Jane*, a 33-year-old woman, came to see me with a chief concern of pregnancy achievement. She had one early miscarriage (chemical pregnancy) 5 months before, and had been trying to conceive again since then. Her medical doctor had suggested fertility treatments if she was not pregnant within the next 7 months, but she preferred pursuing a more natural approach.
Pregnancy achievement can be a long, emotionally-charged process for many women. If they have a history of miscarriage, they may have a lingering fear that this may happen again, which can add stress and anxiety. While there are many factors which influence overall fertility in women, achieving hormone balance is one of the key ways to prepare the body to conceive and sustain a pregnancy. Naturopathic doctors have much to offer to help balance hormones and optimize chances of conception.
Clues that you may have a hormone imbalance include irregular cycles, painful or heavy periods, mid-cycle spotting, migraines, low cervical mucous production, or PMS symptoms. You may have been diagnosed with hormone-related conditions linked with sub-fertility, such as endometriosis or polycystic ovarian syndrome (PCOS). Blood tests and/or saliva testing at specific times of a woman’s cycle can be ordered by a naturopathic doctor to help identify imbalances.
However, one of the best non-invasive tools that we have for assessing whether a woman’s hormones are in balance is through the charting of particular signs and symptoms throughout her menstrual cycle, using a system such as the Fertility Awareness Method or the Creighton FertilityCare charting system (Pallone et al., 2009). This information gives your doctor a better idea of which hormones may be out of balance. For example, spotting or brown bleeding between menses usually indicates a progesterone deficiency (Rouchotas, 2014). Charting also allows you to identify your ‘fertile window’, the stretch of approximately 6 days per cycle during which you could conceive (Pallone et al., 2009). In subfertile couples, this window may be as short as 2 days, and identifying the precise “fertility window” can help the couple conceive (Stanfordet al., 2003).
In the case of Jane, learning to chart and careful tracking allowed her to find out that she was not ovulating on the typical Day 14 of her cycle, but a few days later on Day 17. Since experiencing her miscarriage, her cycles varied from 31 to 34 days, when they had previously been more regular. She experienced cramping around the beginning of her menses, and suffered from frequent headaches and migraines. To help regulate her hormones, we began her on a seed protocol, which included estrogenic seeds in the first half of her cycle, followed by progesteronic seeds during the second half of the cycle. I also prescribed fish oil, magnesium, Vitamin D, and optimized her diet. She was already on a prenatal multivitamin. We then began acupuncture treatments timed specifically with her cycle. I often use acupuncture to enhance fertility because of its role in regulating hormones and assisting ovulation through its effects on the nervous system (Yu et al., 2013). After 4 acupuncture treatments, she postponed her 5th treatment, as her menses had not returned and pregnancy was suspected. She later informed me that she was indeed pregnant and doing well.
Every couple’s conception story is unique, and can be more complex than Jane’s case. Treatment is individualized and addressed from a holistic perspective. Because hormones play a such a significant role in conception and a healthy pregnancy, it is usually best to treat any identified hormonal imbalance prior to attempting pregnancy. The liver is an important organ for processing and eliminating excess hormones, and therefore supporting proper liver function using supplements and dietary changes is one of the cornerstones for balancing hormones naturally. Women who have recently been on hormonal contraceptives may be in particular need of liver support to help clear those exogenous hormones. Any detoxification protocol should be done as a preparation measure and not while attempting to get pregnant, as toxins are mobilized before they are eliminated and could potentially affect the developing baby. Depending on the condition, herbs such as chaste tree may be used to help regulate the cycle (Roemheld-Hamm, 2005). Your naturopathic doctor may also include other approaches to help prepare your body for conception, including eliminating hormone disruptors and food sensitivities from the diet, eating organic foods, managing stress, getting adequate exercise, and nutritional supplementation. In advanced cases of endometriosis or fibroids, co-management with a medical doctor may be necessary. It is also best when the health of both partners is optimized, since the health of the sperm also affects conception and the health of the infant.
Naturopathic doctors can help you understand your cycle and get you as healthy as possible to optimize your chances of conception. If you suspect you may have hormonal imbalances, the best time to take the measures to get healthy is now. Not only will you be more likely to maintain a healthy pregnancy, but you will also be improving your own long-term health.
*Name has been modified to protect patient’s privacy.
Pallone, S.R., and Bergus, G.R. (2009). Fertility Awareness-Based Methods: Another Option for Family Planning, J Am Board Fam Med, 22 (147-157).
Roemheld-Hamm, B. (2005). Chasteberry, American Family Physician, 72:5 (821-824).
Rouchotas, P. (2014). FertilityCare Toronto: A Restorative Approach to Women’s Health,Integrated Health Practitioners, Feb/Mar 2014 (31-35).
Stanford, J.B., Smith, K.R., and Dunson, D.B. (2003). Vulvar mucous observations and the probability of pregnancy, Obstet Gynecol., Jun; 101:6 (1285-1293).
Yu, J.S., Zeng, B.Y., and Hsieh, C.L. (2013). Acupuncture stimulation and neuroendocrine regulation, Int Rev Neurobiol., 111 (125-140).
Dr. Tamar Ferreira is a Naturopathic Doctor in Brampton, Ontario. Her areas of focus include digestive health, hormone balance, and skin conditions.