Infertility (a TCM perspective)

The ability of a woman to conceive is a complex issue that involves both the woman and the man. In Traditional Chinese Medicine (TCM) infertility in woman occurs when the woman is not able to get pregnant (provided the sexual function of the male partner is normal) even though there is unprotected and normal sexual activities for 1 year.

Primary infertility occurs when there has never been pregnancy before, and if the female has not conceived in over 2 years after labour or abortion, it is considered secondary infertility.

Broadly speaking infertility can be classified into three main categories: ovulatory disorders, immune disorders and poor functioning of fallopian tubes. Other reasons include abnormalities of the uterus (congenital or acquired), problems with cervical mucus, undesirable lifestyle, etc.

In Traditional Chinese Medicine (TCM), regardless of the above types (apart from congenital physical abnormality), infertility in women is invariably caused by certain conditions of the body, which can be differentiated into:

  • 1. Kidney deficiency
  • 2. Liver stagnancy
  • 3. Blood stasis
  • 4. Phlegm and dampness

In TCM, terms such as “Kidney” and “Liver” are terms that relate to different systems in the body and not necessarily refer to the physical organ themselves.

1. Kidney Deficiency
Kidney deficiency can be due to congenital condition, age, excess sexual activity, repeated abortions, or illnesses. It can be in the form of Kidney-qi, Kidney-yang or Kidney-yin deficiency.

a. Kidney-Qi Deficiency
Kidney-qi deficiency can be characterised by the following symptoms: irregular cycles or amenorrhea, dark coloured menstrual blood, fatigue, giddiness, tinnitus, weakness in lower back, clear and abundant urine, etc.
Chinese herbs commonly used to treat Kidney-qi deficiency syndrome include prepared rehmannia (shu di), Chinese angelica (dang gui) and Chinese dodder seeds (tu si zi).

b. Kidney-yang deficiency
Kidney-yang deficiency can be characterised by the following symptoms: late puberty, late cycles or amenorrhea, scanty and dark coloured menstrual blood, low libido, coldness in lower abdomen, watery and clear-coloured discharge, giddiness, tinnitus, weakness in lower back, etc. Chinese herbs commonly used to treat Kidney-yang deficiency syndrome include psoralea fruit (bu gu zhi), cinnamon bark (rou gui) and eucommia bark (du zhong).

c. Kidney-Yin Deficiency
Kidney-yin deficiency can be characterised by the following symptoms: short cycles, or extended menstruation, or amenorrhea, bright coloured menstrual blood, feeling of heat on palms and feet, thin body frame, insomnia, blurry vision, heart palpitation, skin and virginal dryness, etc. Chinese herbs commonly used to treat Kidney-yin deficiency syndrome include prepared rehmmania (shu di), white peony root (bai shao) and Chinese yam (shan yao).

2. Liver Stagnancy
Long term stress or suppressed negative emotions obstructs the smooth flow of Liver qi along the Liver meridian, causing blockages in nourishment of the reproductive system and resulting in infertility. Liver stagnancy is characterised by the following: irregular cycles, visible symptoms before cycle – abdominal pain, breast tenderness, abdominal distension, constipation, mood swing, tendency to sigh or take deep breaths, etc. Chinese herbs commonly used to treat Liver stagnancy syndrome include Chinese angelica (dang gui), white peony root (bai shao) and cyperus rhizome (xiang fu).

3. Blood Stasis
Stagnant blood is both a result and cause of pathological conditions. Situations that can cause blood stasis include factors such as coldness, heat, Liver stagnancy, deficiency in Qi, injury, etc. Blood stasis directly causes obstruction in smooth functioning of the reproductive system, thereby causing the inability to conceive. Females diagnosed with endometriosis very often fall into this category.

The following symptoms may appear in this syndrome: normal number of cycle days or long cycle days, menstruation pain which may or may not increase in intensity over months or years, irregular blood flow with clots, reduction in pain after clots are released, periods that drags longer than usual, bleeding in-between periods, pain during intercourse, feeling of compression above anus, purplish dark tongue or dark spots on side of tongue, etc.

Chinese herbs commonly used to treat Blood stasis syndrome include peach kernel (tao ren), safflower (hong hua) and Chinese angelica (dang gui).

4. Phlegm and Dampness
Overweight or over consumption of rich or sweet food can cause the body to create and accumulate excess phlegm and dampness, which obstructs proper functioning of the reproductive system and causes infertility. Genetic factor can also play a part, causing some women to be more prone to accumulation of phlegm and dampness in their bodies. A large proportion of women with infertility diagnosed with PCOS also have this type of body.

The syndrome of phlegm and dampness in infertility can have the following symptoms: obesity or weight gain, delayed menstruation or amenorrhea, heavy white discharge, stuffy chest, getting nauseous easily or lacking appetite, pale facial colour, pale and fat tongue with thick coating, etc.

Chinese herbs commonly used to treat phlegm and dampness syndrome include poria (fu ling), pinellia rhizome (ban xia) and tangerine peel (chen pi).

Infertility can be an independent condition, or a result of other female diseases. Conditions such as pelvic inflammatory disease, fibroids, polycystic ovary syndrome, endometriosis, irregular menstruation, etc. can all cause difficulty in conceiving. To prevent and treat infertility, the following are recommended:

  • 1. Form good personal hygiene habits especially during menstruation period
  • 2. Proactive in treating pre-existing female condition if any
  • 3. Take time to relax, de-stress and keep oneself in good mood
  • 4. Have sufficient sexual knowledge
  • 5. Abstain from smoking and alcohols
  • 6. Lead a healthy and balanced lifestyle and have appropriate sexual activities

(by Tan Shiau Tse, TCM Physician, Copyright® HST Medical Pte Ltd)