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Herbal therapeutics in

female infertility

Herbal practitioner:
Carole Guyette MNIMH
History Taking for Fertility Problems 1

 Delay in conception
 Duration

 Previous

investigations/treatments
 Effect on client's life
History Taking for Fertility Problems 2
 Menstrual History
 Menarche - age & how it was experienced
 Menstrual cycle - length/regularity/changes
 Dysmenorrhoea - self help?
 Premenstrual symptoms
 Blood: colour/flow/clots/ease LMP
 Use of pads/tampons - how many? Symptoms
related to ovulation -
History Taking for Fertility Problems 3
 Mittelschmerz

Mucus changes, bleeding


Bleeding irregularities - post

coital, stress...
Feelings/comments re cycle &

others' perceptions
History Taking for Fertility Problems 4
 Reproductive History
 Previous pregnancies
 Same/different partners
 Time taken to conceive
 Health during pregnancy
 Outcome - incl terminations, miscarriages
 Residual feelings/body/cycle changes
 Labour & delivery, term/pre-term
History Taking for Fertility Problems 5
 Sexual History
 Intercourse
 Frequency

 Enjoyment

 Lubricants

 Dyspareunia

 Difficulties
History Taking for Fertility Problems 6

 Past contraceptive history


 Preference, changes, "failures"
 Oral contraception - Duration, time of

cessation, resumption of menses, side


effects
 IUD - symptoms of infection
History Taking for Fertility Problems 7

 History
of Mothers
and Grandmothers
 May reveal interesting
patterns/attitudes
History Taking for Fertility Problems 8
 Past Medical History
 Pelvic inflammation
 STDs
 Peritonitis
 Pelvic operations
 Tubal pregnancy
 Appendectomy
 Drug therapy
 Endocrine
 Weight change
 Galactorrhoea
 Hirsutism
 Acne
 Smears
History Taking for Fertility Problems 9
 Social History
 Occupation & intentions
 Domestic circumstances
 Relationship with partner
 Diet
 Smoking
 Alcohol
 Stress
 Exercise
History Taking for Fertility Problems 10

 Psychological history
 Reasons for wishing conception
 Conflict re. conception

 Depression

 Previous psychiatric problems


Female Infertility/ Sub-fertility

 What is cause?
physical/emotional/mental
/spiritual
 What block/s prevents

successful pregnancy?
Case History Taking

 Ideally see both parties


 Fully assess nutritional status/ alcohol,
cigarette or drug use/ exercise/ stress/
lifestyle/ environmental factors
 Further investigations?
 Treat underlying pathology e.g. Endo,
PID, PCOS, Infections such as
Chlamydia, low thyroid function…
Common presentations

 failureto conceive (no


underlying pathology)
 recurrent miscarriage

(includes implantation failure)


Diet/supplements/lifestyle

 Foresight 99% success – hair


mineral analysis
 Exercise aerobic 3-4 x weekly
 Yoga, Tai Chi
Woman slow to conceive/history
of miscarriage
 Spend 3-6 months preparing woman
(improve general health & hormone
balance)
 Don’t try to conceive in this time
 Set time limit with patient e.g. 12months
(to review)
 Inspire hope/ positive thought; identify
blocks
 Avoid blame – remember that everything
happens for a reason – ?unknown
Herbs contraindicated in pregnancy
 Toxi c herb s: e.g. Phytola cc a, Sangu in aria , Aconit um, Bry on ia
(L obe li a ca n be useful for threa ten ed misc arri age & in
ch il dbir th ) (Ge ls emi um ca n be usef ul in childbi rt h). In tern al
use of es sen tia l oils due to hig h ris k of ov er dos age (s mall
qu antit ie s fin e in flavouri ngs )
 Oth er her bs :
 Ang el ic a s in. – no t in 1st tri mest er
 Art em esi a sp p. - no more than 50 0mg /day
 Caulo phyl lum - onl y take in l as t 6 week s
 Cheli donium – no m ore t han 100 0mg/d ay
 Dat ura – susp ect ed terat og en
 Ment ha p ul eg .
 Pet ro se linum – due t o a piol co nt ent (neg ligible i n Ap ium)
 Peumu s bol do
 Rut a
 Sarot hamnus
 Tanac etum part heni um – no more than 50 0mg/d ay
 Tanac etum vul gari s
 Thuj a
 Vi scum – onl y tak e i n last 6 we ek s
 Zi ng iber – no m ore t ha n 2 000m g/d ay
 Panax ginsen g – onl y at d eli very
 El euthe ro co ccus
Herbs to avoid at high dose > 3g daily
(i.e. 6ml 1:2, 15ml 1:5, av. 2 teasp dried)
 Achillea
 Aesculus
 Angelica arch.
 Barosma betulina
 Berb spp.
 Hydrastis
 Juniperus
 Lycopus
 Salvia
Herbs to use with caution
 Essential oils external use –
 Cinnamon, nutmeg (these 2 useful for
massage in last few weeks), myrrh, clary
sage (useful for delivery), jasmine,
juniper, pennyroyal, marjoram, oregano,
cypress, thyme, sage, savoury,
wintergreen, hyssop, basil, aniseed,
fennel
 Laxatives (avoid though probably safe at
normal dosage)
 Aloe, Rhamnus, Cassia, Rheum
Herbs for infertility
 FAILURE TO CONCEIVE
 Problems with ovulation and/or cervical mucus
 usually strong hormonal component

 e.g. amenorrhoea - post-pill, commonly seen


after shock or bereavement, excessive
exercise, seriously underweight/overweight…
VITEX
 Sperm antibodies – what’s going on in
relationship?
 ensure patient knows fertile times

 MUCUS CHART Monitor mucus and other


signs of ovulation (e.g. mittelschmertz/temp
changes)
Herbal Therapeutics in Female Infertility

 Ovulating and no known reason for not


conceiving
 What is condition of tissues? (incl
emotional/mental blocks) What actions
required?
 Cleanse toxins – individual needs, ensure

no GU infection, fertility treatments?


 Tonify/nourish/rebalance/relax/stimulate

etc…
Fertility tonics
 Useful herbs:
 Chamaelirium (cultivated) – prime fertility herb, magnificent uterine
and ovarian tonic, strengthens pelvic tissues and promotes pelvic
nutrition. Up to 30ml/week
 Rubus – strengthens and tones pelvic muscles, relaxing at same
time. Soothes kidneys, tones mucous membranes. Tea or tincture
- up to 40ml/week
 Relaxes uterus when contracted, contracts uterus when relaxed.
 Provides excellent support. Emotionally - helps soften the heart and
allow for greater receptivity and intuition.
 Viburnum prunifolium – uterine sedative, anti-spas, relaxant to
uterine muscle,
 spec. for uterine irritability & painful conditions of pregnancy
 improves uterine & ovarian circ > promotes pelvic nutrition
 Strengthens pelvis after prev. miscarriage
 One of best remedies for nervous conditions in pregnancy or affecting
fertility
Fertility tonics
 Vitex increases Progesterone & LH
 Hormonal balancer par excellence esp. where low progesterone –
e.g. woman prone to early miscarriage e.g.9/40 spotting or
miscarriage
 Brings inner strength & emotional balance.
 Alchemilla vulgaris –
 Uterine tonic. Hormone balancer. Promotes fertility. Haemostatic.
Traditionally for soft, gentle women
 Mitchella –
 Uterine strengthener, inspires self-confidence
 Leonurus –
 Uterine tonic and sedative, reduces nervous tension, anti-spas,
helps pelvic irritability. Helps with fears around motherhood.
 Dioscorea –
 Powerful smooth muscle relaxant relieving spasm and
inflammation, regulates hormones, opens up blood vessels
Fertility tonics
 Trifolium
 Alterative, Hormone balancer (phytoestrogens),
lymphatic cleanser, anticoagulant.
 Trigonella
 “there’s a baby in every cup” (Weed) – bitter &
warming, stimulates uterus, soothes irritable tissues,
reduces blood sugar & cholesterol, benefits weak
digestion
 Serenoa
 Adaptagen, sedative, warming, helps sex drive, urinary
antiseptic, endocrine stimulant, helps intimacy &
openness, learning to give & receive
 Anemone
 Sedative, anti-spas, reduces pain in repro system,
soothes inflamed mucous membranes
Fertility tonics
 Too cold
 Zing Achillea – improve circ to pelvis
 Pelvic congestion
 above & Calendula – improve circ of blood & lymph,
 Attention to NS
 Scutellaria, Avena, Hypericum, Passiflora, Valerian, Verbena,
 & Raise vital force
 Salvia

 Uplift
 Rosemary, Melissa
 Loss of libido
 Vitex, Serenoa
 Healthy sex life depends on good ovarian, adrenal and pituitary function (&
psychological)
 Cause could be hormonal, exhaustion, depression, drug-related,
relationship difficulties, fear of pregnancy… related to family attitudes,
childbirth…,psychological(eg prev. abuse)
 Turnera
 aphrodisiac, sexual stimulant, anti-depressive, promotes well-being,
relieves anxiety
Case history 1
 Woman 40yrs Sec. school teacher – v.busy
lifestyle – worrier/stressed
 Trying to conceive for 12/12. Stable, happy
relationship. No prev. pregnancies.
 History of PMT. Regular, ovulatory cycles apart
from times of high stress. Chocaholic.
 R Vitex 20 Chamaelir 20 Verbena 20 Scut 20
Avena 20 (x2) sig 7 ½ ml. bd
 Kept her on same or similar mix for 3 months.
Drastically reduced sugar & chocolate. PMT
disappeared, reduced Vitex to 10 & put in
Chamomilla. Conceived after total 7 months.
Healthy pregnancy & normal delivery.
Case history 2
 Woman 41yrs Trying to conceive 7years. MH 1 healthy FT
pregnancy @ 25. Unplanned. Daughter age 15, raised by patient’s
mother for 1st 3 years. GRIEF & ANGER , husband told her she
was ‘depressed’ for those years although she did not remember
clearly.
 Normal ovulation and hormone levels. Partner’s sperm – good numbers &
motility
 Wanted to avoid IVF.
 Aim: to dissolve grief and other emotions trapped in tissues. Facilitate letting
go of mistaken beliefs.
 R Rosa 20 Borage 20 Leon 20 Alth rad 20 Anem 10 Chamaelir 10 (x2)
sig 5ml bd
 R Alchemilla vulgaris Tea one cup daily
 + flower essences
 Released huge grief. Woke in night saying “I’m not a bad mother”.
Healing dreams. Now feels a different person.
 Similar herbs over 8 months leading to conception and healthy FT
pregnancy.
 Use of ‘medicine bundle’ to connect with uterus – release feelings
without having to analyse.
 IVF etc.
Recurrent Miscarriage

 Can’t stop inevitable miscarriage


 Properly prescribed, herbs will not interfere with nature’s
course - will not delay inevitable miscarriage or in any way
endanger the patient
 Use at low dose prophylactically at danger time
 Use higher dose in acute threatened miscarriage
 Uterus functionally unable to support foetus:
 Chamaelirium –
 esp. helpful where history of miscarriage. Uterine irritability. Poor
tone in cervix. V. safe & nourishing. Ovarian & uterine tonic
 Vib prun-
 tonic, astringent, anti-spasmodic, relaxant, uterine sedative,
improves uterine circ, useful for uterine irritability
 Combine Chamaelir & Vib prun for threatened miscarriage 10-
20gtt every 30-60 mins for spotting, cramping, bleeding. Rept
until symptoms clear > 20gtt (or more) mane until 22/40 approx.
Hormonal imbalance
 Vitex
 helpful when history of early
miscarriage esp. where low
progesterone
 eg 9/40 spotting (?corpus luteum
insuff?) supports progest/corpus
luteum/HCG
 up to 10ml daily (usually much
lower) if history of early
miscarriage, esp. if suspect low
progesterone
Case history 3
 Recurrent miscarriage & low progesterone. Woman – 33 yrs. 5/40 pregnant
 MH-Age 26- miscarriage at 9/40; age 28 miscarriage at 15/40; age 29 FT pregnancy
given progesterone injections from week 7 (>vomiting,constant fatigue which
continued after delivery & cessation of progesterone)
 RVitex 20 Chamaelir 30 Galega 10 Vib prun 20 Fucus 20 (x2) sig 5ml tds +resc. Rem
 Emergency drops: R Chamaelir 30 Vitex40 Vibprun30 (x1) sig 20gtt hourly prn
 Started getting period-type cramps at 9/40 – lasting about ½ hr stopping & starting
 Cramps stopped after 2 days on emergency drops.
 Bed rest/ relaxation/ visualization/ inner dialogue. Keep bowel moving (avoid reflex
irritation of uterus)
 Cramps recurred on a few occasions up to 16/40, soon cleared with drops.
 Continued on original mix until 19/40 when she developed headaches.
 R changed to:
 RChamaelirium 30 Vib prun 30 Mitchella 20 Rubus 20 (x1) sig 40gtt t.d.s.
 at 24/40 - RRubus 30 Mitchella 30 Achillea 30 Aesculus 10 (x2) sig 5ml bd.(varicose veins)
 Went on to have normal FT delivery and healthy baby.
 Mother made quick recovery and reported that her energy was ‘better than it had
been for years’.

 Rubus + Mitchella – Strengthening & relaxing combination for uterus. 20gtt bd/tds up to 5ml
bd/tds
 Leonurus – tones uterus, reduces nervous tension & spasm. Lovely uterine sedative for
false labour pains, nervous debility, pelvic irritability.
 Additional nervines/rescue remedy
Case history 4
 Woman 35yrs.MH Uterine fibroids. Surgery @27. Trying to conceive
past 6/12. History alcohol/smoking
 R Calendula 20 Chamaelir 10 Rubus 20 Tarax rad 30 Achillea
20 (x2) 5ml tds
 Circ/lymph/ uterine/fertility tonics/ liver/ circ/
 Fertility Tea on Full Moon: ALCH. VULG./RUBUS (TRIFOLIUM)
 Conceived after 5/12.
 At 32/40 niggling pains like ‘crampy period pains’ back & front on
walking (not Braxton Hicks) could last 30-60mins. No blood loss
 Stressed. Split with partner.
 R Rubus 30 Mitchella 30 Leon 20 Vib prun 20 (x2) 5ml tds (+
rubus tea)
 Pains became less frequent, shorter duration and ceased after
10days
 36/40 nervine mix R Chamomilla/Val/Pass 10ml nocte
 Normal delivery at 41/40 & healthy baby