Welcome to my blog!

I'm an acupuncturist, teacher, fertility specialist, patient centered advocate, mom, activist and more! This blog is a place for me to write down the things on my mind, the things I discuss over and over, and the things I find helpful, interesting, and inspiring all in the hope that someone else out there, maybe YOU, will find some of these things to be helpful, interesting and inspiring too. I love learning, I love sharing, and I am passionate about helping others lead more balanced, fertile, and healthy lives - while trying to do the same myself. So here goes... The Blogging Life...

8.19.2013

Holistic Views on Clomid - is it right for YOU?

I am not a Reproductive Endocrinologist or an OBGYN. I am a holistic practitioner with 10 years of clinical experience and 7 years of exclusive fertility experience. The information I am giving you here is based on holism and looking at women as a whole (body mind and spirit). It is a different way of looking at fertility and one I am passionate about. What I tell you may or may not agree with what your western practitioner advises you to do. I am simply giving you my way of thinking and what my clinical experience leads me to believe is the most whole person and holistic approach to using Clomid treatments to conceive a baby! As with so many things on this journey, you will get conflicting opinions and you ultimately have to choose what feels right in your heart and body and as a couple. I hope this will help you choose the route that is easiest on you and most likely to really work :)

Clomid is the very first line in many fertility treatments. It is often prescribed with little education or monitoring and here are the things I wish more women and doctors would consider before deciding if it is right for them...

Clomid is a very hot drug from a Traditional Chinese Medicine (TCM) energetic perspective. It is like putting fuel on a fire... which is good if what you are lacking is fire, not so much if you have plenty of fire, but are lacking coolant or blood, or are just too stuck for things to circulate smoothly.

So if you are considering Clomid, here's the type of people who (holistically) do well on it:

If you are chilly more often than overheating (not just your hands and feet, but your whole body-chilled) then clomid might be a good fit for you.
If you tend to be lethargic or fatigued then clomid might be a good fit for you.
If your main emotions tend to be anxious, sad and weepy, or fearful, then Clomid might be a good fit for you.
Some women with PCOS or cystic ovaries will answer yes to the above questions, but due to their higher than average risk of producing extra follicles and developing OHSS (a serious problem) they really need to be monitored EXTREMELY closely to avoid OHSS (as well as super-multiple pregnancies which are unhealthy for both mom and babies) but Clomid still might be okay for them in some situations.

Overall, for most women with the above symptoms, Clomid feels fine (no big side effects). These women get a little boost of energy, feel more comfortable, feel more even emotionally and even like Clomid (in moderation - read on about this).

The following characteristics will tell you if Clomid is NOT a good holistic fit for you... if you are these things, then I'd highly recommend talking to your doctor about skipping the Clomid and try injectables if you are wanting to do fertility treatments or trying holistic methods to correct these things first (which might help you get pregnant and avoid Clomid altogether!)

If you already tend to overheat, have hot flashes or have night sweats avoid Clomid.
If you tend to have high or nervous energy then Clomid is probably not a good fit for you.
If you already have issues with your lining being too thin (uterine lining) then skip Clomid.
If your main emotions tend to be irritated, angry or frustrated, then Clomid probably won't be a good fit.
If you already have migraines that are worse with stress or exercise a lot/very vigorously because it actually makes you feel better (as opposed to because you think you should), Clomid likely isn't for you.

For the women with the above symptoms PRIOR to taking Clomid, Clomid will likely make these things worse. These are the types of women you see blogging about how taking Clomid turned them into raging crazy maniacs, gave them horrible migraines, sent them into 6 months of horrible night sweats that were so bad they had to get up and change the sheets... you've read the blogs I'm sure... it's not so good.

Now, I know Clomid is inexpensive, and I know many doctors prescribe it like it's no big deal. So if you do decide to use Clomid, then you should know this!

Clomid has a long half life... the half life is 5-7 days which means if you take 50mg (a normal fertility dose) in 5-7 days 25mg is still present in your body. 5-7 more days later you are down to 12.5mg. 5-7 more days you are down to 6.25mg. 5-7 more days you are down to 3mg. 5-7 more days 1.5mg. 5-7more days a tiny amount 5-7 more days it's pretty much gone... so that's nearly 2 months.  If your dose is higher, it takes longer!  Women will often remark how they can't believe they are still having side effects from Clomid 2-3 months after they've taken it. This is why that can occur.

Because Clomid has a long half life, doing back to back cycles of it build on each other. This can be good in some cases (if it is agreeing with the woman), but bad in others (when it is causing side effects and not good results). Side effects can get worse and worse with each subsequent cycle (especially when there is no break in between and women are in the don't take Clomid holistic category I listed above).

Also, holistically Clomid is like putting fuel on a fire. This can be okay for a short amount of time, but eventually, even with women who don't start out overheating and irritable it WILL burn up their good coolant (yin). So even after the drug is out of their system, they may be left with really horrible NEW imbalances that have been induced by using Clomid for too long. This is heartbreaking, because perhaps they start out in category A above and Clomid is good for a while, but if they keep it up they end up adding the symptoms of category B above to their category A symptoms and now they are even more of a mess and still not pregnant. This is super hard holistically and takes a long time to fix.

Numerous studies have shown that if pregnancy will occur with Clomid, 75% will occur within the first 3-4 cycles. Doing more cycles causes more side effects, creates increased risk of ongoing hormonal imbalance and will not likely result in a baby. In all my years working with women using clomid, I have seen exactly 1 patient who has gotten pregnant on a round of Clomid that was beyond her 3rd (and it was her 4th).

Clomid makes the fluids in your body "burn up" so it tends to make uterine linings thinner (fine if you have some to spare) and cervical mucus cooked down and thicker (fine if you are using IUI to bypass the sperm needing to swim through the mucus). If you are using Clomid with sex you REALLY need to do something to help insure that the sperm can make it through the cervical mucus.  You have some options... Here is a nice article about natural options (the supplement FertileCM is good if you have it on had ahead of time... you have to order it online). You can buy preseed and pre (sperm friendly lubes) at walgreens, CVS, target etc. and should NOT use any other lubes when you are TTC and doing clomid.

You may have read about taking cough syrup to enhance your fertility. That's actually misleading. You can take cough syrup to thin your cervical mucus which can help with sperm getting to their destination. So if that's your issue (and it likely will be if you take Clomid) then it's something to consider. But for most women it's not needed. But, you're here because you're thinking of or on Clomid right!?  So here's the scoop on doing that... which is good if you aren't doing IUI with your CLomid.

And last but not least! The ultimate goal of Clomid is to make you ovulate if you are not ovulating and make more than one follicle/egg to ovulate and increase your odds of conceiving. It is VERY important to realize that if you are not being monitored via ultrasound during your cycle you have NO IDEA how many follicles/eggs you are making and potentially fertilizing. This is one of the main situations that leads to the stories of women pregnant with multiples, and not just twins... triplets, quads and more. I know you are thinking if I haven't had a baby or gotten pregnant yet, I doubt that will happen (and I get that logic), but it is a real risk and one you need to be aware of. I am a BIG fan of monitoring. (not to mention you want to know how your body responds so you can know if it's worth repeating again or moving on to something else if it doesn't work). Selective reduction or high risk pregnancies for mom and babies are no joke. Both are situations I wouldn't wish on anyone. Especially someone who has already gone through the heartache of fertility struggles.  So ask for monitoring or go to someone who monitors these cycles. It's important!

That's my two cents (okay, maybe more) on Clomid. I hope it is helpful to you on your journey!

Best Wishes,
Nicole

PS:

If you want some layperson info on Clomid and how it works here's a good article from Fertility Today

And here's the official FDA page about Clomid with lots of good information including some absolute contraindications (which I didn't go over because your doctor should know them and they aren't super common!) listed as well as lots of other info on the technical mechanisms of Clomid.

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