Forget about New Year’s resolutions! Spring and summer are much better times to jump-start your healthy habits.  As opposed to mid-winter when it’s tough to get out and exercise, Spring is a time for reconnecting with the outdoors.  Fresh fruits and vegetables also start to come into season, and are a little more affordable than the often expensive – and not so great tasting – produce we have access to during the winter months.  Try these ideas to get started:

Make a list of ways to be physically active outside.  Walking has the fewest obstacles – all you need is a good pair of sneakers and a destination.  Plot out a few neighborhood walks and pick up a pedometer to track your steps (10,000 steps equals one mile).  If possible, try walking to run your errands on the weekend.  Check out the Massachusetts Department of Conservation and Recreation website  to find a new nature walk to check out with a spouse or friend.  And don’t let lack of a lot of time be an obstacle.  Studies show that as little as ten minutes of physical activity provides health benefits.  Don’t forget, “yard work” is how most people got their physical activity throughout most of history, so get out there and start digging!

Find a Farmer’s Markets are in your area. There’s nothing like seeing fresh fruits and vegetables right off the farm truck to inspire you to try something new.  Ask the sales person how they’d recommend you prepare a new fruit or vegetable, or one you know you like but haven’t cooked before. Check out Mass.gov — which provides an interactive map to help you locate a farmers market near you.

Plan your meals around plants.  A healthy “balanced plate” is half covered with vegetables and whole fruits.  Trust me – you’ll remember to make the meat, poultry or seafood.  It’s the veggies that are often an after-thought.  Grill a large quantity of cut up peppers, zucchini, eggplant, summer squash, or any other vegetables you like on the weekends to have on hand during the week.  Make a large salad using baby spinach (it lasts longer than Romaine or mesclun greens), grape tomatoes, sliced cucumbers, bell peppers, and other vegetables or fruits you think will last two or three days.  That way it’s ready to eat when you are without any advanced preparation.  Even better, eat a salad before every meal and still cover 50% of your plate with vegetables.   It’s the best way to assure you’ll walk away full without feeling loaded down with calories!

This year, try viewing Memorial Day as your new “New Year’s” time to set some health promoting resolutions.  With six to eight months of nice weather ahead, you’ll have plenty of time to solidify some new habits before next winter comes around!

ABOUT HILLARY WRIGHT

After 12 years as a nutrition-based educator for Harvard Vanguard Medical Associates (HVMA), the Domar Center for Mind/Body Health’s Director of Nutrition Hillary Wright transitioned to a part-time position at Dana Farber Cancer Institute in Boston. She is also the founder of New Vision Nutrition in Arlington, Massachusetts — a private nutrition consulting practice that includes nutrition counseling, public speaking, and teaching nutrition to colleges and institutions. She is a contributing editor and regular writer for the newsletter “Environmental Nutrition” and is currently working with the Arlington Public Schools on grant-funded programs designed to increase nutrition, education and physical activity in  the community. Hillary’s clinical interests include women’s health and nutritional management of polycycstic overy syndrome (PCOS).

Our modern lives are full of pressures, deadlines, frustrations and demands. These pressures can often leave us feeling overwhelmed and frazzled. The additional stress of an infertility diagnosis can be an added burden, increasing the stress response. Yoga and other mind-body integration approaches help reduce the stress response and promote optimum reproductive health.

When we sense a threat, our nervous system releases a flood of hormones including, cortisol and adrenaline. These hormones prepare the body for the “fight, flight or freeze” response. Your blood pressure rises, the heart beats faster, visual acuity increases, your muscles tense and prepare for quick action because of the perceived threat.

The “fight or flight” warning system is in place to protect us from dangers-seen and unseen. When it’s working well, it keeps us alert, productive, focused and safe.

However, long term and chronic stress response can lead to high blood pressure, suppressed immune function, increased increase risk of heart attack and stroke. It can also contribute to infertility, as well as leave you more vulnerable to anxiety, depression and mood swings.

The most effective tool for managing stress is activating the body’s innate “relaxation response.” The relaxation response brings the nervous system back into balance by slowing down the heart rate, lowering the metabolism and decreasing the respiratory rate. This counterbalance to the “fight or fight” response creates a deep state of mental and physiological rest.

What is Restorative Yoga?

Restorative Yoga is a quiet, therapeutic practice that is suited to everyone. The goal of restorative practice is to reduce the stress response and ignite the body’s parasympathetic (rest and digest) response.

In each pose, blankets, bolsters and blocks support you, allowing you to fully release all of your muscle tension and completely let go. All poses are done lying down and are typically held from 5-15 minutes. Covering the eyes with a towel, or eye pillow allows you to deepen your relaxation. As you let go, the breath slows down, the heart rate reduces, and the blood pressure lowers.

Your only job in restorative yoga is to find physical comfort in a state of “being” and allow the mind/body to realign and rebalance.  As you let go of muscular effort, the body can release deeply held physical, and emotional tension.

~ Additional Yoga Q& A ~

What is the connection between stress and infertility?

Prolonged and unsuccessful attempts to conceive can be highly stressful. This stress can causes anxiety and activate the sympathetic nervous system’s “fight or flight“ response. The hormones released from this response, increase your heart rate, blood pressure, and metabolic rate.

Chronically elevated stress hormones negatively impact overall health, and can lead to heart disease, autoimmune disorders and even adversely affect the reproductive cycle over time.

Studies have shown s a link between stress reduction and conception. A 2009 study by researcher Alice Domar, PhD, showed that 55% of infertility patients participating in a 10-week mind-body program (which included yoga and meditation) successfully conceived compared to 20% in a control group.

What is Yoga for Fertility?

Yoga for Fertility is a therapeutically designed hatha style yoga class. This class supports your fertility by being slow, gentle and focused on the breath. This attention on the breath helps illicit the “relaxation response” and grounds your awareness in the body and in the present moment. The intention of this class is to help you relax and restore your deepest energy reserves. A group setting also provides a supportive community in which to practice.

How can Yoga for Fertility help me?

The poses (asanas) open the hips and increase the energy (prana) to the pelvis and reproductive organs, and they encourage the release of deeply held tension in these areas. Practicing fertility yoga helps reduce toxins in the body, regulates the endocrine system, and can help elevate a low mood.

I’m not very flexible, can I still take the class?

You don’t need to be flexible at all to take this class. Everyone’s body is different and we move in and out of poses in unique ways.  It is important, however, not to ever force yourself into any pose. You are encouraged to always move slowly and mindfully and in a pain-free zone. Modifications and props are always encouraged.

How often should I do yoga?

Since the poses are gentle and restorative you can safely do a little every day. Just lying down in savasana (resting pose) for 5 minutes is good for you. As you quietly deepen your connection to your mind and body, you can positively impact the emotional roller coaster of infertility.

ABOUT CHERYL WARRICK, BFA, MEd, RYT

Cheryl Warrick, BFA, MEd, RYT, is a graduate of the Elemental Yoga Mind-Body Teacher training with Bo Forbes, at the 200 hour level. She also holds a BFA  from the Massachusetts College of Art and Design and an ME.d from Lesley University.

Cheryl practiced nursing in a critical care setting from 1982-1997. She brings with her a wide breadth of professional and life experiences. Her personal journey with yoga has been a powerful, transformative gift in her life. Over time, she has seen how her restorative yoga practice created positive shifts in her emotional, and physical body.  Her goal as a teacher is to give her students experiences to discover a sense of curiosity, balance and ease in their yoga practice.

For the past few months, the psychologists at the Domar Center for Mind/Body Health have begun offering an onsite, free mini crisis management session to patients who have an unsuccessful IVF cycle.

I feel that it is crucial when you receive such unexpected, devastating news to have at least a few minutes to talk, make a plan as to how you can cope over the next few days and learn how to deal with the reactions of others.

It is the reaction of others which really bugs me. I had a miscarriage about eleven years ago and although the vast majority of family and friends were wonderful, compassionate, and understanding – the comment of one family member still sticks with me. I was asked if I had had “a real miscarriage”. That question completely stunned me.

Is there even such a thing as a “fake” miscarriage? 

The pain, both physical and emotional, sure felt real to me!

What I advise my patients is that our society is not really comfortable with pregnancy loss and thus, the reactions of others may well seem unfeeling or callous. After all, in our mother’s day, women were basically ordered not to tell anyone they were pregnant until after the first trimester, so that if they miscarried, no one would know. When a relative of mine got pregnant many years ago and subsequently miscarried, she told all of her close friends and was stunned by how many of them then told her that they had experienced a loss as well. She told me that the stories were coming out of the woodwork, yet she had not known about any of the other losses until she shared her own story.

When one experiences a pregnancy loss, it is not only the end of a much-desired quest for parenthood, it is also the loss of all the hopes and dreams for that child. Many of us begin to discuss baby names as soon as a pregnancy is confirmed. Nursery colors might have been imagined and fantasies of pregnancy announcements and joyous family events are common.  So when a pregnancy ends, it is not just the physical impact of the loss, it can be a profound emotional one as well.

If you ever experience a miscarriage, your biggest priority should be to protect yourself. Allow yourself to grieve in the way you need to, and don’t let anyone tell you how you should be feeling or coping. Having a pregnancy end even 24 hours after the first positive test can still be a terrible loss, and don’t let anyone tell you otherwise!

ABOUT ALICE DOMAR, PhD

Alice D. Domar, PhD is a pioneer in the application of mind/body medicine to men’s and women’s health issues. She not only established the first Mind/Body Center for Women’s Health, but also conducts ongoing ground-breaking research in the field. Her research focuses on the relationship between stress and different women’s health conditions, and creating innovative programs to help women decrease physical and psychological symptoms.

Dr. Domar received her M.A. and Ph.D. in Health Psychology from Albert Einstein College of Medicine/Ferkauf School of Professional Psychology of Yeshiva University. Her post-doctoral training was at Beth Israel Hospital, Deaconess Hospital, and Children’s Hospital, all in Boston.

She has conducted research on infertility, breast cancer, menopausal symptoms, ovarian cancer, and premenstrual syndrome. Dr. Domar has earned an international reputation as one of the country’s top women’s health experts.

She is currently the Executive Director of the Domar Center for Mind/Body Health, and the Director of Mind/Body Services at Boston IVF. She is an assistant professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, and a senior staff psychologist at Beth Israel Deaconess Medical Center.

Dr. Domar has compiled an impressive list of accomplishments as a best-selling author, media authority and sought-after public speaker. She is the author of numerous books, on the advisory board for Parents Magazine, Health Magazine, Conceive Magazine, and Resolve, and on the Board of Experts for LLuminari. Two of her books have been finalists for the Books for a Better Life Award. She was also the Series Editor for a series of mind/body books by Harvard Medical Publications/Simon and Schuster. She is the narrator of the DVD’s “Stress and Relaxation Explained” and “Infertility Explained”, both of which won silver Telly Awards.  Dr. Domar has appeared on the Today Show, Good Morning America, CBS This Morning, Dateline NBC, CNN, PBS, and the CBS and NBC Evening News, to name a few. She presents lectures and conducts workshops throughout the US and around the world and went on tour with Oprah in the spring of 2004 and 2005 with the LLuminari team. Dr. Domar was named to the prestigious list of 15 “Women to Watch in 2004” by Lifetime TV. Her newest book is “Be Happy Without Being Perfect” (Three Rivers Press, March, 2009) and she is currently working on a new book, co-authored with Dr. Susan Love, called “Live a Little” (Crown, December, 2009). She is also a featured expert on the new online social health network BeWell.com.

For the past few months, the psychologists at the Domar Center for Mind/Body Health have been offering a within-the-hour, onsite, free mini crisis management session to patients who come in for a prenatal ultrasound but no heartbeat is seen. I feel that it is crucial when you receive such unexpected, devastating news to have at least a few minutes to talk, make a plan as to how you can cope over the next few days and learn how to deal with the reactions of others.

It is the reaction of others which really bugs me. I had a miscarriage about eleven years ago and although the vast majority of family and friends were wonderful, compassionate, and understanding – the comment of one family member still sticks with me. I was asked if I had had “a real miscarriage”. That question completely stunned me.

Is there even such a thing as a “fake” miscarriage? 

The pain, both physical and emotional, sure felt real to me!

What I advise my patients is that our society is not really comfortable with pregnancy loss and thus, the reactions of others may well seem unfeeling or callous. After all, in our mother’s day, women were basically ordered not to tell anyone they were pregnant until after the first trimester, so that if they miscarried, no one would know. When a relative of mine got pregnant many years ago and subsequently miscarried, she told all of her close friends and was stunned by how many of them then told her that they had experienced a loss as well. She told me that the stories were coming out of the woodwork, yet she had not known about any of the other losses until she shared her own story.

When one experiences a pregnancy loss, it is not only the end of a much-desired quest for parenthood, it is also the loss of all the hopes and dreams for that child. Many of us begin to discuss baby names as soon as a pregnancy is confirmed. Nursery colors might have been imagined and fantasies of pregnancy announcements and joyous family events are common.  So when a pregnancy ends, it is not just the physical impact of the loss, it can be a profound emotional one as well.

If you ever experience a miscarriage, your biggest priority should be to protect yourself. Allow yourself to grieve in the way you need to, and don’t let anyone tell you how you should be feeling or coping. Having a pregnancy end even 24 hours after the first positive test can still be a terrible loss, and don’t let anyone tell you otherwise!

ABOUT ALICE DOMAR, PhD

Alice D. Domar, PhD is a pioneer in the application of mind/body medicine to men’s and women’s health issues. She not only established the first Mind/Body Center for Women’s Health, but also conducts ongoing ground-breaking research in the field. Her research focuses on the relationship between stress and different women’s health conditions, and creating innovative programs to help women decrease physical and psychological symptoms.

Dr. Domar received her M.A. and Ph.D. in Health Psychology from Albert Einstein College of Medicine/Ferkauf School of Professional Psychology of Yeshiva University. Her post-doctoral training was at Beth Israel Hospital, Deaconess Hospital, and Children’s Hospital, all in Boston.

She has conducted research on infertility, breast cancer, menopausal symptoms, ovarian cancer, and premenstrual syndrome. Dr. Domar has earned an international reputation as one of the country’s top women’s health experts.

She is currently the Executive Director of the Domar Center for Mind/Body Health, and the Director of Mind/Body Services at Boston IVF. She is an assistant professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, and a senior staff psychologist at Beth Israel Deaconess Medical Center.

Dr. Domar has compiled an impressive list of accomplishments as a best-selling author, media authority and sought-after public speaker. She is the author of numerous books, on the advisory board for Parents Magazine, Health Magazine, Conceive Magazine, and Resolve, and on the Board of Experts for LLuminari. Two of her books have been finalists for the Books for a Better Life Award. She was also the Series Editor for a series of mind/body books by Harvard Medical Publications/Simon and Schuster. She is the narrator of the DVD’s “Stress and Relaxation Explained” and “Infertility Explained”, both of which won silver Telly Awards.  Dr. Domar has appeared on the Today Show, Good Morning America, CBS This Morning, Dateline NBC, CNN, PBS, and the CBS and NBC Evening News, to name a few. She presents lectures and conducts workshops throughout the US and around the world and went on tour with Oprah in the spring of 2004 and 2005 with the LLuminari team. Dr. Domar was named to the prestigious list of 15 “Women to Watch in 2004” by Lifetime TV. Her newest book is “Be Happy Without Being Perfect” (Three Rivers Press, March, 2009) and she is currently working on a new book, co-authored with Dr. Susan Love, called “Live a Little” (Crown, December, 2009). She is also a featured expert on the new online social health network BeWell.com.

I think that Mother’s Day and the December holidays are the two toughest times for anyone going through infertility. The only good thing about Mother’s Day is that it is for one day only, and most people have some kind of mother to honor, which can take a bit of the edge off of not being a mother yourself. 

But Thanksgiving through New Year’s is a long time to be exposed to all that joy and festivity, much of which is focused on kids. Or family gatherings which feature kids. Or friends’ parties. Which include kids. Or spiritual and religious gatherings which focus on the baby Jesus. Sadly, the season has lost a lot of its emphasis on the religious aspect and focuses more on the toys than on the spiritual. Many church services focus on children, and may also focus on the miracle of the conception and birth of Jesus. This can be a common issue with Christmas Eve and Christmas morning services. So going to your place of worship instead of being a place of shelter and comfort can sometimes be a source of pain.

It is hard to feel celebratory when you feel so uncertain about your future, when your hopes soar each month, only to be disappointed two weeks later.

Many people who are experiencing infertility use Christmas as a marker of time, so that you might be feeling, “here is yet another Christmas and we don’t have a baby” or “that makes X number of years we have been going through this”. If some number is going through your head, remind yourself that this is normal, and perhaps recognize the strength you have to keep on trying. Most people who don’t conceive easily never even see a doctor so if you are actually in treatment, it means you are working hard and pushing yourself in this journey. You need to appreciate what you are willing to put yourself through to become a parent since most people simply give up.

Finally, you are probably getting countless holiday cards which feature pictures of babies and children from your friends and family. Which means that opening the mail can be a daily source of distress.

Many of our patients talk about how lonely, isolated and angry they feel during December.

Although December is traditionally the time to find the perfect gift for everyone on your list, instead think of this month as the perfect time of giving yourself the gift of self-nurturance. Use infertility as an excuse to really think about what you want and need, not in terms of material objects, but what you are thirsty for in terms of what your body and soul crave.

Try to find new meaning in your faith, by perhaps volunteering to help those less fortunate. Go to soup kitchens or homeless shelters to offer your time.

If your families make you crazy on Christmas, there is no rule which says that you have to go. You can either suddenly come down with a stomach bug, simply announce that you will miss the tearing open of gifts but will be there for dinner, or head off for a few days at a B&B.

Try something crazy-go to one of those restaurants where you have to eat with your hands, run barefoot in the snow, or eat ice cream sundaes for dinner.

There is no rule which says you have to actually open holiday cards, or attend parties. Live your life for you. At least for now.

You need to remember that if you are feeling sad or anxious during this season, it is completely normal and don’t let anyone tell you that it is bad or weird for you to feel upset.

Think about what you need, make those needs known to your loved ones, and figure out what will make this season as tolerable or even enjoyable as you can.

ABOUT ALICE DOMAR, PhD

Alice D. Domar, PhD is a pioneer in the application of mind/body medicine to men’s and women’s health issues. She not only established the first Mind/Body Center for Women’s Health, but also conducts ongoing ground-breaking research in the field. Her research focuses on the relationship between stress and different women’s health conditions, and creating innovative programs to help women decrease physical and psychological symptoms.

Dr. Domar received her M.A. and Ph.D. in Health Psychology from Albert Einstein College of Medicine/Ferkauf School of Professional Psychology of Yeshiva University. Her post-doctoral training was at Beth Israel Hospital, Deaconess Hospital, and Children’s Hospital, all in Boston.

She has conducted research on infertility, breast cancer, menopausal symptoms, ovarian cancer, and premenstrual syndrome. Dr. Domar has earned an international reputation as one of the country’s top women’s health experts.

She is currently the Executive Director of the Domar Center for Mind/Body Health, and the Director of Mind/Body Services at Boston IVF. She is an assistant professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, and a senior staff psychologist at Beth Israel Deaconess Medical Center.

Dr. Domar has compiled an impressive list of accomplishments as a best-selling author, media authority and sought-after public speaker. She is the author of numerous books, on the advisory board for Parents Magazine, Health Magazine, Conceive Magazine, and Resolve, and on the Board of Experts for LLuminari. Two of her books have been finalists for the Books for a Better Life Award. She was also the Series Editor for a series of mind/body books by Harvard Medical Publications/Simon and Schuster. She is the narrator of the DVD’s “Stress and Relaxation Explained” and “Infertility Explained”, both of which won silver Telly Awards.  Dr. Domar has appeared on the Today Show, Good Morning America, CBS This Morning, Dateline NBC, CNN, PBS, and the CBS and NBC Evening News, to name a few. She presents lectures and conducts workshops throughout the US and around the world and went on tour with Oprah in the spring of 2004 and 2005 with the LLuminari team. Dr. Domar was named to the prestigious list of 15 “Women to Watch in 2004” by Lifetime TV. Her newest book is “Be Happy Without Being Perfect” (Three Rivers Press, March, 2009) and she is currently working on a new book, co-authored with Dr. Susan Love, called “Live a Little” (Crown, December, 2009). She is also a featured expert on the new online social health network BeWell.com.

If eating healthier is part of your fertility improvement plan, research shows the simple of act of keeping a food diary is one of the single most effective things you can do to change your eating habits.  Numerous studies show that keeping a food diary, journal or log – whatever you want to call it – is highly effective at raising your awareness of what, where, when and why you’re eating, providing useful clues to target behavior change.  In fact, one study on people trying to lose weight showed that, along with attending weekly classes on nutrition and portion control, those who kept a food dairy six days per week lost twice as much as those who logged only once per week or less.

Because human beings are not “hard wired” to notice everything we eat – as hunter/gatherers we were supposed to eat whatever edibles we could find – keeping a food journal is like conducting an “audit” of your eating habits so you can see if what you think you’re eating is accurate. 

Simply picking up your notebook, tapping into an electronic log on your smart phone, or recording in one of the many available on-line food logs, is a reminder that you’re trying to keep food in your focus, and think about what you eat as the day goes on.  Here are a few simple tips from the experts on how to make logging work for you:

• Record your food and beverage intake as the day goes on, ideally right after you eat.  It increases your accuracy and helps keep your intensions to eat healthier alive throughout the day.
• Take time to practice portions control. Buy some measuring cups or spoons, or a food scale if necessary.  Practicing measuring at home so when you eat out you’ll be more accurate at estimating portions.
• Use whatever kind of tracking fits your lifestyle. It can be a small notebook, an eye-catching colorful journal, an app for your smart phone or an online tracker such as those available through sparkpeople.com or nutritiondata.com.
• Record everything – even the stuff that makes you blush.  It’s all part of the process.
• If possible, share your logs with someone who can provide useful feedback, like a registered dietitian, or even a supportive friend.  Being accountable for your intake can reinforce your determination to practice positive behaviors.

ABOUT HILLARY WRIGHT

After 12 years as a nutrition-based educator for Harvard Vanguard Medical Associates (HVMA), Hillary transitioned to a part-time position at Dana Farber Cancer Institute in Boston. She is also the founder of New Vision Nutrition in Arlington, Massachusetts — a private nutrition consulting practice that includes nutrition counseling, public speaking, and teaching nutrition to colleges and institutions. 

She is a contributing editor and regular writer for the newsletter “Environmental Nutrition” and is currently working with the Arlington Public Schools on grant-funded programs designed to increase nutrition, education and physical activity in  the community. Hillary’s clinical interests include women’s health and nutritional management of polycycstic overy syndrome (PCOS).

Mind-body therapies such as yoga, meditation, and deep breathing exercises are leading a wave of complementary and alternative medicine (CAM) use in the U.S. More than a third of Americans use some form of (CAM) and that number continues to rise, according to a study from Harvard Medical School and Beth Israel Deaconess Medical Center (BIDMC).

The research also found that one-in-30 Americans using mind-body therapies has been referred by a medical provider. The results of the study appeared in the May 9 issue of the Archives of Internal Medicine.

This data from Aditi Nerurkar, MD, Integrative Medicine Fellow, Harvard Medical School and BIDMC and her colleagues is welcome, albeit unsurprising, given what I’ve witnessed in my 3.5 years as Director of Restorative Yoga Services at the Domar Center.

As a yoga therapist and medical writer, I’ve had a chance to observe the increasing acceptance of mind-body therapies among physicians — thanks in large part to a growing body of evidence demonstrating the many positive outcomes these therapies provide. Reduced depression, anxiety, insomnia are just a few of yoga’s scientifically proven benefits. In fact, in many circles, mind-body medicine is no longer considered “alternative” – and it is less unusual to find ancient yoga and meditation practices being taught in modern medical centers (such as Boston IVF).  

Anecdotally, I’ve also observed that as more medical providers experience the benefits of yoga and meditation themselves, more are recommending these approaches to patients based on personal experience.

Researchers collected information from more than 23,000 U.S. households from the 2007 National Health Interview Survey. They found that nearly 3 percent (representing more than 6.3 million Americans) used mind-body therapies due to provider referral and that these Americans were sicker and used the health care system more than people who self-referred.

“What we learned suggests that providers are referring their patients for mind-body therapies as a last resort once conventional therapeutic options have failed,” said Nerurkar. “It makes us wonder whether referring patients for these therapies earlier in the treatment process could lead to less use of the health care system, and possibly, better outcomes for these patients.”

I couldn’t agree more.

I tend to see women who have been struggling with infertility for many years before they decide to give yoga a try. The good news is that it’s never too late. But I can’t help but wonder what would happen if more women were to adopt yoga practices long before they began trying to conceive.

ABOUT NATALIE ENGLER, RYT

Natalie Engler, RYT is a National Yoga Alliance Registered Yoga Teacher who offers private yoga and small group classes to women at all stages of the fertility process. Her approach synthesizes ongoing studies in Iyengar-influenced and Vinyasa yoga with immersion in Restorative Yoga, which she learned as part of her 200-hour yoga teacher certification with Bo Forbes, PsyD, creator of Integrative Yoga Therapeutics.

Natalie has been an avid yoga practitioner for 20 years and a yoga teacher for six years. Through a dedicated personal practice and experience teaching individuals and groups, Natalie has witnessed the potent effects of Restorative Yoga on a wide range of issues. She is honored to be able to share this practice with women at the Domar Center for Mind/Body Health.

In addition teaching yoga, Natalie is a wellness coach and health writer who has written for Harvard Medical International, Reuters Health, the Massachusetts Medical Society and Harvard Health Publications. She has been quoted in the Boston Globe, Yoga Journal, Parents Magazine, and Conceive Magazine.

I have been following the research of psychologist James Pennebaker, Ph.D for almost 20 years.  He has been researching the impact of writing about one’s thoughts and feelings on mental and physical health and the data is amazing. Much of his research has been with people who have experienced a trauma, such as physical or sexual abuse, experiencing a hurricane or tornado, witnessing or being a victim of violence, or participating in a war. Simply writing for 15 to 20 minutes for several days can decrease symptoms of anxiety and depression, improve immune function, and significantly reduce doctor visits for months afterwards.

I have seen the results firsthand. Anyone who has read the chapter on infertility in my first book, Healing Mind, Healthy Woman knows that writing for 20 minutes for four days is part of the mind/body program.  The patient interviewed tells her story in a very compelling way. She wrote for 20 minutes in the group, felt very sad afterwards (it is common to feel worse initially but after writing for another couple of days, the improvements hit), but then continued to write and as she puts it, “I woke up and my world was in color again”.  Her black cloud lifted and she felt better than she had since before they started trying to conceive.

Pennebaker’s instructions are simple. The results are slightly better if you take pen to paper but if that isn’t appealing to you, you can write on a computer. Write about your thoughts and feelings, don’t worry about how sloppy your handwriting is, your spelling or punctuation, or censor what you are writing. And don’t plan to show it to anyone-this writing has to be for just you.  Keep it up for four days and you will likely feel an emotional lift.

ABOUT ALICE DOMAR, PhD

Alice D. Domar, PhD is a pioneer in the application of mind/body medicine to men’s and women’s health issues. She not only established the first Mind/Body Center for Women’s Health, but also conducts ongoing ground-breaking research in the field. Her research focuses on the relationship between stress and different women’s health conditions, and creating innovative programs to help women decrease physical and psychological symptoms.

Dr. Domar received her M.A. and Ph.D. in Health Psychology from Albert Einstein College of Medicine/Ferkauf School of Professional Psychology of Yeshiva University. Her post-doctoral training was at Beth Israel Hospital, Deaconess Hospital, and Children’s Hospital, all in Boston.

She has conducted research on infertility, breast cancer, menopausal symptoms, ovarian cancer, and premenstrual syndrome. Dr. Domar has earned an international reputation as one of the country’s top women’s health experts.

She is currently the Executive Director of the Domar Center for Mind/Body Health, and the Director of Mind/Body Services at Boston IVF. She is an assistant professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, and a senior staff psychologist at Beth Israel Deaconess Medical Center.

Dr. Domar has compiled an impressive list of accomplishments as a best-selling author, media authority and sought-after public speaker. She is the author of numerous books, on the advisory board for Parents Magazine, Health Magazine, Conceive Magazine, and Resolve, and on the Board of Experts for LLuminari. Two of her books have been finalists for the Books for a Better Life Award. She was also the Series Editor for a series of mind/body books by Harvard Medical Publications/Simon and Schuster. She is the narrator of the DVD’s “Stress and Relaxation Explained” and “Infertility Explained”, both of which won silver Telly Awards.  Dr. Domar has appeared on the Today Show, Good Morning America, CBS This Morning, Dateline NBC, CNN, PBS, and the CBS and NBC Evening News, to name a few. She presents lectures and conducts workshops throughout the US and around the world and went on tour with Oprah in the spring of 2004 and 2005 with the LLuminari team. Dr. Domar was named to the prestigious list of 15 “Women to Watch in 2004” by Lifetime TV. Her newest book is “Be Happy Without Being Perfect” (Three Rivers Press, March, 2009) and she is currently working on a new book, co-authored with Dr. Susan Love, called “Live a Little” (Crown, December, 2009). She is also a featured expert on the new online social health network BeWell.com.

If you experience pelvic pain, abnormally heavy bleeding, dysmenorrheal (painful periods), back pain, abdominal cramping, painful intercourse, gastrointestinal upset, and/or infertility, you may be suffering from a condition called endometriosis. If you have been diagnosed with endometriosis, there is promising natural treatment available. Acupuncture has been identified as a viable treatment option.

According to a 2010 study in the European Journal of Gynecological Reproductive Biology, researchers examined whether acupuncture was an effective additional pain treatment for endometriosis. The study consisted of 101 women ages 20-40. Results showed a significant reduction of pain intensity after the first 10 acupuncture treatments (Rubi-Klein, et. al., 2010).

What Exactly Is Endometriosis?
Endometriosis is a condition in which cells from the lining of the uterus (endometrium) grow outside the uterine cavity. Under normal circumstances, when a woman menstruates, blood should be discharged vaginally, exiting the body. With endometriosis, it is believed that the menstrual blood and tissue backs up into the abdominal cavity instead of exiting the body. This back up results in pain that is often severe before, during, and/or after the menstrual cycle, with the ovaries being the most common site affected. Fallopian tubes, the back and front of the uterus (posterior and anterior cul-de-sac), uterine ligaments, pelvic back wall, intestines, and bladder and ureters are also common sites of occurrence. Endometriosis can often cause anatomical distortions and adhesions, which can cause infertility.

Who Gets Endometriosis?
Endometriosis occurs in roughly 5-10% of women (Lu, PY. 1995). Women who are estrogen-dependent are often part of the endometriosis population. Also, it is believed that there is a 10-fold increase of incidence in women with an affected first-degree relative (Dharmesh & Davila, 2005). Others believe its incidence can be linked to environmental factors and the immune system.

How Is It Diagnosed?
The only way to 100% diagnose endometriosis is by having a surgical procedure called a laparoscopy. One very interesting fact about endometriosis is that there is no correlation between the severity of the endometriosis and a women’s pain level. For example, a woman can have Stage I (minimal) endometriosis and be in excruciating pain, where as a women with Stage IV (severe) can have no pain at all. It is one of the many mysterious factors of the disease, which continues to baffle patients and doctors alike. During a laparoscopy, if endometriosis is found it is usually cauterized and sent to the laboratory for diagnosis. After surgery, hormonal medications (oral contraceptives), anti-inflammatory medications (NSAIDs), and narcotics are often used to control pain and reoccurrence. One of the believed “cures” for endometriosis, ironically, is pregnancy – although because there is a large hormonal component, endometriosis may cause lack of ovulation.

Besides having a laparoscopy, don’t forget the benefits of acupuncture! Acupuncture can help with not only pain management, but also can help with menstrual cycle regulation.

How Does Traditional Chinese Medicine (TCM) View Endometriosis and How Can Acupuncture Help?
In TCM, the body’s energy or qi (pronounced chee) can become stagnant. The qi of the body should flow smoothly. With endometriosis, often times blood and qi stagnation are often the cause. Blood, kidney, and liver qi deficiency are also often attributed to this disease, as well. Acupuncture, lifestyle modifications, and dietary suggestions often prove helpful in treating this condition.

With a proper examination and diagnosis from one of the talented acupuncturists at the Domar Center for Mind/Body Health, a treatment plan can be formulated and you can be a step closer to pain relief and hopefully improving your chances at fertility. If you suffer from endometriosis, please come to the Domar Center and start acupuncture treatment today, because one day of pain is one day too many!

References
Dharmesh, K. & Davila, W. (2005). Endometriosis. eMedicine. http://emedicine.com/med/topic3419.htm.

Lu PY, Ory SJ. (1995).Endometriosis: current management. Mayo Clin Proc 1995. 70:453-63. http://www.aafp.org/afp/991015ap/1753.html

Rubi-Klein K, Kucera-Sliutz E., Nissel H, Bijak M., Stockenhuber D., Fink M. & Wolkenstein E. (2010). European journal of obstetrics gynecology reproductive biology. Nov. 2010. 153 (1): 90-3. Epub 2010 Aug 21.

Stratton, P. & Berkley, K.J. (2010). Chronic pelvic pain and endometriosis: Translational evidence of the relationship and implications. Human Reproduction Update 17 (3): 327-346, doi: PMID 21106492. (http://www.ncbi.nlm.nih.gov/pubmed/21106492).

Diagnosis and Treatment of Endometriosis – October 15, 1999 – American Academy of Family Physicians (https://www.aaft.org/aft/991015ap/1753.html)

ABOUT CHRISTINA NOONAN, MAc., LicAc.

Christina, a senior staff acupuncturist at the Domar Center for Mind/Body Health, is a graduate of the New England School of Acupuncture, where she received a masters degree in Japanese and Chinese Acupuncture styles.  She is a Diplomate in Acupuncture by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).  Licensed by the Massachusetts Board of Registration in Medicine, Christina is also certified by the Auricular Therapy Certification Institute, and has completed an extensive Integrated Oncology program from Memorial Sloan Kettering Cancer Center in Manhattan.  Her clinical interests include infertility, gynecological issues, migraines, digestive conditions, and anxiety.

IVF is a treatment for infertility that many seek when other methods of assisted reproductive technologies have failed. We are proud of the more than 30,000 babies born through Boston IVF’s exceptional  patient care.  However, for many different reasons, there are some that were unsuccessful in their quest for a baby.  Some of these reasons can be: low sperm count, issues with sperm mobility or issues with morphology.  In these cases I highly recommend Acupuncture treatment at the Domar Center.

Recent research shows that even after three weeks of treatment there were statistically significant improvements in sperm count and quality.  I believe that acupuncture helps hormonal disorder, including testosterone.

I highly recommend that men start their acupuncture treatments at least two weeks before egg retrieval in order to maximize your efforts for conception. 

Although some men may be leery of acupuncture, rest assured that this is a pain free procedure and does not involve any needle placement in the pelvic area.  Needles are placed primarily in the upper body and legs.   

I’d also like to mention that treatment is often very relaxing and peaceful.  We can all certainly use some of that!

ABOUT YAN JIN

Yan received his medical degree from the Zhejiang College of Traditional Chinese Medicine in 1982 and is a Diplomate in Acupuncture and Chinese Herbology with the National Commission for the Certification of Acupuncturists.

He has practiced at the Affiliated Hospital of Zhejiang College of Traditional Chinese Medicine, The Longhua Clinic, and the Clinic of the New England School of Acupuncture, and provides services at the Chinese Natural Health Clinic and Harvard Vanguard Medical Associates. He has taught in China, Japan, Watertown, and Brookline. His expertise lies in the areas of male infertility, male sexual dysfunction, neurological disorders, and pain management.