Chapter III
Types of Diagnosis Traditional Chinese Medicine TCM Perspective
A. Classical 5 Element Theories In Traditional Chinese medicine
I. Definition
The Classical 5 element theory has been used in traditional Chinese medicine for over 4000 years in determining all kinds of disease including infertility, because TCM treats the body as a whole identity. Any malfunction or disease of the body is considered as an imbalance of the 5 elements in the body. The 5 elements include wind, cold, heat, dry, and damp.
TCM diagnosis may contain the following:
1. General appearance
It is amazing that most TCM practitioners can feel some types of deficiency in your body by just looking at your facial appearance:
a) Physical appearance b) Hair distribution
c) Your voice d) Body build
e) Secondary sexual characteristics
2. Your body fat and fat distribution including fat around your breast
3. Thyroid enlargement
4. Irregular testes and penis
5. Infection and inflammation affecting the epididymis and prostate gland
6. Varicoceles
7. External genitalia
III. 5 element diagnosis
1. Wind
It is defined as qi obstruction in the body causing pain such as headaches.
2. Cold
Exposing yourself to cold may increase the risk of qi slowdown and reduce the energy flow in the body. Patients are considered cold if they are diagnosed with slow qi and lack of energy flow such as a slower heart beat, weaken immune system, kidney deficiency.
3. Heat
Exposing yourself to heat may increase the risk of energy overflow as well as speed up your body's function leading to infection and inflammation. The patient is considered to have 'heat' as the diagnosis when there is an overflow of energy, skin diseases, qi interruption, or the inability of the body's organs to discharge enough toxins.
4. Dry
This is considered as dehydration and significant dry skin. It may be caused by internal imbalances between qi, blood flow, yin, yang, and blockages of different energy pathways within the body.
5. Damp
Dampness is the indication of fluid and water retention in the body. It is considered as a common outcome of digestion that isn't efficient, causing diarrhoea and interfering with the natural downward movement of the contents of the stomach leading to heartburn and excessive saliva production. Dampness is normally caused by spleen qi deficiency.
B. 3 Main Organs In Traditional Chinese Medicine (TCM)
I. Definition
TCM considers the kidneys, liver, and spleen as the 3 main organs which have a direct effect in men and women's reproductive system. Any deficiency of the above organs may cause yin and yang qi imbalance leading to infertility.
II. Diagnosis
1. Kidney
The kidney influences the function of sexual desire and regulates the adrenal gland in hormone production. Deficiency of kidney qi causes libido and irregular menstrual cycle, and abnormal menstruation.
2. Liver
In women, according to TCM, the liver is a vital organ in maintaining the levels of estrogen and progesterone thereby leading to normal ovulation and increasing the ability to release a healthy egg. Stagnation of liver qi also causes nervous system disorder including anxiety, stress, and depression, causing hormone imbalance and leading to infertility.
3. Spleen
The liver directly influences spleen function. Without a strong liver there is no treatment for spleen blockage and deficiency leading to abnormal implantation of the egg in the uterus lining.
Since TCM views our body as a whole, it is not about treating a part of the problem, unless it is necessary. Traditional Chinese medicine infertility treatment normally focuses on promoting the balance between organs, glands, and all other elements in the body.
C. What is " Wind " In Traditional Chinese Medicine
I. Definition
It is defined as qi obstruction in the body causing pain such as headache, sudden pain or blood obstruction including stroke and heart diseases.
III. Diagnosis
Wind-pathogen ( An agent that causes disease ), is belongs to the yang pathogen. It has the tendency expansing outward and upward and intruding the yang positions of the body. As wind, it moves quickly through out the body if there is any abnormal body motion leading to all the exogenous diseases the major cause of female infertility.
1. Sluggish Liver
Sluggish liver is caused by toxins accumulation over a long period of time leading to liver yin deficiency or blood deficiency resulting in obstruction of normal menstrual cycle, thereby increasing the risk of infertility in women. In men, the malfunction of the liver leading to reproductive disorder and pain in the testicle region.
2. Immune system
Weakened immune system is the main cause of extreme heat as resulting in infection and inflammation leading to sudden convulsions and high fever. The wind caused by extreme heat also interferes with sperm production in men. In women extreme heat wind may cause immune system to recognize sperm as foreign invasion and kill it.
3. Blood Deficiency
Wind which is caused by blood deficiency may cause over active of the uterine muscle leading to abnormal pain and cramps and increase the risk of infertility in both women and men alike.
Women who is diagnosis with infertility with explained causes, may have a wind problem in the abdominal region causing uterus muscle to contract leading to inability of uterine lining in fertilized egg implantation resulting in infertility and miscarriage.
D. What is " Cold" In Traditional Chinese Medicine
I. Definition
Cold belongs to the Yin pathogen and it tends to impair yang qi causing coagulation and stagnation in blood and muscle contraction as well as a weakened immune system, kidney function, and slowing heart beat as a result of slow qi and lack of energy flow.
II. Diagnosis
1. Weakened immune system
Since cold is the prevalent climate in winter, it often obstructs defensive yang qi, leading to a weakened immune system in fighting against the forming of radicals, bacteria, and virus resulting in an increased risk of the production of an antibody antigen. In men, it increases the abnormal functions of the reproductive system in sperm production as a result of the immune system attacking the body's own sperm.
2. Blood stagnation and coagulation
According to traditional Chinese medicine yang qi is vital in regulating blood and fluid in the body. As cold invasion, it causes low temperature in the body leading to sluggish blood flow and body fluid causing blood coagulation and fluid retention in men. In women, cold pathogen increases the risk of abnormal muscle contraction and pain.
3. Toxins accumulation
As the cold strikes, it causes the muscular striae and the sweat pores to close leading to difficult movements of the muscle and increasing the risk of toxins accumulating resulting in sluggish liver and immune system which are vital for regulating abnormal cell growth such as tumour, adhesion, and implants in the uterus and testes.
E. What is " Heat " In Traditional Chinese Medicine
I. Definition
According to traditional Chinese medicine heat-pathogen prevails in summer and pertains certainly to Yang. It tends to move upward and outward, impairs the body qi and fluid and is often accompanied by damp- pathogen
II. How heat pathogen effects fertility
Expose yourself in heat may increase the risk of energy overflow as well as speed up your body function leading to infection, inflammation and abnormal bleeding. Patient is considered heat are diagnosis with over flow of energy, skin diseases, qi interruption or inability of the body's organs to discharge enough toxins.
1. Kidney function
Since kidney is a second line defence of the body, accumulating heat in the body not only causes lost of fluid but also increasing the risk of kidney stone and abnormal function of kidney, if it is not treated. According to traditional Chinese medicine, kidney plays an important role in men and women reproductive function, deficiency of kidney yin, increasing the risk of sperm production and quality of sperm in men and distorting the normal menstrual cycle in women.
2. Liver function
Liver plays a vital role in regulating the production of certain hormone in the prostaglandins family, fire liver as abundant yang qi causes abnormal function of liver and wakes up the liver diseases leading to menstrual pain and cramps for women, distorting the menstrual hormone production and decreasing the chance of infertility. In men, it may cause abnormal ejaculation and sperm count.
Abnormal liver function also causes abnormal function of spleen, the vital organ for the reproductive system which plays an important role for conception.
3. Blood flow
Heat pathogen interferes with blood circulation in the body, most people with heat pathogen have symptoms of high blood pressure. Since it increases the blood flow uncontrollably, it causes not only nervous tension that can disturb women menstrual cycle, but also increases the risk of abdominal swelling and breaking off of the small vein leading to vagina abnormal bleeding in women. In men, it causes low sperm count.
4. Immune system
Since heat pathogen increases the heat in the body which causes lack of the yin and out flow of energy, leading to weakened immune system resulting in increasing the risk of infection and inflammation that cause accumulation of free radicals and irregular cells growth, thereby increasing the risk of infertility.
F. What is " Dry " In Traditional Chinese Medicine
I. Definition
Pathogenic dryness prevails in autumn. This pathogen is dry in nature, tends to impair body fluid and the lung.
II. How dryness pathogen effects fertility
1. Lymphatic and kidney problem
Since dry is considered as dehydration, it causes abnormal lymphatic and kidney function, leading to more fluid loss, thereby, increasing the risk of dry skin, cervical mucus production, risk of kidney stone and infection of the urinary tract.
2. Respiratory system
Our lung requires moisture to function better, dryness decreases the lung function in oxygen absorption leading to weakened immune system in fighting the forming of free radicals, bacteria and virus and increasing the risk of nervous tension in hormone secretion, thus distorting the menstrual cycle and lowering sperm count.
3. Immune system
It may also increases the risk of abnormal white blood cells production, leading to over production antigen antibody attacking a man's own sperm and increasing the abnormal allergic reaction resulting in thickening cervical mucus.
4. Heart problem
Dryness pathogen makes the blood thicker than normal, thereby besides causing the heart to work harder leading to heart disease, but also making the blood to enter the capillaries more difficult resulting in interfering with ejaculation in men and abdominal blood stagnation in women.
G. What is " Dampness " In Traditional Chinese Medicine
I. Definition
Damp-pathogen is defined as a yin pathogen, it obstructs the flow of qi and damages the yang qi.
II. How damp pathogen effects fertility
1. Lymphatic and kidney function
Damp pathogen besides decreases the lymphatic function in regulating the body's fluid, leading to fluid remaining in the body tissue and causing weigh gain and breast tenderness as resulting of over production of certain hormones which distort the menstrual cycle in women. It also increases the abnormally urinary secretion causing weakened kidney that has directly effected in reproduction of sperm and erection.
2. Digestive system
Deficiency of yang qi increases the risk of digestive disorder that causes digestive system abnormality in absorbing vital vitamins and minerals resulting in nutrients deficiency, leading to hormone imbalance and increasing the risk of irregular menstrual cycle in women and test functions in sperm production.
3. Spleen qi deficiency
According to traditional Chinese medicine damp also attacks the yin localities, leading to spleen qi deficiency that causes damp pathogen symptoms resulting in insulin production disorder symptoms such as loss of energy, dizziness, decreases the production of red blood cell and increases the risk of abdominal pain and cramps in women and distorts the function of reproductive system in men.
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H. What is Kidney function In Traditional Chinese Medicine
I. Definition
The kidneys are paired organs in our body. Besides maintaining the production of urine and urinary secretion, it also responsible for a number of other homoeostatic functions including re-absorption of glucose, amino acids, and production of hormones.
II. How kidney qi effects fertility
A. Kidney jing
Kidney jing is defined as a fluid like base substance which form the material basis for production of kidney qi. Beside helping to control the growth of bones, teeth, hair, brain development and sexual maturation in the childhood, it also plays an important role in regulating the reproductive function such as fertility and normal development into adulthood.
According to traditional Chinese medicine, conception and pregnancy are regulated and controlled by kidney jing. weakening of kidney jing causes infertility, miscarriage and other reproductive problems.
B. Kidney qi deficiency
1. In men
a) Kidney yang deficiency
Kidney yang deficiency is defined as a imbalance of qi with abundant of yin, leading to abnormal function in urinary secretion and problem of reproductive system including erectile dysfunction and sexual libido. Symptoms of kidney yang deficiency also includes feeling cold, fatigue, loss of energy,etc. Since kidney plays an important role in sperm productive, deficiency of kidney yang decreases the quality of sperm.
b) Kidney yin deficiency
Kidney yin is also called primordial yin, true yin or true water. It's function is to keep our body cool and moist. Deficiency of kidney yin causes kidney stone, scanty urinary, dry mouth and loss of body fluid, leading to low quality of sperm production as resulting in increasing heat in the testes,
2. In women
a) Kidney yang deficiency
Since kidney plays an important role in regulating the women reproductive organs. Deficiency of yang may be caused by hormone imbalance or eating habit, thyroid diseases etc. resulting in prolonged menstrual cycle, pale appearance, frequent urine, low back pain, etc. and leading to abnormal hormone production in glands that interferes with normal fertility.
b) Kidney yin deficiency
As opposite to kidney yang deficiency, it is caused by over abundant of heat and fire in the body that red face appearance, dizziness, insomnia and abnormal menstrual cycle including light discharge with red and no clot as resulting of irregular blood flow in the body. It also distorts the reproductive hormone secretion including thick and sticky cervical mucus which is hostile to sperm invasion.
According to Chinese medicine, a couple are required to have a healthy kidney jing and a balance of kidney qi to conceive.
I. What is Liver Blood Stagnation In traditional Chinese Medicine
I. Definition
The liver is a vital organ in our body. Its functions are to help in detoxification, carbohydrate, fat and protein synthesis, and production of biochemicals necessary for digestion.
II. How liver qi effects infertility
Liver blood stagnation or congestive liver is caused by over working liver and toxins accumulation in the liver as resulting of unhealthy diet such as excessive alcohol consumption, coffee, environment toxins and xenoestrogen leading to liver clogged up and sluggish function
1. Nervous tension
Liver plays an important role in fat and protein metabolism and maintaining the secretion of certain hormones in the body. Congestive liver fails to do that, resulting in increasing tension of nervous system including depression, anxiety leading to abnormal hormone secretion causing infertility.
2. Menstrual Disorder
As we know liver is vital in essential fatty acid metabolism, thereby helping in regulating the production certain hormone during menstrual cycle such as estrogen. Blood stagnation in liver distorts the normal hormone secretion procedure leading to abnormal menstrual cycle and causing infertility.
3. Irregular cells growth
Since liver is vital for helping immune system in fighting against forming of free radicals and foreign bacteria and virus, sluggish liver caused by blood stagnation decreases the immune functions as mentioned above leading to irregular cells growth including endometrial adhesion and implants.
4. Circulatory system
Sluggish liver causes insulin build up in the blood stream as resulting of liver inability in regulating the insulin production of pancreas leading to abnormal menstrual cycle and increasing the risk of infertility.
J. What is Spleen function In traditional Chinese Medicine
I. Definition
The humans' spleen also known as pancreas in western medicine is defined as an organ located in the abdomen of the body. It helps to
1. Remove and destroy the old, aged red blood cells.
2. Synthesize antibodies in the white pulp, and
3. Remove antibody-coated bacteria and blood cells from the circulation system.
II. How spleen function effects male infertility in traditional Chinese medicine
1. Liver
Liver has directed influentially in spleen function, without strong liver there is no treatment for spleen blockade and deficiency, leading to abnormal implantation of egg in the uterus lining.
2. Nutritional deficiency
Since spleen helps to transform carbohydrate synthesizing from the the liver to energy and distribute the nutrients to our body needs. Malfunction of spleen disrupts these processes, leading to nutrients deficiency and fatigue, dizziness and emotional stress.
3. Diabetes and blood flow
According to traditional Chinese medicine spleen plays an important role in providing our body qi through insulin secretion. Malfunction of spleen causes abnormal secreting of insulin disrupting the qi flow, causing blood stagnation in the liver and spleen and leading to diabetes and obstruction of blood flow to the abdominal region.
4. Luteal phase
The traditional Chinese medicine view spleen as important organ in helping the pituitary gland in secreting hormone after ovulation. In order to support the egg to be fertilized by the sperm, the luteal phase must be at least 10 days long. Deficiency of spleen obstruct the luteal phrase leading to deficiency.
5. Digestion and elimination
Spleen is view as the organ of digestion ( nutrients distribution ) and elimination ( eliminating the body waste ). Deficiency of spleen causes digestive disorder and toxins accumulation in the body, effecting the liver function and obstructing the normal menstrual cycle leading to infertility.
K. Types of Diagnosis of female infertility In Traditional Chinese
Medicine
Women who seek help for conception with traditional Chinese medicine (TCM) may require to bring in all records of diagnosis, otherwise, you may have to go through some conventional diagnosis, if necessary. In fact, most women come to TCM may have already run through all types of conventional treatments without success or with unexplained causes. Besides personal medical history and medical exam, some conventional diagnosis may be required.
II. Diagnosis of female infertility in TCM
1. Deficiency kidney yin
Women with abnormal menstruation including light discharge such as red and without clots, emaciation, dizziness, red tongue with little fur, insomnia and rapid pulse are considered as deficiency of kidney yin.
2. Deficiency kidney yang
Women with prolong menstrual cycle, no menstrual discharge, lower back pain, lack of sexual desire and slow pulse are considered as deficiency of kidney yang.
3. Blood deficiency
According to traditional Chinese medicine, blood stagnation is caused by weakened spleen organ, thereby, reducing the spleen function in blood formation causing not enough distributing to the body leading to no blood for menstruation. Women with symptoms of late menstruation with pale and scanty or absence of menstruation, dizziness, dry skin, pale tongue, pain in abdomen after menstruation and weak pulse.
4. Blood stagnation
Blood stagnation is normally caused by qi stagnation or qi deficiency in the liver leading to abdominal pain, clotted and dark menstrual flow, nervous tension, premenstrual breast tenderness, a slight purple-tongue and wiry pulse.
KA. What is Deficiency of Kidney Yin In Traditional Chinese Medicine
I. Definition
Kidney yin also known primordial yin or true yin , is defined as the foundation of the yin fluid of the body, therefore it helps to moisten, nourish the organs and tissues and maintain the body fluid balance with fire of kidney yang.
II. How deficiency of kidney yin effect fertility
1. Lack of energy
Deficiency of kidney yin causes inability of kidney in stabilization of energy, leading to abnormal flow of energy, disrupting the blood flow to the body organs including the test in producing sperm and ovaries in egg production resulting in distorting the normal menstrual cycle in women and lessening the chance of fertility.
2. Blood Flow
Deficiency of kidney yin also increases the risk of irregular blood flow as the heart must work harder to provide more energy to our body needs, leading to abnormal function of capillaries and interrupting the normal function of small veins in the nervous system including dizziness, hearing problems and ringing in the ear. It also causes abnormal blood flow to the reproductive organs resulting in distorting the normal menstrual cycle in women and sperm production in men.
3. Digestive system
It also causes abnormal digestive system in absorbing vital vitamins and mineral as resulting of lack of fluid which is necessary for digestive system in stomach acid secretion, leading to constipation and abnormal pain.
4. Burning sensation
People with kidney yin deficiency feel burning sensation not only in the body including the chest, but also see bright yellow color in their urine, leading to oxidative and kidney damage. If the problem is not treated, it may disrupt the production of sperm friendly mucus in women and sperm quality men.
5. High temperature
It also increases the body temperature that interferes with egg, cervical mucus production in women and sperm abnormalities in men.
III. Causes
1. Unhealthy diet
People who eat a lot of high energy food and spicy food are an ideal candidate to have kidney yin deficiency, because those foods increase the yang qi in the body and deplete the body's fluid.
2. Sexual tramitted diseases and frequent sexual activity
Sexual tramitted diseases increase the risk of infection and inflammation that causes the increasing of white blood cells in the body, leading to immunity malfunction of infertility. Frequent sexual activity drain the kidney energy in maintaining a good reproductive system leading to in