Dr. Donata Girolamo, ND
@DonataGirolamo
Many women are delaying having kids due to “career priorities, advanced education, control over fertility, financial concerns, late and second marriages, and infertility”.1 Often, women start to feel pressure from medical professionals, family, and friends, telling them that it’s all downhill for fertility from 35 and on. I see many women who are stressed out, annoyed, sad, and not feeling optimistic when it comes to their chances of conceiving after trying for some time with no success. This prompts women explore assisted therapies such as IUI and IVF. There are also many natural strategies for fertility enhancement if age is a factor for you.
Many women still do get pregnant and deliver healthy babies over 35 years old. It is expected that there will be a 37% increase in births to women between 30-40 yrs old in the United States.2 Women in this age group may have specific factors of health to consider and encourage during this time, such as uterine and ovarian health, HPA-axis stability, and endocrine balance.
Fertility Enhancement with Nutrition and Acupuncture for Uterine and Ovarian health
Oocyte (immature egg cell in the ovary) quality declines with age because the DNA repair pathway becomes impaired. There may be many causes for this; environmental stressors, toxicity, oxidative damage, and zinc deficiency to name some.3 The Harvard Gazette reported,
“We found that we could completely prevent, in a mouse model, essentially every aspect of the declining egg quality typical of older females. Many studies have found that animals whose food intake is restricted but still sufficient to avoid malnutrition live longer and show fewer signs of aging than do animals given access to as much food as they want. Health improvements, including reductions in cholesterol levels and other cardiovascular risk factors, have already been reported (in humans). An earlier study found that female mice maintained on a caloric restricted diet during most of their adulthood maintained their fertility into very advanced ages, even after being allowed to resume free feeding.”4
While all of the research around caloric restriction has been with animals, the consensus is that it can apply to all mammals because the benefit is due to decreased oxidative stress.5
Along with nutrition, Acupuncture can have an impact at this stage of development by supporting Kidney Yin. Kidney Yin can influence the follicle quality. Yin can be damaged by overwork, poor diet, eating in a rushed manner, a polluted environment, inadequate sleep and exercise.6 If a woman has a severe Yin deficiency, it may be advised to work on the factors affecting the yin for some time. This will improve the constitution of the future child.
Tip: Intermittent fasting, a whole foods diet, and/or food combining are excellent strategies to reduce caloric intake while optimizing nutrient dense foods. These regimes can balance blood sugar thereby reducing the tendency to over eat. Please see a qualified health care professional if you are considering restricting calories, to avoid malnutrition.
Reduced uterine implantation with age occurs. This may be due to a decrease in progesterone,7 or other factors which act as obstructions such as polyps, fibroids, or scarring. Different treatment options exist in all cases. For example, chasteberry, combined with other adrenal supporting herbs or nutrients may promote hormonal balance and increases progesterone nicely.
Fertility Enhancement with Nutrition and Stress Management for HPA-axis stability
The HPA-axis, or hypothalamus-pituitary-adrenal axis can destabilize with age, peri-menopause, stress, toxicity, and poor diet. With age, the hypothalamus and pituitary are less sensitive to negative feedback from cortisol causing both ACTH and cortisol levels to rise as we age. Cortisol has many deteriorating effects on the body, such as insomnia, blood-sugar and hormonal imbalances. These factors will negatively affect fertility, especially as women age. I wrote about stress and fertility in another blog post, check it out here). There are many ways to balance the HPA-axis, depending on what level of imbalance exists. Nutrition plays a foundational role; ensuring adequate nutrients and proper absorption of those nutrients. A simple guide is as follows: avoid refined foods, alcohol, recreational drugs, caffeine, sugars, pop and fruit juices. Consume high amounts of vegetables, fiber, moderate protein, and moderate whole fruit. Follow the glycemic index food guide. Eat several small meals throughout the day. Check with your naturopathic physician for food allergies.
Fertility Enhancement with Relaxation for Endocrine balance
If the HPA-axis becomes unstable, the thyroid and pancreas usually follow suit. The thyroid can become sluggish due to age, toxicity, illness, stress, and genetics. It will also destabilize if the adrenal gland, hypothalamus or pituitary become imbalanced. The pancreas will respond to more cortisol in the body, causing dysglycemia, or poorly regulated blood sugar. Along with nutrition, stress management is key. Many studies show stress management helps to heal diabetes, heart disease, and many other chronic diseases which are caused by excess cortisol. The thyroid and pancreas are also key players in regulating hormones, becoming pregnant, and maintaining a healthy pregnancy. Even early stages of thyroid dysfunction can lead to subtle changes in ovulation. This makes the thyroid and pancreas key players for fertility enhancement as women age. Practice some type of meditation 20 mins daily; this has been shown to be enough to regulate stress hormones. Some examples may be yoga, qi gong, mindfulness meditation, and prayer.
Improve these factors of health; uterine and ovarian health, HPA-axis stability, and endocrine balance as you age to support your fertility. Nutrition, herbs, acupuncture, and stress management are effective strategies to support these biological aspects that decline as women age.
Dr. Donata Girolamo maintains a private family practice with special interests in fertility and mental wellness. Her mission is to optimize your health care by combining evidence-based medicine with the art and wisdom of traditional medicine. To address your health concerns she uses acupuncture, herbs, homeopathy, nutrition and lifestyle counselling.
She maintains inspired through continuing education, and has extensive training in homeopathy, biotherapeutic drainage, auricular medicine, and medical intuition. She has additional certification in Wilson’s Temperature Syndrome, First Line Therapy; a lifestyle program for weight loss and chronic disease prevention and treatment, and Psychosomatic Energetics. Due to her interest in the link between mind, body and spirit, Dr. Girolamo has taken intensive courses in Vipassana and Mindfulness meditation, and mind-body medicine through The Benson-Henry Institute for Mind-Body medicine.
She is certified by the Board of Directors of Drugless Therapy Naturopathy and an active member of The Ontario Association of Naturopathic Doctors, the Canadian Association of Naturopathic Doctors, and the Association of Perinatal Naturopathic Doctors. She is a regular contributor to Health Wellness and Safety magazine, and has written for Canadian Health and Lifestyle. She is a guest speaker at Niagara College, teaching stress management with meditation, and is active in the community, giving health talks to groups like Run Girl Run, Happy Hearts, Niagara Pain Program, and Form Fitness. She is appearing in a fertility segment on CHCH news, and has been interviewed on 610 CKTB newstalk radio regarding menopause. Understanding and sharing the body’s wisdom is not only a passion, but her calling.
References:
- Gindoff, PR, Jewelewicz, R. Reproductive Potential in the Older Woman. Europe PubMed Central. 1986. Available at: http://europepmc.org/abstract/med/3536609. Accessed May 8, 2015.
- Gindoff, PR, Jewelewicz, R. Reproductive Potential in the Older Woman. Europe PubMed Central. 1986. Available at: http://europepmc.org/abstract/med/3536609. Accessed May 8, 2015.
- Song, Y, Leonard, SW, Traber, MG, Ho, E. Zinc Deficiency Affects DNA Damage, Oxidative Stress, Antioxidant Defenses, and DNA Repair in Rats. The Journal of Nutrition. 2009. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3151020/. Accessed May 11, 2015.
- McGreevey, S. Cut calories, increase egg quality. Harvard Gazette. http://news.harvard.edu/gazette/story/2011/07/cut-calories-increase-egg-quality/. Accessed May 11, 2015.
- Gredilla, R, Barja, G. Minireview: The Role of Oxidative Stress in Relation to Caloric Restriction and Longevity. : Endocrinology: Vol 146, No 9. 2013. Available at: http://press.endocrine.org/doi/abs/10.1210/en.2005-0378. Accessed May 11, 2015.
- Lyttleton, J. The Menstrual Cycle. In Treatment of infertility with Chinese medicine. Edinburgh: Churchill Livingstone; 2004: 15–17.
- Meldrum, DR. Female reproductive aging–ovarian and uterine factors. Europe PubMed Central. 1993. Available at: http://europepmc.org/abstract/med/8419194. Accessed May 11, 2015.