30 August 2020 by Naomi Jankowski - The question I receive the most frequently in clinic is "How does acupuncture work?" This is such a fantastic question with multifaceted answers. The question I like even better is "How is acupuncture going to help me conceive?" When I consider this, there are two parts to the answer which are relatively easy to explain, and which are very important for patients to hear so they understand what we are doing, rather than just going along with a bunch of arbitrary needles.
The first part of this relates more broadly to the question of how acupuncture works. Through my experience in clinic, I have found that so much of acupuncture works on benefiting blood flow and circulation. Acupuncture does not just work by bringing blood flow to the area where the needle is inserted, in fact often the needles selected will direct the blood flow to an entirely different area of the body. For example, I routinely use points on the hands that have a direct affinity to the ovaries and uterus. If a patient comes to see me on a day that they have menstrual cramping, using these points on the hands usually decreases the pain within a few minutes. By facilitating blood flow to the area, the uterus is then able to function more efficiently.
In many cases, menstrual cramping is caused by a small amount of uterine clotting that is stuck. The cramps occur when the uterus has small contractions to try to push the clots out. Unfortunately, the contractions often become inefficient, and then we have the problem which we so often see in clinic, where a woman either has pain or heavy bleeding. Increasing the blood flow to the uterus facilitates more efficient uterine contractions. This in turn will decrease pain, decrease heavy bleeding, and, most importantly, create a good basis of endometrial lining.
How is acupuncture going to help me conceive?
This brings us to the next point, and our next question of "How is acupuncture going to help me conceive?" Patients often tell me they have low AMH, and that their fertility specialist has told them they cannot conceive as a result of poor egg quality. Egg quality is certainly part of the picture, and cannot be overlooked. But let’s consider another perspective. What good is the perfect egg if the quality of the endometrial lining is so poor that implantation cannot occur?
The analogy of soil works best to illustrate this point. A seed will not be able to form roots in soil that is littered with rocks, debris and clumped up dirt. No matter how much fertiliser you add, if there are enough rocks in the soil, your seed will not grow. These rocks are the clots in the endometrial lining. First and foremost, our job is to help eliminate this clotting. Secondly, we work to add fertiliser to the soil i.e. thicken the endometrial lining. Then, if necessary, we work on egg quality. Often I never need to directly work on step three, because by that time, conception has successfully occurred.
It is important to note here that patients often have their lining measured, and are told that it looks fine. This is a measurement in millimeters that does not take into account quality of lining and possible clotting. Clots will, in a sense, artificially increase the ‘true’ lining of the uterus present on the scan. It is detrimental lining that leads to a false reading in millimeters.
So to summarise and answer these clinically relevant questions, the benefit of traditional Chinese gynaecology is that it takes into account the quality of the endometrial lining. Acupuncture can facilitate blood flow to the uterus, to improve the quality of this lining which increases the ability of an embryo to implant.
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