Menstruation and Fertility
I am going to start off my new column with a subject that is near and dear to my heart: fertility and menstruation. Today, many women are delaying childbirth into their 30s and early 40s. We are now generally filling our 20s with career-building or fun, and waiting until we have "sown our wild oats" and/or are more established before we start trying to have kids. There are many benefits in doing this - we are more mature, hopefully wiser, and are more prepared to take on the responsibility and sacrifice that is the life of a parent. However, one of the main drawbacks to waiting until later in life to have kids is that it is more difficult to get pregnant as we age. This decrease in fertility is especially marked in women.
One of the main reasons for this is a decrease in egg quality in women as they age. Women have all the eggs they are ever going to have at birth. In fact, the egg that was destined to be you was present in your mother's ovaries when she was still inside your grandmother's womb! In men, on the other hand, new sperm is made all the time and takes about three months to mature. The main fertility disadvantage with having all your eggs at birth is that anything a woman experiences over her lifetime, including in her mother's womb, affects those same eggs she is now trying to turn into a baby.
Every chemical or radiation exposure she experiences, her eggs also experience. As a woman ages, the cumulative effect of all these exposures build up. Unlike the other cells in her body that constantly grow, die and replace themselves, the same eggs are always there slowly, steadily being subjected to the vagaries of life. Consequently, the quality and viability of those egg cells diminish over time. The other major factor in overall egg health keys upon the quantity and quality of blood flow.
Imagine your ovaries as egg gardens or seed repositories. Those eggs are living things - dormant, yes, but alive still. Like any living thing, they need a constant supply of air, food and waste removal to remain viable. In this seed repository, the nutrient delivery and waste removal are performed by the bloodstream. A woman's eggs require a constant, steady flow of good-quality blood over her entire reproductive lifespan, or the eggs become less able to perform the task they were born to do - provide half the genetic material of a new baby.
Of the many different factors that affect blood flow to the reproductive organs, stress and diet are the main ones. Here, muscle tension and the resultant reduction in blood flow are the main culprits in how both nutrition and stress affect egg quality.
It is common knowledge that unsaturated fats are better for us than saturated fats. For egg health, there is a more specific reason to include more of the good fat in your diet. In the body's biochemicals, called prostaglandins, are big players in the muscle tension game. The more muscle tension a woman experiences, the more likely the blood flow to the reproductive organs will be adversely affected. (Interestingly, research from the University of Gothenburg, Sweden, demonstrates that acupuncture positively affects the pulsatility index [the Western medical measurement for blood flow], and therefore blood flow, for the uterine and ovarian arteries.1) Eating saturated fat leads to specific prostaglandin formation in the body that promotes muscle tension. Eating unsaturated fat leads to specific prostaglandin formation that promotes muscle relaxation. Other "stressful" foods, such as caffeine and white sugar, have the same effect as the saturated fat. This effect on muscle tension is not limited to egg health. Avoiding saturated fat and the other foods mentioned, while eating more unsaturated fat, especially in the second half of a woman's cycle, can help alleviate lower abdomen muscle tension and thus, premenstrual and menstrual cramping.
The next big muscle-tension monkey is stress. Today, "stress" is a ubiquitous term that covers almost anything unpleasant that we experience. The definition for stress that I am using is an inability to respond appropriately to our environment. There is no judgment involved in my use of the term stress. Here I am only writing about being overwhelmed by our life's current circumstances. The main effect stress has on our bodies that we are interested in here is - you guessed it - muscle tension.
Some amount of stress is healthy and necessary to lead interesting lives; however, when we over-experience stress, the body responds by getting tight. The stronger-than-normal menstrual cramps a woman experiences after a particularly stressful month are a good example of the relationship between stress, muscle tension and the reproductive system.
The odd stressful month does not have a large impact on egg quality; however, for many, stress is a chronic companion. My typical late-30s fertility patients are busy folks who have well-established careers that they have dedicated well over a decade of their lives to in developing, and routinely work at least 60-hour weeks. Most of them do not even have time to notice they are feeling stress and have been "not feeling" for most of their adult lives.
Back to the point about ovaries being gardens that need constant watering. You can imagine that stress over a long period of time, and the resultant muscle tension and persistent slowdown of blood flow, leads to seeds that are drier and less robust than the well-watered ones. I do not want to end this column on a doom-and-gloom note. All hope is not lost. Most gardens do just fine once the regular watering is resumed. Stay tuned next time for the Chinese medicine perspective on healthy menstruation and fertility.
- Stener-Victorin E, Waldenström U, Andersson S, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Human Reproduction, 1996;11(6):1314-7.
Click here for previous articles by Kaleb Montgomery, DTCM.