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Question
Hello Scott,

I was hoping to ask your advice about the Chinese herbs I am currently taking.

My husband and I have been trying to conceive our first baby for 15 months. The doctors can't find anything medically wrong with either of us, so in February I turned to acupuncture. Three months ago I also started taking Chinese herbs; my herbalist has been prescribing me pre- and post-ovulation herb mixtures.

The first month I took the herbs was a normal cycle for me. By the second month I had a very strange cycle: I experienced mid-cycle bleeding for the first time ever. I started spotting 2 days post ovulation and it continued right up until my period which arrived on 14dpo, as normal. I had a scan around 8dpo and it showed that I was already shedding my lining, even though my progesterone levels were very high. My doctor put it down to a 'hormonal imbalance'. At the time I thought I was simply having an 'off' cycle and didn't think it was due to the herbs.

The following month my cycle seemed to be back on track - no luteal phase spotting (though I did spot for 8 days after my period had stopped, which has happened on and off over the last 15 months). This month, the mid-cycle bleeding is back. I am 3 days post-ovulation and have been bleeding very lightly (bright red and brown blood) for the last two days. Now I can only think it is the herbs causing this bleeding?

This is the pre-ovulation formula I took this month:
Bai Shao (Chao)
Chai Hu
Dan Shen
Dang Gui
Gan Cao
Gou Qi Zi
Hong Hua
Mei Gui Hua
Shan Yao
Shan Yu Rou/ Shan Zhu Yu (Jin Zhi)
Shu Di Huang
Tao Ren (Dan)
Tu Si Zu
Xaing Fu (Cu Zhi)

I spoke to my herbalist and he said: "It is not unusual to experience hormonal fluctuations when taking the herbs...in fact changes to the cycle are generally seen as positive...I would keep taking the herbs and monitor the rest of your cycle." But, when I told him that it wasn't just the odd spot of blood, and that the scan I had last time showed I was actually shedding my lining, he said "that's not common at all with herbs, so I doubt it's the herbs. But it's up to you if you continue taking them or not". Which has left me feeling very confused.

Part of me thinks that perhaps my body/hormones are just readjusting to the herbs and I should stick with them, but part of me can't bear the thought of going through this another month, especially as we are considering trying IUI in a few months time - something I could never proceed with if I was still having mid-cycle bleeding...

Can I please ask what your thoughts are?

Thank you so much,
Nicola

Answer
Hey Nicola,

It's the herbs.

There are several herbs in this formula that invigorate the blood. This can cause excessive bleeding.
There is also a marked lack of herbs to tonify the spleen which would help build energy and restrict bleeding a bit.

This formula would be better suited for someone with blood stasis, especially pain from blood stasis. Sever PMS pains would be a good example, or pain from deep bruising where the blood is static in the body.

In my clinic I would look at building both blood and qi or energy. I would also make sure to balance the Dai, Ren, Chong, Liver, Spleen and Stomach meridians.

Without a diagnosis, I'll only be able to give you a basic, general idea of what you might need.
Possibly Gui Pi Tang or Ba Zhen Tang with additions and subtractions to suit your symptoms.

I don't often say this, but I would find another practitioner.
To bring up the issue of bleeding and not have the formula even considered as the culprit is a problem, especially considering what's in it.
At the very least offering to look at and change the formula, and possibly add herbs to inhibit bleeding is in order.
If your practitioner is incapable of even considering that there is an issue, that's a problem.

You always have to listen to the patients complaint and suspicion and consider it.
I have patients take a very basic and benign formula and not feel right. 99.8% of my patients could take it and thrive, but sometimes people have a reaction to one single herb in a formula. The proper response is to stop taking it and see if the symptoms abate, if they do then the formula needs to be looked closely and reformulated.  An additional look at the diagnosis would be in order to make sure it's spot on.

My guess is that you have Spleen Qi deficiency and possibly blood deficiency as well. If this is so, you need herbs to build and tonify both blood and Qi.

I would not proceed with the IUI until these issues are cleared up.
One of the functions of the Spleen that is crucial is the function of holding. If the Spleen is not strong, the body will not be able to hold
the baby and miscarriage is a very real issue.

There is a wisdom in the body that makes conception difficult if not impossible if the body is unable to carry it to term.

If you would like a more in depth diagnosis, you can send me an email at dt.acup@gmail.com and request an intake.
I'll look at your issues and make recommendations. There is no charge for any of this.

Be well,

R. Scott Malone L.Ac.

Acupuncture

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R. Scott Malone L.Ac.

Expertise

I can answer questions on Acupuncture and Chinese medicine. I specialize in women's issues, mental-emotional issues and headache.

Experience

I have been in practice for 10 years.

Organizations
I am certified and state liscensed.

Education/Credentials
Graduated from the T'ai Institute of Oriental Medicine with certificates in acupuncture and Chinese herbal medicine.

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