TCM & Infertility
Because the Kidney Zang is related to reproduction, Traditional Chinese Medicine (TCM) often views the kidneys as involved in both male and female infertility. In women, however, the Eight Extraordinary Channels may be involved as well.
The Chong and Ren Meridians are channels that represent the overall function of the kidneys, spleen, and liver. All three of these organs participate in the production of Qiblood and essence. Essence can be defined as sperm in men and tian gui in woman.
Many TCM practioners mistakenly refer to tian gui as the menstruate, but this is incorrect. The literal translation of tian gui is "heavenly water," and heavenly water mixed with sperm yields pregnancy. Tian gui comes from the heart, and kidney essence comes from the kidneys. The tian gui and heart Qi travel to the uterus via a channel called the bao mai and the kidney essence travels to the uterus via a channel called the bao luo. So, in most female infertility patients, the heart Qi and kidney essence frequently is nurtured and tonified.
The reasons for this are complex. It may be said that the kidneys' energy is divided into Kidney Yin and Kidney Yang, both ultimately deriving from the Kidney Jing (essence). These Fundamental Substances in turn are responsible for nourishing the Chong and Ren Meridians, which support reproductive capacity.
Other Zang (organs) may be involved as well. Because emotional disharmony, which causes Qi Stasis, lies at the root of many energetic imbalances, the liver, which is responsible for the free flow of Qi, often is thought to be involved. This concept is particularly important because the Liver Channel wraps around the genitals in men, and the reproductive organs in women, and is closely related to reproductive capability.
Apart from disorders in the Zang Fu, disruptions in the Fundamental Substances can contribute to infertility. Blood Stasis and Phlegm Stasis, which can prevent the proper circulation of Qi and Blood and disrupt reproductive capabilities, are common causes. These disharmonies usually result from overwork, improper diet, sexual intemperance, emotional disharmonies, and constitutional factors.
Traditional Chinese Medicine Categories of Infertility
In categorizing infertility, Traditional Chinese Medicine looks for Zang Fu involvement and disruption in the Fundamental Substances as keys to understanding the full energetic disharmony causing infertility.
Thousands of years of clinical TCM experience indicate the following categories of infertility:
- Kidney Yang Deficiency: Signs and symptoms include aversion to cold, pale complexion, fatigue, weak lower back and knees, loose stools, tendency to urinate frequently with large amounts of urine, and a low sex drive. The pulse is deep and weak, the tongue pale with a thin white coat. In men, symptoms also may include impotence and sensations of cold in the scrotum; in women, symptoms may include prolonged menstrual cycles with pale menstrual discharge or lack of menstruation.
- Kidney Yin Deficiency: Signs and symptoms include sensations of heat in the palms, soles, and chest; irritability; aversion to heat or sensations of heat in the afternoon or evening; difficulty sleeping; night sweats; dizziness; possible palpitations; a hyperactive sex drive; and weakness in the lower back and knees. The pulse is thin and rapid, the tongue red with a scanty coat. In men, symptoms may include decreased ability to control ejaculation or abnormally protracted erections; in women, symptoms include short menstrual cycles with scanty menstrual discharge that is dark in color. Kidney essence Vacuity in women is indicated by empty follicles, low ovarian reserve at a young age (under the age of 30), dizziness, hair loss, blurred vision, and infertility. In men it is often represented by azoospermia in the absence of anatomical anomalies.
- Liver Qi Stagnation: Signs and symptoms include emotional depression, irritability, the tendency to anger easily, and distending pain or discomfort in the abdomen or ribcage. The tongue may be a dusky color with a thin white coat, and the pulse wiry. In men, symptoms may include sagging pain in the scrotum, inability to maintain an erection, and difficulty ejaculating; in women, symptoms may include irregular menstrual cycles with cramps, dark menstrual discharge with clots, and symptoms of premenstrual tension.
- Blood Stasis: Signs and symptoms include sharp and stabbing pain in the body, emotional disharmony, stress, dark facial complexion, and dry rough skin. The tongue may be dark purple with severely distended sublingual veins. The pulse may be choppy. In men, there may be varicocele or a history of hernia. In women, the menstrual cycle may be irregular and may contain a significant number of clots.
- Phlegm: Signs and symptoms include obesity, a sensation of bodily heaviness, feelings of "fuzzy" thought, expectoration of copious amounts of phlegm, and possible dizziness or palpitation. The tongue may have a greasy white coating, and the pulse may be slippery or slippery and wiry. In men, there may be an accumulation of fluid in the scrotum. In women, there may be a large amount of vaginal discharge with no menses or a prolonged menstrual cycle.
Dual Patterns of Disharmony also might exist. For example, it is common to find Liver Qi Stagnation and Blood Stasis together, or dual Kidney Yin-Yang Deficiency.