Endometriosis Awareness Month: Bridging Hope and Healing With Acupuncture
March marks Endometriosis Awareness Month, a time to spread awareness about a debilitating disorder that affects millions of women worldwide. Endometriosis is more than just a medical condition. It's a confusing and painful journey, often fought silently. Amid these challenges, hope emerges through treatments like Chinese medicine and acupuncture, offering relief and a pathway to healing.
Understanding Endometriosis
Endometriosis is characterized by the presence of uterine-like tissue outside the uterus, notoriously causing pelvic pain, inflammation, irregular and heavy bleeding, and sometimes infertility. The complexity lies in the symptoms and the resilience it demands from those it affects. Despite its prevalence, the journey to a diagnosis can be long and fraught with hurdles.
Endometriosis affects an estimated 190 million women globally. Approximately 30-40% of women with endometriosis may face challenges with fertility. Endometriosis is also one of the leading causes of gynecological surgeries and hospital visits in the country.
Managing Endometriosis
Unfortunately, there's no cure for endometriosis. Treatments for managing it range from conventional medical and surgical interventions to integrative practices like acupuncture and Chinese medicine. These ancient modalities, grounded in self-healing, offer relief without the side effects often associated with standard treatments.
Discover Integrative Reproductive Medicine with Dr. Lee
Dr. Lee Hullender Rubin, a renowned acupuncturist in Portland, Oregon, integrates Eastern and Western medicine to enhance reproductive health. Rosefinch Health is a testament to her dedication to offering compassionate care to those battling endometriosis and fertility challenges.
With over two decades of experience, Dr. Lee has helped countless individuals navigate their endometriosis journey. Her individualized approaches ease physical symptoms and address the emotional and psychological aspects of the condition.
If you or someone you know is fighting endometriosis, Dr. Lee has your back.
Under her care, acupuncture treatments have been shown to alleviate pain and reduce inflammation, improve blood flow, and promote the release of endorphins. Fertility acupuncture, a specialized form of acupuncture, also improves the outcomes of fertility treatments like IVF.
Dr. Lee's approach to endometriosis treatment is highly personalized, safe, and practical, considering each patient's unique health profile and goals. Through the compassionate and expert care of practitioners like Dr. Lee Hullender Rubin, there is hope for managing endometriosis and reclaiming quality of life.
Embrace Your Transformative Journey Today!
This Endometriosis Awareness Month, let's commit to spreading awareness, fostering understanding, and taking proactive steps toward healing. Dr. Lee's work in acupuncture and Chinese medicine opens new possibilities for patients seeking relief and hope. Her commitment to patients extends beyond symptom management; she embodies a vision of long-term health and recovery.
If you're affected by endometriosis, know that you're not alone. We can help you get on a path to a brighter tomorrow. Call us at 503-807-0158 and set up a free 15-minute consult now.
Tea, tea bags, and microplastics
Tea brewed in plastic teabags can provide a large dose of nanoplastics that may disrupt metabolism and hormones.
When you live in a damp or cold climate, sometimes a hot “cuppa” is just the thing to help warm you up. So, you reach for your favorite Camellia Sinensis tea conveniently packaged in a tea bag, put the kettle on, and await its boiling whistle. The tea’s aroma is released as the hot water opens the leaves, allowing them to remove the antioxidant-rich polyphenols and modest amounts of caffeine into the brew.
“Tea is the elixir of life. ”
Research has found significant health benefits in daily tea drinkers. The risk of developing type 2 diabetes, heart disease, experiencing a stroke, or premature death is significantly less in people who enjoy 2-3 daily cups of tea. For those trying to conceive, one to two daily cups of tea may slightly increase one’s chances of conceiving compared with those who don’t drink tea.
Impact of microplastics on human health
Tea’s health benefits may quickly diminish and even become a source of endocrine disruption, inflammation, and possibly disease when prepared in a microplastic bag. These silken bags vaguely resemble a pyramid and are usually used by premium tea brands. As the boiling water brews the tea, it also brews the plastic tea bag, leading to thermal degradation of the bag.
A 2019 study found a single plastic tea bag released upwards of 11.6 billion microplastics (plastic particles <100μm) and 3.1 billion nanoplastics (particles less than 1000nm) in one cup of tea. This is important because nanoplastics can be easily absorbed in the gut, leading to inflammation, oxidative stress, and endocrine and metabolic disruption. The full impact of micro- and nanoplastics remains unclear, but there are clear signals that these chemicals may contribute to significant issues. Plastics in the form of phthalates were associated with lower antral follicle counts, fewer eggs retrieved, and, ultimately, fewer high-quality embryos during IVF.
What can we do?
If you are a tea drinker, ditch the prepackaged tea bag and choose loose tea. I’m a personal fan of the small ceramic tea pot with a stainless steel basket. When I’m done brewing the tea, I remove the metal basket, and poor a cup into a ceramic cup and enjoy with splash of oat milk. If you only want a single cup, when brewing your tea, use a stainless steel basket or tea ball in your cup or mug.
When on the go, avoid having your tea served to you in a plastic cup or with a plastic top. Bring your own container that has its own tea basket or an unbleached, reusable tea bag. There are many portable tea containers on the market and choose glass or stainless steel versions. Avoid clear plastic containers or plastic baskets.
If you can’t avoid pre-bagged tea, choose tea bags free from epichlorohydrin and completely biodegradable, plastic-free, organic, or made with plant-based materials.
Does Laser acupuncture improve fertility?
Does laser acupuncture improve fertility? In this post, we take a close look at the current evidence investigating laser acupuncture’s effects on fertility.
Laser acupuncture for fertility research
Laser or laser acupuncture for fertility is a photobiomodulation (PBM) therapy that is safe and painless. It may help support ovarian and reproductive function in women and people with ovaries. Laser is also known as low-level laser therapy (LLLT), cold laser, and laser acupuncture. It uses focused, collimated, coherent light to penetrate the skin and treat the underlying tissues. Some laser manufacturers suggest their laser can penetrate as deep as 5 inches. At Rosefinch Health, Dr. Lee offers Laser Acupuncture for fertility and uses a Class 3B infrared and red laser in her Portland, Oregon clinic. She uses laser for fertility to support people trying to conceive at home or while undergoing assisted reproductive therapies like in vitro fertilization, egg freezing, embryo banking, and frozen embryo transfers.
One way laser may help fertility is that it powers up the tired mitochondria within the cells. Red and infrared laser may reduce inflammation and improve blood flow locally and throughout the body.
Is there any evidence that laser or low-level laser therapy can improve fertility? Yes, there is some evidence that suggests benefit. One randomized controlled trial found that laser application on the day of embryo transfer significantly increased implantation rates compared with controls.
→A Japanese doctor observed that people in menopause would spontaneously begin menstruating again after a series of laser treatments. His group then went on to prospectively follow people with diminished ovarian reserve who were struggling to conceive. After 21 or so laser treatments, there was a 22.3% clinical pregnancy rate and an 11.3% live birth rate in a cohort of 701 people. The average live birth rate is about 5% for a similar population. They also observed an increase in pregnancies in people undergoing IVF with ICSI in another cohort of younger women.
→They also found in his research that when looking back at how patients may benefit from laser therapy, treatment once weekly for 5-6 cycles may positively impact egg quality.
→In a cohort of 400 women aged 34-50 years old, a physiotherapist reported 65% became pregnant after they received 6 laser sessions during their follicular phase.
→In a small pilot study, people with PCOS who received approximately 10 laser treatments were compared with placebo laser treatment. Laser treatment reduced androgens, AMH, and insulin resistance measures compared with placebo. It also helped improve hormones related to ovulation.
Clearly, more research is needed to understand how laser and PBM can support fertility. Still, the current research signals potential fertility benefits with very little risk. Want to learn more or schedule an appointment? Set up a free 15-minute consult.
We are moving!
Rosefinch Health is moving to SW Portland and joining the Rose City Sexual Health Collective.
Moving truck illustration on pale pink background with the text “We are moving!” and the address 110 S Bancroft St., Ste B Portland OR 97239.
I’m so excited to share Rosefinch Health is joining the Rose City Sexual Health Collective in Southwest Portland. This move means we can expand and work alongside likeminded professionals supporting people’s sexual health. This of course includes the fertility and pelvic/genital pain specialties of my practice, but overlaps with my oncology and dermatology specialties as well.
Starting January 2, 2023, I will offer all in person appointments there. Here are a few things to know before we meet at the new space:
Masks are still required by the Oregon Health Authority through at least March 31, 2023.
No food or water are allowed in the treatment rooms.
Parking is free. There is one guest space marked Rose City SHC Guest in the parking lot. If the space is open, feel free to take it! Please don’t park in any other space as they are reserved. There is also plenty of free on-street parking as well.
There is a waiting room! When you arrive, the waiting room is to the left of the entrance. Tap my picture on the iPad to notify me you have arrived. Make yourself comfortable, and I will be out shortly to welcome you.
Have questions? Email me anytime at hello@rosefinchhealth.com.
New research: acupuncture and frozen embryo transfers
Welcome sign to American Society for Reproductive Medicine meeting.
I just got back from the American Society for Reproductive Medicine 2022 Scientific Meeting. It was a whirlwind of information, networking, and socializing. Let me tell you about an abstract I was honored to have contributed.
In an abstract presented by my dear colleague Kate Phillippi in a very early Poster Session on Tuesday morning, we looked back at 2,330 of patients who completed a Frozen Embryo Transfer cycle in Chicago. Personalized acupuncture (not a simple protocol that was applied universally to everyone) was used as an additional therapy in 579 patients on their transfer day. We compared these patients with 1,751 patients who did not add Acupuncture on the day of embryo transfer.
The two groups were different in many ways. Specifically, the folks who chose to add acupuncture were a bit older and more of them were diagnosed with Diminished ovarian reserve, ovulatory related infertility, and were undergoing their first ET compared with the FET group.
We found a strong association of benefit when personalized acupuncture was added to FET compared with no acupuncture. Acupuncture was associated with a 55% increase in the odds of live birth (OR=1.55, 95% CI 1.29-1.88; p<0.00001), and 42% decrease in the risk of biochemical pregnancy (OR=0.58 95% CI 0.41-0.83), p=0.002. Rates of miscarriage and ectopic were similar between groups.
Limitations to this study are these are associations of benefit, not causal relationships. Data on the number of genetically screened embryos and embryo quality were not available. And, two sessions of acupuncture on the day of embryo transfer is typically a limited dose. It is possible some of these patients had acupuncture elsewhere during the run up to their transfer day.
Why is this retrospective cohort study important?
Most IVF and acupuncture studies to date have looked at a standardized Acupuncture protocol added to the day of embryo transfer. This is great for research but not representative of how acupuncture is practiced in th real world. This study applied acupuncture taking into consideration the individual patient presentation. It was a patient-centered acupuncture treatment.
Studies haven’t kept up with IVF practice in the US. Most of the acupuncture and IVF studies were with fresh embryos, not frozen. This study suggests Acupuncture may provide real benefit to patients undergoing FETs in the US.
Have questions? Email me.
Citation: Phillippi K. Kamel L, Hullender Rubin LE, Jeelani R, Soy T. DOES INDIVIDUALIZED PRE- AND POST-EMBRYO TRANSFER ACUPUNCTURE AFFECT LIVE BIRTH RATES? Fert Steril 2022; 118(4)Supp: E269-270. DOI:https://doi.org/10.1016/j.fertnstert.2022.08.755
Air pollution may reduce fertility
Air pollution may reduce fertility by damaging eggs/sperm and reducing IVF success.
Air pollution may damage eggs/sperm and reduce IVF success.
Air pollution reduces air quality and is associated with multiple health risks. While air quality may impact overall health, it may also reduce fertility by negatively impacting egg and sperm development. (Environ Health. 2017 Jul 28;16(1):82). Even short term exposure to air pollution may negatively influence IVF outcomes, as it was associated with lower pregnancy rates and higher miscarriage rates. (Reprod Biol Endocrinol. 2021 Oct 6;19(1):151.)
The Air Quality Index or #AQI not only tells us if hazardous gases are too high, but it also looks at particulate. Particulate matter (PM) is a mixture of solid particles and liquid droplets found in the air like smoke and other types of air pollution that may or may not be seen with the naked eye. This fine particulate (2.5-10 micrometers in diameter) is easy to inhale and can generate or exacerbate health problems.
What can I do to reduce my risk?
As the summers continue to get warmer, the western US will be exposed to more forest fires and subsequently more air pollution. Here are some steps you can take to reduce its impact on your health and fertility.
· Keep an eye on the AQI. If you carry an iPhone, it is included on the Weather app, just scroll down, it is located under the 10-day forecast. You can also go to Airnow.gov and put in your zip code for the latest AQI reading in your area.
· When the AQI is above 100, wear a mask outdoors. The best masks have a good seal around the face and are multi-layered like the N-95 or KN-94/5 masks. Those are good to protect you from fine particulate. Surgical or cloth masks do not provide much protection due to their poor fit. If you have other health issues like upper respiratory condition (e.g. asthma), an inflammatory disease, or autoimmune disease, consider wearing a mask when the air quality is rated moderate (51-100 AQI).
· Damp mop floors regularly to limit the amount of particulate you track into your home.
· Use a vacuum with a HEPA filter if you can access one.
· Dust with a damp cloth.
· If you have pets, clean their paws and wipe them down with a wet cloth after being outdoors.
· Use a HEPA air filter to help reduce circulating fine particulate.
Have more questions? Contact us.
TEAS and IVF
A TENS machine with a blue light display and electrode pads and carrying case.
TEAS and IVF
Can using electrodes on acupuncture points help improve your chances of IVF success? Two new studies found IVF patients may benefit from using TEAS with IVF.
What is TEAS?
TEAS is transcutaneous electrical acupoint stimulation and is a convenient way to deliver needle-free stimulation to acupuncture points. It is like TENS on acupuncture points. What is TENS? If you have ever had back pain, you may have used a device that sent gentle, electrical stimulation through sticky pads placed on your back to help reduce your pain. This electrical stimulating device is called TENS or transcutaneous electrical nerve stimulation and is often used for pain control.
What impact does TEAS have on IVF?
There were two studies released in the previous week.The first study was a meta-analysis of 19 randomized controlled trials that included 5,330 IVF patients. When TEAS was added to IVF, there were several significant findings:
42% more clinical pregnancies
9% more high-quality embryos
45% fewer biochemical pregnancies
42% more live births
The certainty in the results is low (i.e., they will likely change as more research is done), EXCEPT for live births where the certainty was moderate (i.e., this result may change with more research)
The second study was a randomized controlled trial of 739 IVF patients who could receive TEAS or no TEAS treatment. This was not included in the meta-analysis since it was so new. Overall, there were significantly more clinical pregnancies in women who added TEAS to their IVF cycles than those who did not (55.1% vs. 46.7%). When they looked at the age of participants, they found in women aged 35 and over, TEAS significantly increased clinical pregnancy rate (48.9% vs. 23.7%, p=0.004) and implantation rates (30.8% vs. 13.9%, p=0.001) compared with no TEAS. There were clinically more live births (34.0% vs. 19.7%), but it was just below statistical significance.
What was also interesting is the researchers looked at a smaller number of patients within the study to see if there was a difference in their uterine lining with TEAS. They found several vital outcomes on the theoretical embryo implantation day:
several factors indicate the uterine lining was better developed with TEAS, specifically more pinopodes (extensions from the lining that help the embryo implant)
improved progesterone levels
How does it work?
Adhesive electrodes are placed on acupuncture points that are associated with fertility support. With gentle stimulation, the body responds in three primary ways:
Calms the nervous system’s fight/flight response, allowing the blood vessels to dilate and direct nutrient-rich blood to the reproductive organs and glands.
Triggers the release neurotransmitters that help ensure open communication between the deep brain and the reproductive glands, also known as the hypothalamus-pituitary-ovarian (HPO) axis in women or people who menstruate and the hypothalamus-pituitary-testicular (HPT) axis in men or people with sperm. Ultimately, this dialogue across the HPO axis may help one ovulate more regularly, have regular periods, and ultimately overall fertility. In the HPT axis, it supports sperm production.
Helps the body release endorphins, which help reinforce the first two functions and pack an added stress-relieving boost. IVF is stressful enough, but this can be one way to support yourself throughout your cycle.
Want to learn how to add TEAS to your next egg freezing or transfer cycle? Contact me.
Sales receipts and fertility
What do sales receipts and fertility have to do with each other? Evidence is mounting that sales receipts may be a significant source of endocrine-disrupting chemicals.
Card card terminal with a long stream of receipt paper on an orange background
Sales receipts and fertility - is this something to cause concern? At least once a week, you will likely find yourself waiting in line at a grocery store or pharmacy. Maybe you used the free hand sanitizer as you walked in the door. You check out, pay for your items, and the cashier hands you a receipt. No big deal, right? Evidence is mounting to the contrary. Handling sales receipts may be affecting your hormones and fertility.
Sales receipts can be a source of bisphenols — about 250 to 1,000 times more than a can of food! A report found that 9 out of 10 receipts contained at least one type of Bisphenol. Bisphenols are a plasticizer used in paper receipts. They can leave the bisphenol residue on your hands and fingers, easily absorbed through the skin. The hand sanitizer you use to protect yourself from germs contains alcohol. If your hands are still wet from the hand sanitizer or lotion applied while waiting in line can increase bisphenol absorption even more.
Bisphenols have been identified as threatening to fertility in both eggs and sperm. It has also been considered a potential environmental factor contributing to symptoms that look a lot like Polycystic Ovary Syndrome. They have also been implicated in lowering sperm count and affecting the functionality of sperm.
How can you reduce exposure? Here are some ideas:
When checking out, ask your cashier or choose on the credit card terminal to email or text your receipt.
Avoid touching receipts with wet or greasy fingers/hands.
Keep receipts away from your little ones and pets.
If you have to keep the receipt, store it away from other paper or currency as they can become contaminated with plastic.
To learn more, here are a few interesting articles.
Is retinol safe when trying to conceive?
Is retinol safe to use when trying to conceive?
A patient asked me a great question, which seemed fitting to share here. She has issues with hyperpigmentation, so she was using retinol each evening. Her question was:
Is it ok to use retinol when trying to conceive?
Great question! Here’s what we know:
+ What is retinol?
Retinol is an over-the-counter topical in the Vitamin A family. It is used to smooth fine lines and wrinkles, and reduce the appearance of sun damage, hyperpigmentation, and uneven skin texture.
+ Any side effects?
Retinol can irritate the skin, leading to dryness, redness, itching, and peeling skin. It can also exacerbate eczema and acne in some.
+ Safe in pregnancy?
No. Retinol is similar to isotretinoin, a drug form of Vitamin A that may cause severe birth defects. While retinol is applied on the skin and not taken internally, the dose is likely much lower. However, we don’t know precisely the amount that is safe to avoid birth defects, so it is commonly recommended to be avoided.
+ What can I use instead?
Consider an alpha-hydroxy acid (AHA) in a concentration less than 10%, though 7% may be the sweet spot for when you are trying to conceive or currently pregnant. AHAs are exfoliants, making your skin more sensitive to sunlight and UV light exposure. Using an excellent mineral-based sunblock rated at 30SPF or more is vital.
Have a question? Submit it here.
Image by Humphrey Muleba.
Anxiety and IVF: Can acupuncture help?
People undergoing IVF also are burdened with anxiety. New research published by our founder investigated whether acupuncture might help.
Struggling with infertility is hard. Really hard. Whatever issues are leading to difficulty conceiving, there can also be the additional burden of anxiety. People describe anxious feelings swirling around unanswered questions. Will I have a healthy baby? Can I carry a pregnancy? Will I even be able to get pregnant? Breathing becomes shallow, and the chest tightens. Maybe the heart beats a bit faster. Anxiety is very common and deteriorates people’s quality of life, so much so that it can cause them to stop trying before they reach their goal.
I have worked with people struggling with infertility and undergoing IVF for two decades using acupuncture and the whole system of East Asian Medicine. We work together to help them manifest their family-building goals into reality. I’ve also published research looking at ways acupuncture may help people struggling with infertility and undergoing IVF. In addition to assisting them in conceiving alongside IVF, I recently published a study examining whether acupuncture provided any benefit to anxiety related to IVF.
When we looked at eight studies that assessed changes in anxiety with acupuncture in 1,785 patients undergoing IVF, we found acupuncture significantly reduced anxiety, similar to other psychological therapies. Our study did have some limitations as there were a moderate number of studies that measured anxiety. There were also many differences in the acupuncture treatments (how many and how often), the type of control arm, and how anxiety was measured. It is also possible that these results could change as more research is done.
When I work with patients, I support them wherever they are in their process. If we focus on an egg or embryo freezing cycle, then our focus is on helping their ovaries to produce the highest quality eggs possible. If we focus on a frozen embryo transfer, we prepare their uterus to be as receptive to implantation as possible. All the while, we are supporting the whole person: their body, mind, and spirit. We also work with men and people with sperm to help improve their sperm if needed.
In East Asian Medicine, we do not separate emotions from other conditions. We assess and address them together with acupuncture and other modalities. If you are dealing with infertility, anxiety, and are going through IVF, reach out. You don’t have to suffer alone. Contact me with questions.