Journey into Treating Male Factor Infertility

Over the last few years I've taken a deep dive into how acupuncture and Eastern medicine can help with male factor infertility.

Thanks largely to the work of folks like @drshannaswan and others - my interest sparked as I became aware of the massive drop in fertility rates that we're facing in Western industrialized nations. It's not particularly great, we're not too far from a point of no return (more on that to come).

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INFERTILITY BREAKDOWN — approximately 1/3 female factor, 1/3 male factor, 1/3 both and 10% unknown

Despite our problems and complexities, I think humans are unique, beautiful beings, capable of incredibly amazing things. I truly believe, as a species, we've barely begun to plumb the depths of our greatest potential. So, I can't personally imagine a better thing than to help make more of them. Especially to aid those suffering from the ability to do so without a bit of extra help.

While much of the onus is placed on women in the fertility process when things aren't working out, males are a hugely overlooked factor. It was astonishing to me that in many infertility situations, the male factor is something of an afterthought. In fact, when it comes to fertility problems, the general breakdown is somewhere around: 1/3 female factor, 1/3 male factor, 1/3 both and 10% unknown.

So, why such a lack of focus and/or support for males? Very good question. There are likely many reasons and I intend to explore all of them.

So, if you're finding yourself in a situation where you or your partner is having difficulty, or would just like to optimize sperm health throughout your fertility journey please feel free to reach out. Acupuncture and Eastern medicine is a great complimentary therapy for male factor infertility issues.

A typical session will consist of a semen analysis review (if an analysis is available), a look at diet and lifestyle, some recommendations for supplementation and herbs (if needed), acupuncture and likely some infrared light therapy.

All very easy, comfortable and painless.

If you’d like to learn more, I highly recommend checking out the work of Dr. Shanna Swan. In this interview from Mt. Sinai Hospital, Dr. Swan discusses how endocrine-disrupting chemicals are contributing to decreasing sperm counts and more.

 

Why are American College Students so Stressed? - Facing Invisible Tigers and Surviving the Stress Epidemic

We’re very smart, clever animals. With our intelligence, we’ve created a world with unparalleled amenities like running water, solar panels, electric cars, even pocket-sized supercomputers that give us access to unprecedented information, allow us to explore the solar system, and connect us to nearly every human being at the farthest reaches of our own planet. These are things our ancestors couldn’t have even dreamt of - so why are we so stressed and anxious?  

The simple answer is survival. In many ways, we still respond to our modern stressors as though we’re facing famine, or there is a sabertooth tiger pouncing at us, and we are the main course. For all our modern luxuries, our body processes stressful inputs in much the same way it would have tens of thousands of years ago; the key difference is that we don’t do it acutely for 5 minutes at a time during a tiger attack, we do it chronically over the course of our lifetimes. This is where the danger lies. 

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more than 60 percent of college students said they had experienced “overwhelming anxiety” at some point in the past year

The “parasympathetic” and “sympathetic” nervous systems may not be household concepts, however the symptoms associated with an overactive sympathetic stress response are well known to almost all of us. We’re all familiar with ‘fight or flight’, this is the sympathetic nervous system in action, when we’re in this mode briefly it’s healthy, it helps us survive. When we’re in it chronically, it can have massively damaging effects on our wellbeing. This is the overwhelmed physiological state many college students are finding themselves in on a daily basis. In fact, According to a 2018 report from the American College Health Association, more than 60 percent of college students said they had experienced “overwhelming anxiety” at some point in the past year.

American college students are living in a very interesting time. Most can’t recall a day when they didn’t have ubiquitous access to the internet, and thus, constant flows of bite-sized information, and floods of social media. In nature, our brains are hardwired to be rewarded with a dopamine flush when we discover food, a water source, find a mate, etc., this process creates neural pathways which are beneficial to our survival. In our modern lives, this process is happening at an alarming, unnatural rate with instant gratifications being sought in the digital world, and is proving to have deleterious effects on our brain’s neurochemistry.

This combination of living chronically in the ‘fight or flight’ stress response, and the rewiring of our neural pathways creates a perfect storm for a physiological imbalance that may lead to a myriad of mental and physical problems:

• Loss of sleep, memory and concentration impairment
• Digestive and immune disorders
• Musculoskeletal pain, migraines, etc.
• High blood pressure, heart disease, diabetes
• Depression, generalized anxiety disorder, and more.

Ironically, one of the sneakiest symptoms of an overactive sympathetic nervous system is a marked decrease in one’s ability to cope with, you guessed it, stress. Unsurprisingly, this can lead to a dangerous spiral if left unchecked. Luckily for most, there are very effective coping skills and simple steps that can be taken to change the course of one’s wellness path:

Meditation and Breathing: These could be the single most important tools for mitigating stress. There are many types of meditation and breathing that fit different personality types and situations.
Movement and Diet: Taking care of our physical health and discharging stress through movement is an important and often overlooked aspect of stress management.
Connecting, and disconnecting: Simply keeping a healthy balance between social activity and solitude (including digital detoxing).
Recalibrating: Mindset training is gaining traction as a powerful technique, backed by a significant and fast growing body of research.
Exploring Complimentary Wellness Modalities: Evidence based activities such as acupuncture, yoga, qi gong, etc. are gentle, safe, efficacious ways to mitigate stress and anxiety, help the body release it’s own ‘feel good’ chemicals, and engage the parasympathetic nervous system.

While the epidemic of stress and anxiety on our campuses may feel daunting, there is much that can be done to help students find balance. Many of these techniques are easily integrated into daily routines and feel remarkably natural to most; as it is simply a return to their healthy, harmonious physiological state. After all, we are humans in a modern world coming to terms with modern stressors - and if all goes as planned - not finding ourselves in life or death, fight or flight standoffs with sabertooth tigers. Our student’s stresses are bouts with paper tigers, and while still very real to them, that’s a match they stand a fighting chance of surviving.

If you’d like to learn more about the physiology of stress, I highly recommend you look into the work of Dr. Robert Sapolsky and Dr. Andrew Huberman. Both incredible, highly intellegent researchers in their own right and also remarkably good at distilling their knowledge into a language that’s easy to understand. Here are a few videos to get you started!

"Why Zebras Don't Get Ulcers: Stress and Health" by Dr. Robert Sapolsky

Science writer, biologist, neuroscientist, and stress expert Dr. Robert Sapolsky presents the inaugural Fenton-Rhodes Lecture on Proactve Wellness. Sapolsky states that our bodies' stress response evolved to help us get out of short-term physical emergencies - if a lion is chasing you, you run. But such reactions, he points out, compromise long-term physical health in favor of immediate self-preservation. Unfortunately, when confronted with purely psychological stressors, such as troubleshooting the fax machine, modern humans turn on the same stress response. "If you turn it on for too long," notes Sapolsky, "you get sick." Sapolsky regards this sobering news with characteristic good humor, finding hope in "our own capacity to prevent some of these problems... in the small steps with which we live our everyday lives." This lecture was recorded on September 22, 2016 at the Krannert Center for the Performing Arts' Colwell Playhouse as part of the Pygmalion TechFest

Tools for Managing Stress & Anxiety | Huberman Lab Podcast #10

This episode explains what stress is, and how it recruits our brain and body to react in specific ways. (Dr. Huberman) describes the three main types of stress, and how two of them actually enhance the function of our immune system making us less vulnerable to infections. (He) reviews tools that allow us to control our stress in real-time, as well as tools to prevent long-term stress, burnout and stress-induced illness and anxiety. As always, (he) covers behavioral tools and supplements that can assist or hinder stress control.

 

Acupuncture: A Natural Evidence-Based Alternative to Opioids for Chronic Pain Management

By:  Dr. Shamus Clancey DACM, L.Ac 

Far too many people live with chronic pain. It is estimated that over 1.5 billion people suffer from chronic pain worldwide (NCHS, 2006). In many cases, individuals have exhausted all options available to mitigate their conditions and are left with the possibility of invasive surgery, or turning to opioid based pain medication to mask the root causes of their conditions. Acupuncture, as part of the larger system of Chinese Medicine, exists as a promising evidence-based, complimentary, or alternative option for mitigating this suffering; in many cases by treating branch symptoms, as well as the root causes.

Opioid based pain medication is an option that often arises when a medical professional is out of solutions in a given treatment plan, and must make the decision to ‘treat the branch’ in order to provide a patient with immediate relief. Unfortunately however, it is becoming all too common that these medications are used as a first line of treatment, when other options are not yet exhausted or incorporated. Pain medication can be something of a modern medical miracle to provide temporary relief, however there are no guarantees of efficacy. A study by the American Pain Foundation found that only 23% of patients with chronic pain found pain medication to be effective (APF, 2006), while another meta-analysis and systemic review in 2016, appearing the the JAMA Internal Medicine, found that opioid pain medication was not effective for chronic back pain at guideline recommended dosages (Saheed, Maher, Williams, et al ., 2016). Furthermore, opioid based pain medication carries its own array of side-effects such as constipation, respiratory depression, dizziness, mental fog, and more; not the least of which being the well documented risk of addiction, which has now reached epidemic levels in the United States. Currently, it is estimated that nearly 2 million Americans are addicted to opioid based pain medications (Schuchat, Houry, Guy, 2017), and more overdose deaths occur from these medications than from heroin (Rudd, Seth, David et al., 2016).

While still in relative infancy in Western culture and consciousness, acupuncture exists as part of a complete medical system that offers natural evidence-based relief from pain. Growing in acceptance among Western biomedical professionals, acupuncture is becoming integrated into treatment plans as an option to not only treat the ‘branch’ - the resulting symptoms of a condition - but to be leaned upon to treat the ‘root’ causes of painful conditions as well. For these reasons amid the current opioid epidemic in the U.S., the Food and Drug Administration is now recommending that physicians learn more about the role that acupuncture and other complementary therapies can play in the mitigation of pain, as an alternative to opioid based prescription pain medication. 

While still not fully understood through a Western scientific lens, the evidence base of acupuncture’s efficacy is growing and it’s biomedical mechanisms are beginning to be discovered. Recently research has been conducted that maps the neural pathways from acupuncture points, to the spinal cord, to pain deactivation centers in the brain (Yin, Brucheit, Park, 2017), for this reason many posit that acupuncture has the unique effect of re-mapping the brain’s response to pain by re-routing the pathways via the act of needle insertion and stimulation at acupuncture points. This can be particularly useful in cases involving musculoskeletal systems such as chronic back, neck and shoulder pain. 

In contrast to using prescription synthetic opioids to mitigate pain, acupuncture has been shown to engage the body’s self-healing mechanisms by encouraging the body to activate its own innate natural opioids, as well as to increase the brain’s sensitivity to these opioids (Harris, Zubieta, Scott, et al. 2009). Not limited to naturally occurring opioids, acupuncture has also been shown to encourage the release of other ‘built-in’ biochemical pain reducers such as ATP, adonsinine, GABA and substance P (Zhao, 2009). When faced with potentially very dangerous procedures, or the risky and unwanted side effects of pain medication, acupuncture represents a very safe complimentary or alternative treatment that is worth exploring. 

Many patients of acupuncture will attest to the lasting relief they have gained, in some cases after only one treatment. While these accounts are common and plentiful, they are understandably not enough to satisfy those equipped with healthy skepticisms. In the largest open pragmatic study of its kind, 454,920 patients with chronic headache, back pain and osteoarthritis were treated with acupuncture, of 8727 treating physicians it was found that a “marked or moderate” decrease in pain occurred in 76% of participants (Weidenhammer, Streng, Linde, et al., 2007). In a 2 year retroactive survey published in 2016, 93% of 89,000 participating patients declared success in the reduction of chronic pain (ASHIHSD, 2016). While a strong case for acupuncture is becoming well established, more studies are warranted and are currently underway to examine its effectiveness, as well as determine the underlying mechanisms through a Western biomedical lens. 

With an opioid epidemic currently in full bloom in the United States, and a growing evidence base of efficacy, there has never been a more appropriate time to consider acupuncture as a complimentary or alternative therapy to pain medications when treating chronic pain. With a proper treatment plan that may include Chinese bodywork, Chinese herbal medicine, exercise/diet/lifestyle modifications, and acupuncture; much work can be done naturally to mitigate chronic pain via a ‘root and branch’ approach, and avoid the adverse and potentially dangerous side-effects that may arise from the use of opioid-based pain medications.

Dr. Shamus has been practicing various aspects of Chinese medicine for over a decade. He is a graduate of Pacific College of Acupuncture and Oriental Medicine's Acupuncture and Chinese medicine doctoral program. He received his Master of Science in Acupuncture from the Finger Lakes School of Acupuncture of New York State Chiropractic College, and completed his herbal studies at the Won Institute of Graduate Studies in Philadelphia, PA. His interest in Chinese medicine was sparked at an early age when an acupuncture clinic opened up next to his house. Thereafter, he began studying and practicing medical Qi Gong with 5th generation acupuncturist and medical qi gong practitioner, Grandmaster Tzu Kuo Shih, OMD, L.Ac. His circuital route from qi gong to acupuncture brought him through masonry, music production and performance, geography studies at SUNY Geneseo, and nearly a decade of organic farming; this path forged a life-long dedication to the importance that natural medicine plays in mental and physical well-being, which he currently cultivates with his patients as a licensed and board certified acupuncturist in Rochester, NY.

References:

Abdel Shaheed, C., Maher, C. G., Williams, K. A., Day, R., & McLachlan, A. J. (2016). Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 176(7), 958–968. http://doi.org/10.1001/jamainternmed.2016.1251

American Specialty Health Incorporated Health Services Department. (2016). Acupuncture: Does Acupuncture Provided Within a Managed Care Setting Meet Patient Expectations and Quality Outcomes?, 1–12.

Harris, R. E., Zubieta, J.-K., Scott, D. J., Napadow, V., Gracely, R. H., & Clauw, D. J. (2009). Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on μ-opioid receptors (MORs). NeuroImage, 47(3), 1077–1085. http://doi.org/10.1016/j.neuroimage.2009.05.083

National Center for Health Statistics (2006) Health, United States, 2006 [Online] Available from: https://www.cdc.gov/nchs/data/hus/hus06.pdf [Accessed 25 October, 2017]

Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: http://dx.doi.org/10.15585/mmwr.mm655051e1

Schuchat, A., Houry, D., & Guy, G. P. (2017). New Data on Opioid Use and Prescribing in the United States. Jama, 318(5), 425–426. http://doi.org/10.1001/jama.2017.8913

Weidenhammer W, Streng A, Linde K, Hoppe A, Melchart D. Acupuncture for chronic pain within the research program of 10 German Health Insurance Funds–basic results from an observational study. Complementary therapies in medicine. 2007;15(4):238-46.

Yin, C., Buchheit, T. E., & Park, J. J. (2017). Acupuncture for chronic pain: an update and critical overview. Current Opinion in Anaesthesiology, 1. http://doi.org/10.1097/ACO.0000000000000501

Zhao, Z.-Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355–375. http://doi.org/10.1016/j.pneurobio.2008.05.004