As an acupuncturist, I pose many questions to my female fertility patients to gain insight and knowledge into the complicated internal systems and situations that contribute to fertility issues. Asking detailed questions helps me treat a patient’s specific concerns, as well as her general wellbeing. Determining the answers to these questions plays a crucial role in comprehensive, successful treatment.
Ovulation is a key component to getting pregnant. (That fact may seem obvious to many women trying to conceive, but it bears repeating.) As we were all taught in health class long ago, a regular cycle generally consists of 28 days. Essentially, a follicle containing an egg grows during the first 14 days; on day 14 ovulation (when the follicle releases the egg to travel down the fallopian tube) should occur ; and the uterine lining thickens during the last 14 days, allowing for the egg to implant. During implantation, the fertilized egg attaches and burrows into the uterine lining to grow. Typically, implantation takes place seven days after ovulation.
These concepts may seem straightforward, but many factors can alter a cycle and extend or shorten each of the follicular, ovulatory, and luteal phases. Any variation can make pregnancy elusive. A woman may have issues with ovulation or no ovulation, cystic ovaries, fibroids, poor cervical mucous, abbreviated cycles or extended cycles, and endocrine issues to name a few. Any of these factors can interfere with conception, but by understanding the landscape of a cycle, we know how to start to treat the issues.
Here are some important questions to consider, whether you are trying to conceive or not. Knowledge is power, so the answers to these simple questions can demystify your cycles and provide an invaluable understanding of your body. Of course, if you are on birth control pills, the hormones supplied by the pills control your cycles and the pills are designed to prevent ovulation. These pills and any hormone-based birth control can affect your period’s flow and cycle.
How many days are your cycles (Count day one as the first full day of bleeding.)
How long do your periods last?
Do you consider your periods heavy, medium, or light? (Heavy would be having to change pads or tampons every two hours.)
Do you have cramps? Before, during, or after your period starts?
Do you have clots? How big are they? (Pea size, quarter size, or larger?)
Do you have painful periods?
Do you have spotting between periods? Unexplained bleeding? Dark blood with onset of period? Dark blood at the end of menses?
Is your flow stop and go? Or constant?
Any dizziness with your period?
Any pain with ovulation?
Do you get PMS? Breast tenderness, irritability, weepy, moody, bloating, depression, breast tenderness? If so, does it start one day, one week, two weeks before your period?
How would you describe your libido (sexual desire)? High/medium/low?
Is there any cervical mucous? When? Color? Odor?
Is there any pain with intercourse? Only certain positions?
Do you have frequent urination? Dribbling urine when you cough, sneeze or laugh?
Have you ever had fibroids? Surgery for fibroids? Endometriosis? Cyctic ovaries? Uterine polyps? Bladder infections? Yeast infections? Cystitis?
Have you ever had abdominal, pelvic or back surgeries?
Have you ever had serious accidents? Any trauma to the tailbone? When?
Are you experiencing any menopausal symptoms? Including hot flashes/insomnia/irregular menses/ poor memory/irritability/vaginal dryness?
Do you experience chronic constipation? Chronic low back pain?
Are there any acute emotional stressors in your life?
Have you ever been sexually abused?
Have you ever been diagnosed with cancer of the uterus, cervix, vagina, fallopian tubes, bladder,or colon?
If you have been pregnant before, here are additional questions:
Number of pregnancies? If more than one, how far apart?
Number of deliveries?
C-sections?
Have you had miscarriages? When? Any complications?
Have you had abortions? When? Any complications?
Did you have an episiotomy?
What was your experience with pregnancy? What was your experience with labor and/or delivery? Any complications?