• E1eutheI'PCOCCII$

Common presentations

• failure to conceive (no underlying pathology)

• recurrent miscarriage (includes implantation failure)

Woman slow to conceive/history of miscarriage

• Spend 3-6 months preparing woman Om prove general health & hormone balance}

• Don't try to conceive in this time

• Set time limit with patient e.g. 12months (to review)

• Inspire hopeI positive thought; identify blocks

• Avoid blame - remember that everything happens for a reason - ?unknown

Herbs to avoid at high dose> 39 daily

(l.e. Sml1 :2, 15ml1 :5, avo 2 teasp dried)

• Achillea

• Aesculus

• Angelica arch.

• Barosma betulina

• Berb spp.

• Hydrastis

• Juniperus

• Lycopus

• Salvia

3

Herbs to use with caution

• Essential oils external use-

• onnamon, nutmeg (these 2 useful for massage in last few weeks), myrrh, clary sage (useful for delivery), jasrrnne, juniper, pennyroyal, marjoram, oregano, cypress, thyme, sage, savoury, wintergreen, hyssop, basil, aniseed, fennel

• Laxatives (avoid though probably safe at normal dosage)

• Aloe, Rhamnus, cassiar Rheum

Herbal Therapeutics in Female Infertility

• Ovulating and no known reason for not conceiving

• What is condition of tissues? (incl emotionaUmental blocks) What actions required?

• Cleanse toxins - individual needs, ensure no GU infection, fertility treatments?

• Tonify/nourish/rebalancelrelaxlstimulate etc ...

Fertility tonics

• Vltex increases Progesterone & LH

• Hormonal balancer par excellence esp. where low progesteronee.~. woman prone to early miscarriage e.g.9/40 spelling or rmscamape

• Brings inner strength & emotional' balance. . • Alcheml/la vulgaris -

• Uterine tonic. Hormone balancer. Promotes fertility. Haemostatic.

Traditionally for soft. gentle women

• Mltchella-

• Uterine strengthener, inspires seif-eonfidence • Leonurus-

• Uterine tonic and sedative, reduces nervous tension, anti-spas helps pelvic irritability. Helps with fears around motherhood. '

• Dloscorea-

• Powerful smooth muscle relaxant relieving spasm and inflammation, regulates hormones, opens up blood vessels

Herbs for infertility

• FAILURE TO CONCEIVE

• Problems with ovulation and/or cervical mucus

• usually strong hormonal component

• e.g. amenorrhoea - post-pill, commonly seen after shock or bereavement, excessive exercise, seriously underweight/overweight ... VITEX

• Sperm antibodies - what's going on in relationship?

• ensure patient knows fertile times

• MUCUS CHART Monitor mucus and other signs of ovulation (e.g. mitte/schmertzltemp changes)

Fertility tonics

• Useful herbs:

• Chamae/lrlum (cultivated) - prime fertility herb, magnificent uterine and ovarian tonic, strengthens pelvic tissues and promotes pelvic nutrition. Up to 30mVweek

• Rubus - strengthens and tones pelvic muscles, relaxing at same time. Soothes kidneys, tones mucous membranes. Tea or tincture - up to 40mVweek

• Relaxes uterus when contracted, contracts uterus when relaxed.

• Provides excellent support. Emotionally - helps soften the heart and allow for greater receptivity and intuition.

• Viburnum prunifolium - uterine sedative, anti-spas, relaxant to

uterine muscle,

• spec. for uterine irritability & painful conditions of pregnancy

• improves uterine & ovarian circ > promotes pelvic nutrition

• Strengthens peMs after prevo miscarriage

• ~: best remedies for nervous conditions in pregnancy or affecting

Fertility tonics

• Trifolium

• Alterative, Hormone ba!ancer (phytoestrogens), lymphatic cleanser, anticoagulant.

• Trigonella

• "there:s a baby in every cup" (Weed) - bitter & wannmg, stimulates uterus, soothes irritabla tissues, reduces blood sugar & cholesterol, benefits weak digestion

• Serenoa

• AdaptafJ!ln, sedative, w,anning, helps sex drive, urinary antiseptic, endocnne stimulant, helps intimacy & openness, learning to giva & receiv«

• Anemone

• Sedative, anti-spas, reduces pain in repro system, soothes inflamed mucous membranes

4

Fertility tonics

• Toocold

• Zing Achillea - improve eire to pelvis

• Pelvic congestion

• above & Calendula - improve eire of blood & lymph. • Attention to NS

• Seutel/aria, Avena, Hypericum, Passiflora, Valerian, Verbena,

• & Raise vital force • Salvia

• Uplift

• Rosemary, Melissa

• Loss of libido

• Vrtex. Serenoa

• Heatthy sex I~e depends on good ovarian, adrenal and pituitary function (& psychological)

• caLl!~e could be hormonal, exhaustion, depression, drug·related, relabonship difficulties, fear of pregnancy ... related 10 family attitudes, childbirth ... ,psychological{eg prev. abuse)

• Turners

• aphrodisiac, sexual stimulant, anti-depressive, promotes weU-being, relieves anxiety

Case history 2

• Woman 41yrs Trying to conoeive 7years. MH 1 healthy FT pregnancy @ 25. Unplanned. Daughter age IS, raised by patient's mother for 1513 years. GRIEF & ANGER, husband told her she was 'depressed' for those years aHhough she did not remember clearly.

· =' CMIIaIon and hormOne levels. _. sperm _ good numb .... &

• wanted to avoid IVF.

• ~m~ ~~s:;;e ~~nd other emotions 1rapped in 'issues. Fadita1s ieUing

• R Rosa 20 Borage 20 Leon 20 Alth rad 20 Anem 10 Chamaelir 10 (x2) sig 5ml bd

• R Alchemilla vulgaris Tea one cup daily

• + flower essences

• Released huge grief. Woke in night saying "I'm not a bad moIher".

Healing dreams. Now feels a different person. ,

• Similar herbs over 8 months leading to conoeplion and heaHhy FT pregnancy.

• Use of 'medicine bundle' to connect with uterus - release feelings without hevlng to analyse.

• IVF etc.

Hormonal imbalance

• Vitex

• helpful when history of early miscarriage esp. where low

progesterone '

• eg 9/40 spotting (?corpus luteum insuff?) supports progestlcorpus luteumlHCG

• up to 10ml daily (usually much lower) if history of early miscarriage, esp, if suspect low progesterone

Case history 1

• Woman 40yrs Sec. school teacher - v.busy lifestyle - worrier/stressed

• Trying to conceive for 12112. Stable, happy relationship. No prev, pregnancies.

• History of PMT. Regular, ovulatory cycles apart from times of high stress. Chocaholic.

• R Vitex 20 Chamaelir 20 Verbena 20 Scut 20 Avena 20 (x2) sig 7 Yo ml. bd

• Kept her on same or similar mix for 3 months.

Drastically reduced sugar & chocolate. PMT disappeared, reduced Vitex to 10 & put in Chamomilla. Conceived after total 7 months. Healthy pregnancy & normal delivery.

Recurrent Miscarriage

• can't stop inevitable miscarriage

• Properly prescribed, herbs will not Intelfere with nature's course· will not delay Inevitable mlscarrtage or In any way endanger the patient

• Use at low dose prophylactically at danger time

• Use higher dose in acute threatened miscarriage

• Uterus functionally unable to support foetus; • Cbamaellrium-

• esp. helpful where history of miscaniage. Uterine initabil~y. Poor tone in cervix. V. safe & nourishing. OVarian & uterine tome

II Vib prun~

• tonic, astringent, anti-spasmodic, relaxant, uterine sedative, improves uterine eire, usefu! for uterine irritability

• Combine Chemaelir & Vib prun for threatened miscarriage 10- 20gH every 30-60 mins for spoHing, cramping, bleeding. Rept until symptoms clear> 20gH (or more) mane until 22140 approx.

Case history 3

• Reo.rrent miscarriage & low progesterone. Woman - 33)'1"$.5140 pregnant

• MH-Age 26- mSC8niage at 9/40; age 28 m'SC8niarn at 15140; ~ 29 FT ~egnancy

g:;nt:r~~:~%~:'~I~n~=~r,constant 81i9OO YItl h

• RWfll( 20 Chamaeir30 Gaktga 10Vlb prun 20 FLaIS 20 (x2) 5(1 5mI ids +reeG. R$ITI

• Emergencydr'op&:RChamaellr30Vitex40~(x1) sig~OOur1ypm

• Started getting periOd-type cramps at 9/40 -laSting about Y.. h" Slopping & starting

• Cramps stopped after 2 days on emergency crops.

• Bed rest{ relaxafionl Visualzatlon/ Inner dialogue. Keep bowel moving (avoid reflex

irTi1ation of uterus)

• Cramps rec1.Jl'Ted on a few occasions up to 16140, soon cteared with crops.

• Continued on original mix until 19140 When she deYeloped headalches.

• R changed to:

• RChiJmaelitium 30 Vlbprun 30 MlcheIa 20 Rubus 20 (1('1) $Ig 40alt t.d.!L

• at 24140 - RRI.Ibu& 30 "!chella 30 Achillea 30 Ae!ICUIus 10 (x2) I5ig 5m bd.(va~ wins)

• Went on to have normal FT delivery and healthy baby.

• Mother made ql..ick recovery and reported that her energy was 'better than H had been for years'.

• :::: +MtdleIIa-~ng&relaxlngcontHnalionforLietus.2OgttbMd.upto5ml iii I.eoruu5 -toon uterus, teduces netvOUS tension & spasm. LCMIIy tierine &edatlYefarfalse aatIoLr pains, nervous debility, peMc lrriablity.

• Adcitlonal MMnesfresc:ue remedy

5

Case history 4

• Woman 35yrs.MH Uterine fibroid s. Surgery 027. Trying to conceive past 6112. History alcohoVsmoking

• R Calendula 20 Chamaelir 10 Rubus 20 Tarax rad 30 Achillea 20 (x2) Sml Ids

• Circllymphl uterinelfertility tonicsl liverl ciml

• Fertility Tea on Full Moon: ALCH. VULGJRUBUS (TRIFOLIUM)

• Conceived after 5/12.

• At 32140 niggling pains tike 'crampy period pains' back & front 011 walking (not Braxton Hicks) could last ~Omins. No blood loss

• Stressed. Spfrt with partner.

• R Rubus 30 M~chella 30 Leon 20 Vib prun 20 (x2) Sml Ids (+ rubus tea)

• Pains became less frequent, shorter duration and ceased after 10days

• 36140 nervina mix R ChamomiliaNaVPass 10ml nocte

• Normal delivery at 41/40 & heaHhy baby

6