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Male Factor Infertility

Sperm health is declining in the Western world at worrying rates, with sperm counts having dropped around 50% in the last 40 years. There is now some limited data to show that this not just be restricted to the West, and may in fact be more widespread.

 

Research shows that between 1973 to 2018, the levels of decline in the West were 1.2% annually, but since 2000 those figures have accelerated to 2.5% every year. 

 

Currently 1 in 7 couples experience infertility, and 30% of those are solely male factor related (and another 30% down to a combination of both male and female factor). As such, male factor infertility is now the primary cause of couples seeking IVF treatment. Deteriorating semen quality and male reproductive health is beginning to escalate into a general fertility crisis. 

 

Why is this happening? 

 

Recent research (Kortenkamp et al, 2002) suggests the answer may be complex, with lifestyle playing a part (including recreational drug use or smoking during pregnancy being possible components), but also that exposure to chemicals looks to be contributing factor. Perry (2023) suggests use of pesticides is also playing a role in this decline, while Osadchiv et al (2024) argue that the semen microbiome (and in particular high levels of the bacteria lactobacillus iners) may be affecting semen parameters.

 

So what can be done?

 

Perry et al recommend trying to limit exposures to BPAs and other forever chemicals and caution expectant mothers at the beginning of pregnancy to avoid paracetamol unless specifically advised by a doctor. Other suggestions from recent studies include thorough washing of vegetables, avoiding alcohol and smoking, exercising regularly, minimising stress, avoiding processed foods, and eating a diet rich in antioxidants, probiotics and fibre.

 

What are the common issues that men face with fertility?

 

  • Suboptimal semen analysis (ie motility, morphology 
  • varicocele (a pooling of blood in the veins around the testicles, leads to DNA fragmentation) – 10-15% of men affected. In couples experiencing infertility this goes up to 40%
  • Azoospermia (no sperm in the ejaculate -affects 1 in 100 men). Can be obstructive or non obstructive)- referral to urologist needed, as this can be worked on 
  • Hormonal imbalance 
  • Infection
  • DNA fragmentation – can be a cause of embryonic development failure and recurrent miscarriage
  • oxidative stress – usually caused by lifestyle / infection – needs to be within a certain range to help with hormone balance
  • Testicular trauma
  • History of undescended testicles
  • History of mumps or glandular fever

 

How can working with a practitioner help?

 

  • knowledge and roadmapping of testing and available options, referrals etc 
  • Working with diet, lifestyle and supplementation which can have a huge impact on sperm health
  • Emotional support 
  • Stress management 

 

When I work with couples experiencing infertility, I always look at both sides of the equation – both male and female. Get in touch to find out more.

Burnout

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Burnout is a chronic state of stress which leads to physical, emotional and mental exhaustion.

 

Cases of burnout are becoming increasingly common due to societal and work pressures and in societies where there are fewer boundaries – in today’s fast paced world we’re often expected to be constantly productive and always available. 

It can (and does!) happen to anyone – not just the stereotypical city worker. In fact, it’s more common amongst younger people and women, as well as those in caring professils as people tend to over-give, to the point of exhausting themselves.

It can be a very gradual process, starting with enthusiasm which eventually leads to exhaustion, often over several years. People experiencing it often don’t realise that they’re experiencing burn out initially and sometimes there’s a sense of shame that surrounds it, or a feeling of failure.

 

It can seem hard to know where to turn if you’re experiencing burn out, or what to do.  Most advice seems to be centred around individual failings…i.e. to exercise more, holiday more, ‘do’ more, ‘care’ less – often people are in fight and flight so this advice isn’t always very helpful.

 

Signs of burnout:

  • Environmental triggers – usually something has changed in environment, which means that more energy is being expended, or something  introduced with more demands (new job, relationship issues, extended working hours, difficult project etc) so our levels of stress increase
  • In addition to this, often something isn’t working in that change of environment – not enough time, increased responsibility, not feeling valued, lack of resources etc. Personal values are compromised and there is usually a feeling of a lack of support / lack of control 
  • Then follows adaptive behaviour – compromising boundaries or taking less responsibility for self care / reducing non-essentials in life (resting, having fun etc)
  • Typically we try to exert more energy to combat this, we try harder, or work longer, telling ourselves if I try harder, do more, or give more, things will get better. Or we feel powerless to change, and think we have to put up with things
  • In Polyvagal theory, when people are burning out they are in fight and flight and then dorsal vagal (feeling emotionally unsafe, hyper vigilant)

Burnout has a profound affect on the body and mind and can include the following signs and symptoms:

  • Headaches
  • Fatigue
  • Digestion issues 
  • Brainfog 
  • Nausea
  • Feelings of overwhelm or helplessness 
  • Procrastination 
  • Irritability 
  • Changes in appetite and sleep

Sometimes we try to deal with strong feelings but addictive behaviours, such as numbing with alcohol, excessive social media use, over exercising, recreational drugs etc 

The following can be helpful in addressing burnout: 

  • Acknowledging whats happening 
  • Frequent checks in with the body
  • Visiting a talking therapist and / or bodyworker 
  • Getting support on the situation that’s changed
  • Seeking help from friends and family
  • Not judging yourself 

How acupuncture can help:

In Chinese Medicine, burnout is often associated with the Kidneys (and adrenals), which influence our hormones and response to stress, shock, fear and trauma. The kidneys are considered to be our ‘Gate of Life’ as they house our Qi (energy) and Jing (vital essence). Acupuncture can help to treat burnout by: 

  • Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010)
  • Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain’s mood chemistry to help to combat negative affective states and increase relaxation and reduce tension (Lee 2009; Samuels 2008; Zhou 2008; Yuan 2007
  • Down-regulating the body’s flight or fight response (Arranz 2007)
  • Increasing the body’s natural opiates and endorphins (Arranz 2007)
  • Reversing stress-induced changes in behaviour and biochemistry (Kim 2009).
  • Reversing pathological changes in levels of inflammatory cytokines that are associated with anxiety (Arranz 2007)
  • Increasing cerebral blood flow (Yan 2010) reducing sympathetic nervous system activity, hence increasing relaxation (Lee 2009a)
  • Increasing circulation to relax tight muscles and reduces joint stiffness (Komori 2009)
  • reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003).
  • reducing insomnia through increasing nocturnal endogenous melatonin secretion (Spence 2004).
  • Improving the body’s immune system (Liu 2003)

Immunity Boosting, Chinese Medicine & Covid-19

What is the Immune System?

You’ve probably heard about the immune system and its role in the prevention of sickness and fighting off viruses and bacteria, but what is it exactly?  It’s a complex network of cells and proteins that defends the body against disease or other potentially damaging foreign bodies. When functioning properly, the immune system identifies threats, including viruses, bacteria and parasites, and mounts an immune response to protect the body.

How Do You Boost The Immune System?

Boosting immunity means maximising potential for the immune system cells to readily do their job.  If the body is perfectly healthy and functioning, this will be much easier.  If the body is taxed by stresses, illnesses, or malnutrition, it will be harder.  This is why, in Chinese medicine, the focus is not always on strengthening the immune system specifically, but rather the whole body to allow the immune system to function optimally.  Since the immune system resides in the blood and lymphatic system, proper circulation of these systems is essential to good health and must be promoted.

How does Traditional Chinese Medicine Boost the Immune System?

First and foremost, proper diet and exercise are fundamental, and the key to having a healthy and fully functioning immune system.  In addition to this, there are some amazing herbs and acupuncture/acupressure points to boost the entire body and immune system. 

What Can I Do to Strengthen Immunity with Diet?

Nourish blood: 

Nourishing blood ensures proper circulation in the body and helps the organs to function.  It helps to moisten and warm the body and tissues and transports oxygen and nutrients around the body.

Foods to include:

  • Animal protein: bone broth, red meat, chicken, lamb
  • Vegetables: mushrooms (especially oyster and shiitake), root veg such as squash, sweet potatoes, pumpkin, turnips, carrots, garlic, onions and leeks, dark leafy greens (combine with vitamin c to aid iron absorption)
  • Fruit: stewed fruits and fruit such as goji berries, figs, prunes, cherries, pomegranate
  • Herbs and spices: nettles and nettle tea
  • Other: eggs, sesame seeds, seaweed and algae

Strengthen the lungs & digestive system and reduce phlegm:

Foods to include:

  • Cooked and easy to digest foods
  • Whole Grains: small amounts of legumes and grains e.g. rice, oats, barley
  • Herbs and spices such as garlic, fresh ginger, fennel, turmeric and nettle
  • Vegetables: watercress, onions, radish, mushroom, sprouts, potatoes
  • Other: fruit, sprouts, seaweeds
  • Eat simple small meals and include foods that are easy to digest

Foods to avoid:

  • Excessive amounts of raw vegetables, fruits and salad.
  • Avoid dairy products as they are mucous producing
  • Minimise sugar and sweets as they weaken the digestion
  • Avoid cold foods and foods that are hard to digest. Ice cream, iced water, cold smoothies etc can all slow the digestion down and cause phlegm/dampness to build

What else can I do?

  • Foods known for their anti viral properties include – garlic, onion, ginger so make sure you’re eating plenty of these 
  • Limit stimulants such as coffee, alcohol and nicotine
  • Take medicinal mushrooms (particularly cordyceps)
  • Chinese herbal medicine: herbs can help to modulate the immune system and have been used alongside western medicine in around 85% of cases in China to combat Covid-19.  Many herbalists are offering remote sessions and delivery of herbs during this time, so do get in touch if you’d like a referral
  • Adaptogens such as ginseng help to boost energy
  • A good probiotic (ie Symprove) helps to strengthen gut flora 
  • High levels of vitamin C have been shown to help ward off viruses and trials are currently underway in China to test the efficacy of this against Covid-19.  Vitamin D and Zinc may also be helpful 
  • Qi gong and breathing exercises can help to strengthen the body’s energy and lung function so try spending a few minutes building a regular practice – there’s a routine here, and lots more available on YouTube: https://youtu.be/Sv7IvgwR6hk
  • Get lots of sleep! Wind down before bed and incorporate calming things such as meditation, sound journeys to help de-stress and improve sleep quality.  There are lots of free resources out there at the moment for guided meditations, my favourites are the Live Awake series: https://soundcloud.com/liveawakepodcast/s02-dont-forget and Deepak Chopra and Oprah Winfrey’s Hope in Uncertain Times series: https://chopracentermeditation.com/
  • Have acupuncture! Studies have shown that stimulating certain acupuncture points raises lymphocytes, which help to produce antibodies and destroy compromised cells in the body.  The clinic is currently closed but will reopen as soon as the government deems it’s safe.  Please contact me if you would like to go on the waiting list and receive a notification when we re-open.

REFERENCES

Pitchford, P., 2009. Healing With Whole Foods. Berkeley, Calif: North Atlantic Books.

https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/

https://www.ifm.org/news-insights/boosting-immunity-functional-medicine-tips-prevention-immunity-boosting-covid-19-coronavirus-outbreak/

https://en.m.wikipedia.org/wiki/Immunity_(medical)

https://clinicaltrials.gov/ct2/show/NCT04264533

https://classicalchinesemedicine.org/role-chinese-medicine-covid-19-epidemic/

https://pubmed.ncbi.nlm.nih.gov/20709154/

https://pubmed.ncbi.nlm.nih.gov/21616623/?from_single_result=Investigation+of+the+large-scale+functional+brain+networks+modulated+by+acupuncture&expanded_search_query=Investigation+of+the+large-scale+functional+brain+networks+modulated+by+acupuncture

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

https://www.sciencedirect.com/science/article/pii/S1021949814000301

https://pubmed.ncbi.nlm.nih.gov/12856872/

Mental Health Matters

Whether it’s BPD, BDD, OCD, PTSD, PMDD, OCD, SAD, anxiety, depression, panic attacks, paranioa (to list but a few), mental health problems come in many guises and according to figures are on the up, with the increase showing no signs of abating, causing some to call it the epidemic of our generation.

Whether rising statistics are because (thankfully) the social stigma surrounding mental health is finally starting to fall away, meaning that more people are seeking help, or because, as some would have it, we live in an age that contributes to mental health problems, be it via social media, anxiety about global warming, disconnected societies or smartphone addiction, the facts don’t lie, and it is estimated that 615 million people worldwide now suffer from depression and one in four in the UK will experience at least one diagnosable health problem. 

Eckhart Tolle refers to the “pain body”, which lives in humans and is the emotional aspect of egoic consciousness, feeding on negativity.  When it becomes active, it triggers emotional reactions, and hijacks our internal dialogue, interpreting situations and judging – ourselves and others – and distorting the present with old emotional pain. 

In Traditional Chinese Medicine, the mind and body and inter-connected, so when we are emotionally upset, our internal environment becomes disrupted.  Emotions are connected to the organs, and anxiety and depression are usually due to an imbalance of the Heart, Kidneys, Liver, Lungs or Spleen.  The Heart houses the Mind, and is the origin at the centre of all emotions, while the Kidneys are related to fear and phobias. The Lungs are related to grief and letting go, and the Spleen to over-thinking and worry.  Depression is often considered to be unspoken anger, so clearing the Liver channel (which is the Organ linked to the emotion of anger) can be helpful in releasing old frustration and stuck emotions.

So what can be done?  The good news is that just as we maintain physical health, certain practices can help to lift and enhance mood, for example:

– Labelling your emotions – studies have shown that simply labelling emotions actually defuses them, and often anxiety and depression stem from repressed emotions, so going into your body and allowing the feelings can help to release them

– Keep a gratitude diary – our brains are pre-wired to look for threats, as in the past this sense of alertness kept us alive, however in today’s world of fast living where excess cortisol levels run high, this trait does not serve us. However, keeping a gratitude diary helps to rewire our neural pathways, helping us to become more optimistic and increase positivity

– Physical exercise – there’s no shortage of evidence that physical activity releases endorphins, which make us feel good, and which in turn can help to alleviate depression and anxiety

– Mindfulness or meditation – our minds often can caught up in worrying about the future, or ruminating on the past. Practising mindfulness or meditation can help to detract from this, with studies showing that mindfulness can change the brain and help to prevent depressive relapse

– Ensure you’re sleeping well – links have been found between sleep deprivation and depression, so having a bedtime ritual, getting up at the same time each day and reducing screen time before bed can all help to ensure you get the recommended 8 hours a night

– Eat a balanced diet – Mind, the mental health charity states that food can affect mood, give more energy and help us to think clearly, citing that eating regularly, ensuring that we’re getting enough protein, fibre, vitamins and minerals and staying hydrated can reap benefits for mental health, while caffeine and alcohol can affect mood detrimentally

– Find meaning in your life, whether it’s through a career, hobby, caring for a person or pet, or volunteering, having a sense of purpose is fundamental to wellbeing. Vktor Frankl, a psychotherapist captured by the Nazis and forced to endure years in Auschwitz famously said: “Those who have a ‘why’ to live, can bear with almost any ‘how’…. Life is never made unbearable by circumstances, but only by lack of meaning and purpose.”

– Speak to someone: whether it’s a friend or a trained professional, find someone to talk to. There is truth in the old adage that a problem shared is often a problem halved, and there’s no shame in asking for help when it’s needed. There are people out there that can help, so don’t suffer in silence

The Chinese Medicine Guide To Winter

Winter: the ultimate time of Yin, when it’s dark outside, the Yang energy of summer has gone inwards, the trees have lost their leaves and the frost settles.  Daoists believed in living at one with nature and in accordance with the seasons – rising when the sun came up, eating seasonal produce and adapting their behaviour depending on the time of year, so as to fully connect with the environment and keep immunity strong to stay healthy.  Winter in Chinese Medicine is associated with the Water Element and is a time of stillness and quiet.  It is a time to nourish and warm; many animals hibernate and although we don’t have that luxury, we’re reminded of the need to rest in order to nourish our Yin energy and build our reserves up.

Chinese nutritional therapy is an important component of Chinese Medicine and the food that we eat has a profound effect on the body and our health and wellbeing.  Chinese dietary philosophy suggests eating locally sourced foods that grow in season.  Food such as broths and stews are recommended during winter time, as are foods that grow naturally at this time of year, such as squashes, potatoes, root vegetables, winter greens, dark berries and lots of hearty vegetables, such as carrots, mushrooms, cabbage etc.  We should be avoiding raw foods at this time, which are harder for the body to break down, and instead eat lightly cooked foods.  Lentils and legumes, such as black beans help to nourish the Kidneys, the organ associated with the Water element and winter time.  Herbs such as Ginseng can be used to boost energy and help relaxation.

The Chinese believe that winter is a time of inward reflection so meditation is encouraged during winter and gentle activities such as yoga and Qi Gong.  Stay wrapped up and use the wintertime as a time to catch up on some much needed sleep!

What Can Acupuncture Help With

Acupuncture can help with a number of issues.  From hives to hangovers and everything in between.  But it’s easy to make unsupported claims, so let’s look at the evidence instead.

The Cochrane Review provides evidence that acupuncture can help with the following: endometriosis, breached babies, pain management in labour, tension headaches, chronic lower back pain, fibromyalgia, shoulder pain, migraine, osteoarthritis, elbow pain, hot flushes, stroke rehabilitation, schizophrenia and sties.

NICE (the National Institute for Health Care and Excellence) recommends acupuncture for migraines and tension type headaches.

The ACP (American College of Physicians) endorses acupuncture for lower back pain.

WHO (The World Health Organisation) lists the following for which acupuncture has been proved -through controlled trials – to be an effective treatment: adverse reactions to radiotherapy and chemotherapy, allergic rhinitis, biliary colic, depression, dysentery, facial pain, headache, knee pain, lower back pain, morning sickness, nausea, neck pain, toothache, shoulder pain, post-operative pain, renal colic, period pain, rheumatoid arthritis, sciatica, sprain, stroke, tennis elbow.  It also lists the following has having shown some therapeutic effect in trials when treated with acupuncture, but that further trials are needed: acne, abdominal pain, alcohol dependence, bell’s palsy, cancer pain, earache, eye pain, female infertility, facial spasm, fibromyalgia, herpes zoster, insomnia, labour pain, Meniere’s disease, addiction, Raynaud’s syndrome, schizophrenia, sore throat, tonsillitis, spine pain, stiff neck, Tourette’s, vascular dementia and whooping cough

Acupuncture is now being widely used and accepted as more and more people are finding out how it can help them.  Book now and find out how it can benefit you.