Photo credits Angus Colloff
How to navigate the experience of menstruation, the pain hormones can cause, the freedom to decide for one’s body whether or not to become a mother. These fundamental themes have been a constant throughout women’s history. Through struggles and victories, joys and sorrows, women have always been warriors of peace and freedom, ready to defend the rights of themselves and all others. Over the years, we’ve witnessed a growing ability to speak freely about these topics, but at the same time, we’ve also seen a spread of misinformation, influenced both by a patriarchal society and by a tendency to not select sources carefully, given that social media now is a Wild West of information. This has led to the current dominant issue: the possibility of becoming mothers at an older age. This factor is determined by the times we live in, the biological changes in our bodies, and much more. And we have to be aware of what is important to do for our body and emotions nowadays. Ultimately, what matters most and we should feel it more deeply, is our health, our happiness, and the freedom to choose without constraints. We discuss this with Amy Landman, acupuncturist and Doctor of traditional Chinese medicine, founder of Inner Flow Acupuncture in Melbourne, Australia.
Many women suffer from menstruation and menopause, and we’ve become accustomed to thinking it’s normal. Is it really so? Can we live without these pains?
It’s been normalized, but it’s not normal. A normal menstrual cycle, according to Traditional Chinese Medicine (TCM), should be painless. It certainly brings with it unique sensations of movement and release, but it shouldn’t interfere with daily life. Most often, women who experience menstrual pain put up with it, but it is deserving of further investigation and intervention. This shows how much menstrual pain is trivialized in society. Only recently has the seriousness of endometriosis been discussed. When women overexert themselves, facing a very stressful month, they may experience more painful periods. Therefore, it’s really important to maintain a healthy lifestyle because this has a significant impact on the menstrual cycle. When we consciously listen to our body, when we heed the messages it sends us, its requests to slow down and take even more care of ourselves, then we can make changes in our lives and, in addition to living pain-free, live more in connection with ourselves. At the same time, pain can also be caused by genetic, hormonal, trauma-related and environmental factors. In any case, it’s not normal to experience pain during menstruation and menopause; it’s a sign that something is out of balance, whether it’s with your hormones or your nervous system.
How can we tell if pain stems from a stressful lifestyle or if it’s chronic and genetic?
First, we need to consider whether it’s a problem that’s been present since your first menstrual cycle, if it started later in life, or after taking hormonal contraceptives. Or if it appeared during a particularly stressful time, a change of environment, or after an illness. Observing these details is crucial. I believe that when the pain persists for more than one cycle and interferes with daily life, or requires pain medication, it’s time to delve deeper. It could be a long-standing problem, an underlying condition, environmental, emotional or genetic in origin. In Traditional Chinese Medicine (TCM), we focus on all the information the body provides us to investigate. What color and volume is your menstrual bleeding, how long it lasts, the overall cycle length and ovulation, what your mucous membranes are like, everything related to your premenstrual cycle, your emotions, breast tenderness, changes in your tongue and pulse—we observe every nuance. TCM is based on the collection of all this evidence of underlying patterns. Instead of saying that if you have menstrual cramps there’s a generic cure, treatment for each person is different, because each of us is unique and requires a specific approach. This is why TCM is so beneficial and effective, because each treatment is individualized.
Could you clarify the meaning of hormonal imbalance?
Our body is so intelligent that it has numerous hormonal systems that interact with each other in a perfect, intelligent regulatory system. During the cycle, hormonal fluctuations triggering the release of the egg, is called the ovulatory phase. At that moment, the signal sent to the brain says, “Well, now it’s time to ovulate again.” Everything works in sync to keep the body in this perfect cycle. Hormonal imbalance occurs when one or more hormones fall outside their optimal range or when the body’s hormonal communication becomes disrupted. This can be influenced by factors such as chronic stress and elevated cortisol, poor sleep, environmental toxins and hormone-disrupting chemicals (including plastics and synthetic fragrances), nutritional deficiencies, the list goes on. Our bodies’ feedback systems are intelligent and do their best to heal and adapt to these blocks and imbalances.
Have you noticed an increase in women suffering from menstrual cramps and decreased fertility in recent years?
Certainly, any endocrinologist or fertility specialist has noted it. We’re seeing ever-increasing progression and prevalence as the years go by. For example, we can also consider the situation among men. Data is demonstrating a huge disparity in sperm quality, reduced by 50% in those under 40. Average sperm concentration worldwide declined by 51.6% between 1973 and 2018, falling from approximately 101 million sperm/mL to 49 million sperm/mL. (Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Jolles M, Pinotti R, Swan SH). More current research is showing even more rapid decline. For anyone trying to concieve, a sperm analysis is essential. Women’s fertility is also of huge concern more so regarding ovum (egg) quality, it is more challenging to show this in research on a large scale study as it is invasive to collect eggs.
What are the possible triggers of this hormonal imbalance?
As we said at the beginning, lifestyle, diet, genetics, and external factors are crucial and interconnected. By lifestyle, we mean a person who overdoes physical exercise, has a poor diet that isn’t appropriate for their body, and doesn’t get enough rest. High levels of stress and circulating cortisol don’t help. Or vice versa, when a person is too sedentary and overeats. In this case, dampness and Qi stagnation builds up, which hinder fertility. According to the Western perspective, estrogen production occurs, which doesn’t support fertility. Excesses aren’t healthy and cause imbalance. incorrect- redacted. And when this happens, our body language speaks clearly and powerfully. All of this, even if it stems from personal choices, is influenced by a modern, industrialized lifestyle, compounded by the commercial offering of processed, fast, and ready-to-eat foods, productivity-driven existence, and thus a disconnect from nature and a disregard for circadian rhythms, along with hormone-disrupting chemicals and the enormous amount of microplastics we ingest every day.
How does fertility affect our emotions?
In TCM, when discussing emotions in relation to fertility, the first aspect to consider is the heart. An additional meridian called the Bao Mai, which connects the heart to the uterus. The Bao Mai mediates emotional effects on the menstrual cycle and uterus. It is essential to have it clear, without qi blockages, to promote the harmonious flow of blood and Qi. Prolonged emotional anxiety, combined with a lack of blood, can affect the uterus, Qi, and our fertility. The Liver meridian is also intrinsically involved. It determines the harmonious flow of Qi and blood throughout the body and is therefore also responsible for regulating the menstrual cycle. Very often, when my clients experience very painful periods, there’s a stagnation of Liver Qi that manifests itself before the period with depression, sore breasts, headache, frustration, anger, or even an inability to express one’s emotions. In this case, TCM treatments and even yin yoga or qigong to stimulate the meridians are essential.
How can Traditional Chinese Medicine help us? Do you have any tips that Bloom as You Are readers can use at home?
The kidney meridian is the most important when it comes to fertility. It’s connected to the uterus, and since it’s the only traditional meridian that starts under the sole of the foot, it represents the very roots of life. Furthermore, the kidneys contain Jing, the ancestral energy that determines our well-being and lifespan. Therefore, it’s important to always keep both the kidneys and feet warm, because walking or sitting on cold surfaces contracts the cold energy into the Kidney channel. In TCM cold feet equal a cold womb, which restricts blood circulation. You can take hot foot baths and apply heat packs to the lower abdomen. To strengthen, nourish, and warm the flow of Qi, you can also eat ginger and cinnamon. To help the uterus, you can also apply moxibustion (mugwort) at home. For the uterus, moxa is a wonderful tool. You can do it yourself. It penetrates the birth canal and the uterine space. It’s warm and relaxing for the muscles, benefits uterine blood circulation, helping to support our yang energy and make it more fluid. A healthy uterus is synonymous with healthy fertility. TCM also supports us through acupuncture tailored to the specific situation and personalized herbal formulas. One of the most important things is keeping the nervous system calm. A healthy diet rich in iron-dense vegetables, goji berries and red dates nourishes the blood, whilst black sesame and walnuts are great for kidney health, growth and development. Adequate rest and relaxation are essential to preserve Kidney Jing, the genetic component of fertility.
Lately, there’s been a lot of talk about late-life motherhood. Some call it an easily accessible condition, others speak with judgment, and still others argue that there’s little information about it and that many women don’t consider the possibility of having more difficulty getting pregnant at an older age. What are your thoughts on this, based on your perspective as a Chinese medicine doctor?
It’s a very sensitive topic. I believe late-life motherhood should be a free and accessible opportunity for all, as it is now. There’s a lot of misinformation in both directions. Some influencers and celebrities, in my opinion, communicate this possibility too easily. “I’m 50 and I’m pregnant,” downplaying the reality of how difficult it can be to get pregnant at a certain age, the arduous journey many women face. But this is a challenge that many women face today, regardless of age. At the same time, many doctors and scientific publications scare young women by saying that if they don’t try to conceive before age 35, the medical threshold for declining fertility, they can no longer get pregnant. This isn’t true because fertility begins to decline very slowly and gradually, and this decline is influenced by many factors, including those we mentioned previously, which affect our health. I believe it’s a nuanced conversation because every person is unique. There are very mature women who have gotten pregnant at an advanced age without problems, while others had difficulties when they were younger. My advice to those who want to have a child at an advanced age is to prepare themselves to maintain their fertility. And this advice certainly applies to our health globally, not just to pregnancy. Specific herbal treatments, acupuncture, and so on, are impactful in creating the optimal conditions for welcoming pregnancy. From a social perspective, the possibility for women to choose this is indisputable. Whether they want to do it with a partner or alone, if there’s a desire for conscious motherhood, I believe there should be no limits. Just like if a woman decides not to have children. Whatever the decision, the important thing is to support our body, listen to it, and maintain its balanced functioning for our profound psychological and physical well-being.
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