secondary infertility

Menstrual Phases (Part 2): Menstrual (Blood)

According to the yin/yang model, the blood phase governs the 12:00 to 3:00 position.


The beginning of the menstrual cycle is heralded, as all new beginnings are, with a release. A viable pregnancy was not supported. The corpus luteum involutes, progesterone levels and temperatures drop, and as one cycle turns over, the next one begins with letting go. This is a crucially important time. Energetically, the lung initiates the movement of release. Like a finger on top of a straw, when its holding capacity is withdrawn, the liver directs the release of menstrual blood, as the heart-kidney axis pours its heavenly essence through the vaginal canal. The bao mai or envelope of potential, causes the uterus to liquefy and shed its lining.


The energy of this internal channel, directed inward and downward, must be unobstructed. There must be an outlet through which the life force, in the form of blood, can flow. Energies are directed within and down, not up nor without. We release and let go. With any process of letting go and moving on, there is sadness and loss.  We may feel depressed. That’s because the energies are depressed. This is natural and normal, and nothing to be resisted. Grief experienced and expressed, allows a new cycle to begin. If we inhibit this movement, we can halt the resetting of a new cycle, upsetting the delicate balance. For example, if we do not experience the internal sadness and instead cover up with a false positive attitude, we are going against the flow of nature. If we overindulge in despair, we can cause too much of this downward movement, holding the energies of renewal down, inhibiting a new cycle of creation.


This can result in blood stasis, where the blood remains congealed in the channels, blocking the upcoming cycle. During the blood phase, we are to be at rest. TCM tells us not to expose ourselves to severe temperatures, too much exercise, immersion in water, or intercourse. Because the cervix is open, it can take in during this time if we are not calm and releasing from within.


Any disruption of the natural flow can result in blockage of the heart kidney axis, counterflow qi, blood stasis, and inability to turn over to initiate a new hormonal cycle.


Days 1 – 3 of the menstrual cycle indicate the menstrual expulsion, and the hormonal resetting. If this cycle is complete, estrogen, progesterone, and FSH should be at a low on day 3. Complete release then initiates a rise in yin. Hormones will start to rise; the uterine lining will start to fill.


Scanty blood flow – blood deficiency; the uterine vessels have not received adequate nourishment.

Early menses, spotting – can be due to blood stasis, heat, or qi deficiency

Continued bleeding – same as above, interrupting the “reset” of  a new cycle.

Failure of temperatures to drop – heat, inflammation, incomplete release

Pain during menstruation – cold, blood stasis, qi stagnation; interrupted outflow

Emotional stagnation – unwillingness to go within and experience the full release

All of the above issues can be obstructed by blockage in the heart-kidney communication. The vibrant energies of the life force, love itself is not adequately directed to or not capable of being received by the deep kidney energies.

Menstrual Phases (Part 1): Shen

Endocrinology + Gynecology = Potential for Life Introduction to the Menstrual Cycle: Part I

On the left, we have the energetic generating cycle of the endocrinological system, whose job it is to respond to the patterns in life that are already in existence.

On the right, we have the Taoist cross model of interaction, which illustrates the ability to jump to a higher level of possibility - evolution. This also allows us to look at the interface of the “reverse generating” cycle, which takes us into the “preheavenly” realm, where the unborn is brought into the earthly realm.

The menstrual cycle is the interplay between the generating (hormonal) cycle, and the reverse generating (menstrual) cycle.

During menses, the full uterus empties itself, and the hypothalamus returns to a zero point to reset the entire process. At ovulation, the full ovary empties itself, as the hormones are high. The generating cycle creates hormones in response to the way we perceive the world. The reverse generating cycle occurs invisibly beneath the surface, pulling out possibility based on the interface between our response to the world and how the spirit of existence wishes to manifest itself as a reply to the messages we have transmitted.

12:00 – onset of the blood phase.

The uterus empties itself as the hormones begin to rise.

3:00 – we move into the yin phase.

Hormones support follicular growth and proliferation of the uterine lining.

6:00 – yin transforms into yang.

Yin and hormones peak as a conversion occurs to a more active secretory endometrium.

9:00 – we enter the qi phase.

The uterus will either hold, or direct a new cycle to begin. Hormones will either rise to support conception or will reset to begin another new cycle.

We will go over each of these cycles in more depth as we look at the interactions, hormonally and gynecologically between the earthly generating and pre-heavenly cycles of conception.

A Doctor’s Role in Fertility

I just finished our annual retreat with our Continuing Excellence in Fertility Professionals, where we combine personal introspection, TCM education, qi gong, and a Taoist view of the elements. The universal view of the order that govern all of life is:

The Blood follows the Qi.

The Qi follows the Xin (Heart/Mind)

The Xin follows the Shen (Spirit)

The Shen follows the Tao.

In this model, Blood = the physical body, and the mental and emotional functions which it embodies. It is the last in line. When we, as practitioners, work at the “blood” level, we are relatively inefficient if we are not concurrently working at the energetic level of the heart’s wisdom, which follows the workings of the spirit, which is the universal Way of all things.

When a doctor is trying to manipulate the Blood level while neglecting the other levels, there is no therapeutic change. While the form may adjust itself slightly, when there is no change at the level of Qi and higher, there will be no lasting change at the manifest or Blood level.

You cannot change egg quality by working only at the level of the blood. Therefore, changing your diet and taking supplements while neglecting the way you respond to the world will have little effect. If your energetic reaction to the world is one of stress, protection, and survival instinct, it will lock the Blood level in place. Changing your diet, then, while improving the level of manifestation, will not reach the level of potentiality, which is of Spirit.

A doctor at retreat asked me, “So what’s the use?” Why do we use acupuncture, herbs, diet, and lifestyle adjustments if all true change happens at the level of spirit?

The answer is that we work at the level of the Blood and Qi in order to bring someone into the recognition of true changes that occur at the Shen level. If a doctor is not accessing the Spirit level, true transformation is not possible – only slight manipulation of the form. While at the level of Blood, we may improve the menstrual flow somewhat, lower FSH temporarily, and improve mental outlook for a cycle or two, these changes will not be lasting. They will not reach the level of potentiality, which is of Spirit.

The Nei Jing tells us, “Of course, before needling, we must be rooted in Spirit.” If your doctor is not rooted in spirit – her own and yours, she is practicing at the level of Blood. The ancients called these practitioners “technicians.” While they could diagnose and needle, they didn’t have the power to transform.

All true transformation occurs at the level of the Heart, which houses the Spirit, which gives rise to all potentiality. Here, egg and sperm quality change. Hope is a palpable force, not a weak begging the universe for what you want. The heart opens to allow all possibility. This is true healing; a doctor’s highest role.

A Little Bit Pregnant

You can’t be a little bit pregnant; you either are or you aren’t.  We can laugh at the absurdity of thinking otherwise. This analogy, used to illustrate definitives, brings the mind to one side or other of the equation. Yes or no; black or white; no room for gray. I’m going to be a parent or I’m not. What happens, though, when we are forced to live in the gray zone?  I might be; I might not be; I don’t know. On this journey, we are always just a little bit pregnant with possibility. Few of us are comfortable with the state of limbo. Who wants to live in the state of “I don’t know”? Who doesn’t want the brightness of certainty? Yet, we seem to fear the gray zone more than we fear the darkness. If I know that it will be, I will power through anything; if I know it will never be, I won’t like it, but I will learn to accept it. One side or the other; yes or no; black or white; no room for gray.

See if you have the courage to live in the gray zone for just one day. Try residing in the state of “I don’t know” all day long. The mind lives in definitive sides of life; but life itself resides right in the middle. There is a great wonder there. This is the place where miracles occur.

Many people ask me how to let go when the desire is so great. How can I not hold on to the reins of life and direct it the way I want it to go? Life seems not to be responding to my desires in my timeframe. Therefore, it must be no. Yet, because of this enormous desire, it can’t be no. It must be yes. But it can’t be yes because…. Conflict ensues because it isn’t one side or the other. It is both.  Yes and no; not now; maybe later; gray. Yuck.

Yet, the middle way is not a bland acceptance – it is vibrantly alive with the glimmer of all possibility. When we aren’t demanding life appear in a certain way, it can flow as it must.  The spirit of existence, which flows through the heart and gives birth to all things, lives in the state of not knowing. It loves the miraculous, eternal expression of unknowable potential. Anything else is limitation. The flow of life does not respond well to absolutes. Feel the energetic contraction of the fear based, demanding mindset –

“I know it must be the way I want it, now!” vs. “I don’t know how it must be, but I’m open to it.”

If you can try this out for just one day, and then start expanding it, you will be amazed at the results. It will eliminate the energetic contraction that closes you off from the miraculous flow of life. Give it a try. And keep practicing it until something inside clicks – the vibrant current of life itself, sparked into miraculous existence when we are willing to let go of the reins of control.

Stop the Problem Solving Approach!

Chinese medicine is based on the maintenance of harmony. Yet how can harmony be maintained?  I used to think of harmony as synonymous with balance - almost like walking a tightrope where the left and right sides have to be equalized. This is how many people approach healing and fertility, too. Moderation, balance, harmony. Not too much of this, not too much of that. While it is true that too much of anything will make the organism unstable, life carries a miraculous ability to return to equilibrium with or without our help. We do not have to keep ourselves walking the tightrope of life, too afraid to be set off balance. Life is meant to be lived, fully, vibrantly, and sometimes in excess.

You don't grow your hair, beat your heart or create skin cells. Nor can you create a baby through living a controlled life.

I recall a woman I treated who went through an IVF cycle just before the holidays. She carefully managed every controllable aspect of her life, yet her pregnancy test came back negative just before Christmas. So distraught at the unfairness of life when she did everything right, she went to the other extreme - eating and drinking in excess, smoking cigarettes, staying up late and partying until New Year passed. She never got her period. The next pregnancy test came back positive. And yes, the baby was just fine, adjusting to the excesses that are a part of life.

Remember when our mothers thought it was ok to drink, smoke and even diet during pregnancy? We turned out kind of okay. Obviously, I don't advocate this. Moderation and balance tend to induce health and well being. But what we can control needs to be balanced with what we cannot. We can't control life itself. Life is not a problem to be solved; it is an organic process to be lived. We try, we fail. We fall, we get back up. Sometimes life works out the way we expect it to, sometimes it doesn't. We go on and do the best we can, laughing, crying, and  making it up as we go along. Life is not composed of rules to be followed.

Life is the way it is, not the way we would have it be. Our individual life expression is always in harmony with the whole. It's laws are carried in the heart, subject to a higher law than imposed order. The Tao te Ching tells us that when man forgets the Tao, he creates laws and rules. Order is a poor substitute for the spirit's unimpeded expression

Life comes through the friction of opposites - the highest ecstasy of the lowest expression. Birth itself is violent, messy, and life threatening. yet from it comes a love so tender, nothing can threaten it. Stop trying to control, manage, or fix yourself. Give yourself over to life as it is. Let the spirit of life use you as you are, desires and all. You aren't a mistake to be remedied. You are life's expression, bursting with harmonious imbalance, longing to be expressed!

Falling Pregnant

Trying to make ourselves pregnant is like trying to force sleep. It doesn’t work very well. We fall pregnant just like we fall asleep - effortlessly. Only those who have difficulty sleeping try various methods to get to sleep; most of them fail. Those that are effective are methods which allow their troubled minds to rest, so that the deeper state of restoration takes over. Chinese medicine has a concept of Xin, or heart-mind, which is different than the thought based, conceptual mind, which demands answers, as if it could control life. Xin holds the deeper wisdom of life itself, which is perfectly comfortable not knowing. It moves from the space where miracles occur. It understands that all of life is wondrous in its expression. When an individual resides in her heart-mind, she allows life to move through her effortlessly. She seems to create miracles around her.

What are some ways to move into the space of Xin? Stop letting the thought-based mind lead. Get out of the books, off the internet chat rooms, and touch into the space of your own heart. Literally bring your attention to your heart, as your mind quiets. Let it reveal its own quiet wisdom to you, as you loosen your attention on the demands of the world. Listen to your own intuition instead of giving your power to the medical professionals.

Our attention goes where we direct it. When we direct out attention into the repetitive thought obsessed mind, we are dominated by the brain’s beta-waves. In this state, our blood pressure is highest, our adrenal glands put out more stress hormones, our growth hormone output is minimum, and our blood flows away from the internal organs to feed the brain and eyes. We are not in a receptive state.

When we direct our attention to deeper aspects of our body-mind, especially the heart space, and away from thoughts, worries and concerns, we can access alpha, theta, and delta brain waves, where we drop into deeper states of relaxation. The body directs its inner attention away from the adrenal glands and sympathetic nervous system, and provides more blood flow to the internal organs. Stress hormones decrease. Growth hormones increase. The brain’s feel good chemicals increase.  Our digestive system functions more effectively. And most importantly, the receptivity of our reproductive system improves.

Sleep is a receptive process of allowing. It cannot be forced. So is conception. Feel the beauty in the idea of falling pregnant. Allow yourself to feel whatever resistance you have to the idea, too. It can feel quite threatening to require yourself to “allow” rather than struggle. Many of us are conditioned to feel like the struggle is necessary to achieve the desired outcome. If only this were true – you know you’d already be pregnant. It isn’t true. What’s true is that you already have that which it takes. I invite you to experience your own heart’s wisdom and move into the space where miracles occur.

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Secondary Infertility

Next week, one of our Continuing Excellence in Fertility Professionals (CEFP) members will be co-leading an educational call with me on secondary infertility. There arises a whole host of confusing body-mind issues when there is difficulty after one already has one or more children. Wikepedia defines secondary infertility as difficulty conceiving after already having conceived (and either carried the pregnancy to term or had a miscarriage). Secondary infertility is not present if there has been a change of partners (this follows tautologically from the convention of speaking of couples, rather than individuals, as being infertile; if there is a change of partners, then a new couple is created, with its own chances to be infertile.)

I can’t help but snicker at the last comment, “with its own chances to be infertile.” The conventional medical approach always focuses on what can possibly go wrong. Unfortunately, the more one focuses on what can go wrong, the more likely it will manifest. But I digress.

I suffered from “secondary” issues. I had no trouble conceiving my daughter. Once you have experienced the miracle of giving birth to a child, it brings up an added element of frustration – why can’t I do what came so easily before? Now you compound that with a hefty dose of guilt for wanting more of what you already have, and you become an energetic mess inside.

After you give birth to a child, your entire physiology can change. Energetically you might become deficient in blood or essence. Your spirit energies might be scattered. Your qi may become depleted. Your body may become more reactive, and reject another pregnancy. Your relationship with your partner may have changed. You may feel more strain in your life with less support. The demands of motherhood change you at every level. If you “try” from a deficient energetic starting point, it will be more difficult. When you add the guilt and frustration to the equation, the pattern of imbalance can consist of deficient blood, and stagnated qi, not allowing access to the already deficient reproductive essence.

When we view the individual presentation through the lens of TCM, we address the pattern, deal with the stagnated qi brought about by the conflicted emotions, and open up to life again.

Every pregnancy is different. You are a different person with every pregnancy. In fact, you change with every menstrual cycle. Certain patterns repeat themselves, especially the more you have habituated yourself in these imbalanced patterns of expression.

The good news is, when these patterns are identified and corrected, fertility can open up again. I’d like to make a new definition of secondary infertility that includes a deeper ability to pay attention to how life is affecting an individual, right now, that may be different than in the past. It actually provides us with an opportunity to become more fertile than ever before.