Yoga for Infertility

A recent question from a reader:

Theres a bunch of resources on the internet prescribing certain poses to increase the chances of fertility (Viparita Korani, baddha konasana, shoulder stand) Is there any science behind this? No doubt the stress relief element of yoga will help successful conception, but do shoulder stands? And if so, is it really because the pose traps more sperm, therefore enhancing the odds for fertilization?  It sounds suspiciously simple.

For sure, Yoga can help couples who are trying to conceive.  “Trying” to get pregnant is often anxiety provoking and it can become “work” and a source of stress between partners.  If in no other way, Yoga helps both men and women to center, to find balance, and to relax and relieve anxiety and stress.  Yoga’s ability to decrease anxious feelings and alleviate stress is well documented.

Yoga for fertility goes beyond facilitating partners’ psychological abilities to cope with their feelings and emotions though. When women are stressed, their hormonal axis gets disrupted.  The hypothalamic-pituitary-ovarian axis goes out of balance, and the ability to ovulate and to maintain the right conditions in the uterus for implantation and nurturing can go askew.  There’s a solid, physiological basis for Yoga’s stress reducing effects to promote a healthy reproductive system and to facilitate the induction of pregnancy.  Through the mind-body connection, alleviating stress supports the proper functioning of the hypothalamic-pituitary-ovarian axis so that the hormonal cycle can support a pregnancy.

It makes sense if you think about it. During times of severe stress throughout evolutionary history, women who got pregnant were at a disadvantage.  If there was war, famine, or a natural disaster, getting pregnant when resources were already scarce was likely to hinder a woman’s ability to survive – and for their offspring to survive if born during bad times.  These days in our modern world, stress and stress hormone levels rise and are maintained over long intervals just from day-to-day life experiences.  Controlling those physiological effects of stress can go a long way towards renewing fertility.

According to a recent study, infertility rates throughout the world are fairly constant at about 9% across countries.  In general, infertility is defined as an inability to get pregnant after one year of trying. Estimates vary by source, but it appears that about 30% of the time, female hormonal factors are responsible for a couple’s inability to conceive. Another 30% of the time, female anatomy may be the problem.  If there have been pelvic infections that cause scarring, particularly in the fallopian tubes, if are present in the uterus, or if the uterus is positioned or shaped a little irregularly, then mechanical barriers present a problem for the sperm as it tries to reach the egg.

My good friend, Ava, swears that standing on her head in sirsasana immediately after sex is the one thing that helped her to conceive after several years of trying without success. Although there’s no scientific evidence from experimental trials, it makes sense that adding some simple gravitational support in the form of inverted postures after sexual intercourse can help sperm challenged by anatomical obstructions to reach their target. A woman’s inverted positioning after sex may also help when a man’s sperm has lower motility or numbers. Yoga for helping with infertility includes sirsasana or other inverted postures after sex when possible.

Not everyone agrees with gravity-based help like sirsansa or viparita karani for infertility though. Some gynecologists say the sperm is likely to miss the narrowing opening of the cervix and to pool behind it at the end of the vagina. That means there is the potential, particularly for those women with normal anatomy who haven’t been trying to become pregnant for very long, that inverted postures could possibly decrease the chances.

Either way, there are no studies and no proof. It’s all just conjecture. If youre in your first year of trying and havent yet become pregnant, theres no need to stand on your head after sex. Doing so may even be contradictory to your goal. However, if youre like Ava and youve been trying for awhile without success, giving inverted postures after coitus a good try might be just the thing you need – at no cost and with no side effects.

Yoga’s emphasis on natural, clean living promotes fertility.  Drinking too much caffeine and alcohol has been shown to reduce reproductive capabilities.  Environmental toxins have been implicated in infertility.  Eating a healthy vegetarian Yoga diet as promoted by the gurus, one with tons of organic fruits and vegetables, will help to neutralize toxicity.

From an energetic perspective, a daily Yoga practice will also help to promote fertility for couples wishing to conceive.  Concentrating on building energy in swadhistana chakra, and purifying and balancing that chakra through asana, visualization, and meditation, will help to harmonize the energy body for proper reproductive functioning. Visualizing the reproductive anatomy and focusing the mind in that area of the body increases blood flow to help oxygenate tissues and supply needed nutrients.

Yoga works holistically through mind, body, and spiritual connections to help couples get pregnant when they are having difficulty conceiving.  Alice Domar, Ph.D., in her work at the Mind Body Institute, found that one year after participating in a 10-week program involving relaxation, asanas, and nutrition counseling, 55% of couples in the program conceived versus only 20% in the control group.

On a final note, a diagnosis of “infertility” should be taken with a grain of salt. Some things, for reasons beyond our comprehension, take longer than we’d like. It turns out that fully half of all couples diagnosed as “infertile” (based on the one year of trying without success criteria) go on to conceive a child spontaneously within two years. Other couples get pregnant naturally in the following years. There’s no need to rush to fertility drugs. Yoga helps you to balance and to work with your body so that you can get pregnant naturally.

Vamana Dhauti Flabby Stomachs

A readers comment and accompanying illustrations:

I’ve always wondered whether the average, non-yogic stomach is indeed flabby as we draw it onto the whiteboard. I was taught that vamana dhauti would make the stomach less flabby, otherwise said, it would shape up, so that the lower part of the stomach that in my drawing holds food (purple color) will become less flabby and in time tighten up so that it becomes something like the 2nd image I attach.

First, what exactly does a non-yogic, normal stomach look like when it’s inside the living human body? Here’s a link to a CT scan photograph of a normal stomach. It’s the darkest blob taking up most of the frame. Here’s another CT scan photo showing a stomach with a cancer growth.  This photo is of someone who swallowed barium, which shows very light colored on x-rays, to highlight the stomach. (You’ll need to scroll half-way down the page.)

While these “real, live” photographs are nice, they’re still only part of the picture. The stomach isn’t static. It doesn’t just sit like in either of the above images submitted by the reader. It’s dynamic, with waves of contractions that distort the shape. The strongest contractions originate in just that lower area mentioned, the antrum. They’re basically a grinder that churns food and sweeps it towards the outlet, the pyloric valve, into the small intestine.

At a snapshot in time, the same stomach could look like either drawing depending on whether the antrum was contracting or not.

Also, the details of the outline, or the shape, of the stomach, which is a distensible container, will change depending on how much food and drink is in there. It’s basically a sack that holds 1200 to 1500 ml, but it has a capacity of greater than 3000 ml.It’s reasonable to consider that someone who consistently eats too much may have a “flabby” and stretched out stomach compared to someone who eats very little and who has the smooth muscular layer of the stomach wall tight.

But does vomiting daily with vamana dhauti (otherwise called kunjal kriya) tighten that muscle and reduce any ‘flab” in that area?

When you vomit, the primary muscles involved are the abdominal wall muscles, the same ones you work out to have a six-pack. Respiratory muscles contract, too, and so does the antrum of the stomach. Exercising any muscle, even the smooth muscle of the stomach antrum, will build it up and tighten it. And, as with a six-pack, that may reduce flab.

But put it in context. The antrum contracts forcefully on average about every 20 seconds. A few extra contractions from forced retching every morning in vamana dhauti is unlikely to cause much increase in muscle strength and tightness. Therefore, vamana dhauti isn’t likely to change the shape of the stomach significantly. Vamana dhauti won’t make the stomach less flabby.

References:

  1. Robbins Pathological Basis of Disease, Sixth Edition. WB Saunders Company. Philadelphia,1999, pp 787.

Warning: Vamana Dhauti

Vamana dhauti is a daily kriya (kunjal kriya), or cleansing technique, that some yogis use daily to cleanse the stomach of mucus.  Its self induced vomiting. Theres a question regarding the true yogic basis of this technique, and from a physiological and medical perspective, vamana dhauti as a Yoga detox method does little to help an aspirant and can do much to hurt.

 

The medical literature citing harmful effects from repeated vomiting comes mainly from studies of bulimic patients who may throw up more than once a day.

Habitual self-induced vomiting and repeated contact of the teeth with acidic juices from the stomach can cause ugly erosions of tooth enamel and cavities. A progressive decalcification occurs that leads to a loss of enamel and dentin, wearing away the teeth slowly over time. Habitual vomiting leads to an increased number of cavities and a higher dental fracture rate as well as increased sensitivity to hot and cold temperatures of food and air.

Another feature occasionally observed in self-inducing vomiters is swelling of the parotid glands intermittently.  That gives the cheeks a chipmunk like appearance, similar to those suffering from the mumps.

Heartburn and chest pain occur in many people due to the high acid content of the stomach juices (pH of 2) burning the esophagus.  Repeated self induced vomiting can cause esophagitis which can be a precursor to esophageal cancer, and it can lead to abnormal oropharyngeal swallowing patterns and achalasia.  That means that repeatedly dousing the esophagus in acid can disrupt the motor movement of the muscles so they don’t function properly and therefore you can’t swallow your food properly.

Another thing that we are seeing medically from increasing amounts of acid regurgitating from the stomach are lung problems. It only takes a tiny amount of stomach acid going down the wrong tube into the lungs through the trachea. Acid in the lungs destroys them. Asthma and trouble breathing from scar tissue formation are the result, and tiny amounts of stomach acid in the lungs has been postulated to be the cause of death in the mysterious illness, BOOP.

An article in the Archives of Internal Medicine reported on five patients who developed pancreatitis from frequent vomiting.  Pancreatitis is a disorder is which the pancreas becomes inflamed and begins to digest itself with the enzymes usually meant for digesting food.  One of those five patients died from her pancreatitis.  Death is a pretty serious complication to risk from doing a kriya that hasn’t shown any benefit.

There’s another way that death can occur after vamana dhauti.  It’s called Boerhaave’s Syndrome, a rupture of the esophagus, and it’s caused by repeated, forceful retching and vomiting.   All that force and pressure can also cause minor bleeding from a tear in the mucus layer of the esophagus, a condition called a Mallory-Weiss tear.  For heaven’s sake, if you see blood in your vomit, stop.

If vomiting stops, that Malloy-Weiss tear will heal nicely on its own. But if it gets out of control with further vomiting, then the full thickness of the esophageal wall can rupture, spilling acid and stomach contents into the surrounding chest tissue Boerhaaves.  That’s often more than the body can take, and it succumbs to infection and death.

While its true that a lot of things in life involve a little risk, the benefit to risk ratio has to be high enough to make it worth it. Theres not much benefit obtained from the practice of vamana dhauti.  There are other, better ways to cleanse and to sublimate energy.

 

References:

Gavish D et al. Bulimia. An underlying behavioral disorder in hyperlipidemic pancreatitis: a prospective multidisciplinary approach. Arch Intern Med. 1987 Apr;147(4):705-8.

Stacher G.  Gut function in anorexia nervosa and bulimia nervosa.  Scand  J Gastro 2003;38:573.

Why Say No to the Master Cleanse

For those of you who haven’t heard of the Master Cleanse, it’s a cleansing program from the 1950s that’s developed a cult-like following. Believers drink only water mixed with maple syrup, the juice of fresh lemons, and a touch of cayenne pepper. It’s cool to cleanse, and the Master Cleanse just sounds like it must be the best, right?

But there are problems with the Master Cleanse detox, two big ones:

  1. It won’t lead to the health and spiritual benefits that come from a fast in which you adhere to true caloric abstinence.
  2. It doesn’t really cleanse.

What? Yeah, really. Let me explain.

As a fast, the Master Cleanse falls short.  Two tablespoons of maple syrup per glass provide 110 calories, and if you’re drinking the recommended 8 glasses per day that means you’re consuming 880 calores – OF SUGAR. Don’t give me that nonsense about how it’s “good” sugar and not “bad” sugar. It’s freakin’ sugar.

Along with 8 calories in two tablespoons of lemon juice per glass that means the total amount of calories consumed in a day on the Master Cleanse is 944. That’s a low-calorie diet, not much of a fast. And most of those calories are in the form of SUGAR.

Yes, SUGAR. Real maple syrup from the tree, unadulterated by manufacturing and processing, is sucrose. It does have some nice natural things to give it flavor like trace amounts of amino acids and healthy plant nutrients. While that part is great, it’s still almost entirely SUGAR. Maple syrup, like table sugar that comes from natural cane and beets, is made of sucrose. Like table sugar, a bottle of maple syrup has no fiber which is paramount in blocking the toxicity of freed fructose. One molecule of sucrose is composed of half fructose and half glucose. For a review on the hazards of fructose, read Sugar Explained and watch Dr. Lustig’s popular video that’s gone viral.

Consider fructose without its natural antidote, fiber, to be a poison. Now realize that almost half of all the calories you get while doing the Master Cleanse are coming from poison without any antidote. Yuck.

Since your body has to process all of that fructose, there’s no rest for the liver. A fast that is healthful gives the liver a rest. Our bodies need a chance to go through periods of catabolism, or breakdown, in order to work efficiently at anabolism, or rebuilding. We need a healthy cycle, a balance. Constant intake of sugar throughout the day prohibits that balance, that cleansing of all stored sugar as glycogen from the liver and the resetting of physiological processes. It’s like shooting yourself in foot while you’re fasting.

The health benefits from a good fast are many, and I highly recommend fasting for most people. (Of course, there are some medical conditions in which one should be wary, and anyone with a serious condition should check with their doctor.) For a review of the health benefits of fasting, read the section “Are There Health Benefits to Fasting” towards the end of my article, The Yoga of Fasting: Is it Good for You or Not?

Maybe the biggest “oops” of the Master Cleanse detox is that while you’re trying to clean, you’re actually doing the opposite. Animals, including humans, store toxins in fat cells – nasty chemicals like PCBs and dioxins. On a low-calorie diet like the Master Cleanse, fat cells break down and release their stored energy to make-up for what’s not being brought in as food. When they do, those fat cells also release toxic chemicals they’ve stored. While that may sound great on first take, please realize that it’s a disaster.

 

Toxic chemicals are stored in fat cells to sequester them, to remove them from the general circulation where they can cause greatest harm. Fat cells are like a jail for the bad guys. To some extent, you want them there because its better the bad guys are in jail than at a crime scene where they kill. If there’s a jail-break and they get out, which will happen on the Master Cleanse, what’s to keep them from seeking out their targets and creating victims, killing them by promoting cancer?

You want to make sure the bad guys are courteously escorted beyond the gates of the castle, but on the Master Cleanse, there are no available escorts. The most important escort for their removal is fiber. On an alternate-day fast, tons of fiber remains in the intestinal tract to bind up the bad guys and deposit them in the toilet where they belong. On the Master Cleanse, particularly by the 10 day mark, there’s absolutely no fiber hanging around anywhere and the bad guys are free to return to the circulation and kill.

Another primary escort for toxins like heavy metals and free radicals is glutathione. This fabulous little substance is of paramount importance in handling bad guys. The sad thing is that on the Master Cleanse, it gets totally and completely depleted. Way before the tenth day, there’s no glutathione around to protect us. Anarchy prevails, and the bad guys are free to produce victims.

In summary, here’s why to say a big, fat “No” to the Master Cleanse detox:

  1. It’s not much of a fast when your daily consumption of calories is 944almost all sugar in the form of sucrose. That’s considered a low-calorie diet.
  2. Half of the calories consumed are from fructose (a poison) without its antidote (fiber).
  3. With all that sugar, there’s no rest for the liver, no period of catabolism without anabolism. Studies of fasting have shown tremendous benefits from zero calorie intake for sustained periods, ideally 24 hours.
  4. There’s no fiber in the intestine, especially after 10 days of only sugar water, to bind toxic chemicals like PCBs and dioxins released from fat cells. Fiber escorts toxins out of the body and prevents the bad guys from finding targets and creating victims.
  5. Glutathione is depleted after about 24 hours of fasting. Without its replenishment, the body’s natural ability to detoxify is seriously hampered.

Eating Clay

A reader expressed the following comment after reviewing the recently posted The Yoga of Fasting: Is it Good for you or Not?:

“In your interesting article about fasting, you omit something about fasting with water which has been added with clay.  I know first hand that in that way even 28 day fasting is less dangerous.”

I’m grateful to the reader for bringing up the subject of adding clay to water fasts to prevent toxicity.  Clays are promoted as cleansers by many marketers.

Although it sounds strange, humans and animals have been eating clay and other forms of dirt for hundreds of years.  If you’re curious, here’s an interesting article about the history of clay ingestion.

There are many theories about why we’ve done that as a species. The foremost ones are that by eating clay we are taking in minerals lacking in our diets, that we are preventing the absorption of naturally occurring toxins such as aflatoxins from molds, and that in times of famine we have simply needed to fill our bellies with something.

It’s true that clay absorbs toxins like PCBs, but there are many types of clay, and each type will have different absorptive properties that cause it to bind to one thing but not another. Primarily bentonite clay in used during cleanses, but there are different forms of that as well.  Although it likely does bind some, I haven’t found any direct evidence that bentonite specifically absorbs particular environmental toxins released with fasting.  Its ability to limit the absorption of primary vitamins and nutrients has not been well studied either, but there is some evidence that it significantly impairs the ability of the intestines to absorb zinc which is needed by more than 300 different types of enzymes for them to function properly.  The antioxidant Cu-Zn -superoxide dismutase (SOD) has been shown to have decreased activity when low zinc levels are present.  The result is excess free radicals that damage cells and lead to disease and cancer, and that’s exactly the opposite intention of a fast.

When it comes to subtle damage like that caused by free radicals, there’s no way to know just by how you feel whether you were hurting or harming yourself with a 28 day fast with clay.  Other dangers exist beneath the surface too, ones that you won’t feel or be conscious of while fasting.  Lead, mercury, arsenic, and other environmental toxins may contaminate the source, even those obtained commercially as there is little regulation or quality control.

Also, don’t forget that when fasting on water with clay for 28 days, you won’t be renewing glutathione which runs out after about the first 24 hours.  Glutathione is needed to prevent toxicity and free radical damage.  The metabolic rate slows down after a couple of days without nutrition, and eating clay provides no source of energy to prevent that.  With a slower metabolic rate, when you go back to eating real food, the same number of calories will cause you to gain more weight than they did before the fast.

Fasting for 24 hours on water only is healthy.  Plenty of evidence is accumulating to prove it.  Fasting longer than that on water only, or water with clay, may cause more harm to the body than good.

Salt and Iodine

Wise gurus from the ancient past tell us to stay away from salty foods in classic Yoga texts like the Gheranda Samhita (5:23) and the Hatha Yoga Pradipika (1:59).

Modern medicine, too, recommends with increasing fervor that we don’t eat salty foods. We need to limit our overall intake of sodium, which is half of sodium chloride, or regular common table salt.

High sodium intake leads to high blood pressure, heart attacks and strokes.

The recommended limit is 2,300 mg of sodium per day, about one teaspoon of salt. For adults like me who are over 40, the recommendation is stricter. For us, and for those who have already been diagnosed with high blood pressure (hypertension) or who are African American, the magic number is 1,500 mg of sodium per day – and that’s not much more than half a teaspoon.

Restaurant meals and packaged, processed, store-bought food account for most of the sodium in our diets. Around 5% comes from salt added while cooking and another 5-6% is added at the table.

While I don’t have to counsel most yogis to stay away from crappy processed junk food (where the sodium content is clearly written on the label), it’s a little harder for them (and for me!) to come to grips with reigning in one of our favorite pastimes – going out to eat. Self control is a foundation of a good Yoga practice, but there are other tricks like asking for nutrition information on specific dishes or choosing restaurants where you can special order a no-added-salt preparation.

One problem with avoiding salt is that by eating less of it we’re also avoiding a cheap and efficient iodine supplement. In the States, little iodized salt is now used in processed foods, the milk industry is changing the way they do things so that less iodine is in milk products, and many people are choosing non-iodized salt for their homes since supplementation isn’t mandatory. After being almost all but eliminated, iodine deficiency is reappearing in the US, Australia, and parts of Europe.

What’s that you say? But iodine is toxic and you wouldn’t touch it with a really long pole? Yep, that, too.

Like many of our vitamins and nutrients, iodine walks a fine balance line in our bodies. Too little iodine is a big problem, but too much iodine can be a problem, too.

Iodine deficiency during pregnancy is still the number one cause of preventable mental retardation in the world, and there are studies linking it to hyperactivity and behavioral disorders in the offspring of moms who didn’t get enough during early pregnancy. In a 2002 study, 7% of pregnant American women were iodine deficient. It’s not just a problem in the so called “third world” over there.

Children with iodine deficiency have lower brain functioning. Adults with mild to moderate low iodine levels have higher rates of more aggressive forms of thyroid cancer, goiter, and hypothyroidism. Some researchers believe that low iodine levels increase the risk of prostrate, breast, endometrial, and ovarian cancers.

The majority of serious practicing yogis I know choose natural sea salt without added iodine. That’s great if they’re getting iodine from another natural source, but many eat little seafood or dairy – or they’re vegan and eat none. To compound the problem, a healthy yogic diet contains lots of cruciferous vegetables and some soy, both of which have goitrogens that can interfere with the way the thyroid gland processes iodine.

If you’re vegan, try to eat natural sources of iodine like seaweed, celery, baked potatoes with the peel, strawberries, and navy beans. With the latter bunch, realize that the iodine content of plants depends upon the iodine content of the soil they are grown in, which is rapidly being depleted in many areas. Seaweed can be a source of mercury and other heavy metals if not organic, and there are instances in the Japanese population of iodine toxicity from over-doing the seaweed.

Don’t cut cruciferous veggies like broccoli, bok choy and cabbage from your diet. They’re loaded with nutrition. Cooking them neutralizes the compounds that interfere with iodine. While raw food is spectacular, sometimes cooking food, like the cruciferous vegetables, is a great idea, too!

References:

Crawford BA, Cowell CT, Emder PJ, Learoyd DL, Chua EL, Sinn J, Jack MM. Iodine toxicity from soy milk and seaweed ingestion is associated with serious thyroid dysfunction. Med J Aust. 2010 Oct 4;193(7):413-5.

Zimmermann, MB. Iodine Deficiency. Endocrine Reviews 30 (4): 376-408