Holistically Enhancing Female Fertility
From guest blogger Dustienne Miller, PT, MS, WCS... In the United States, 6.7 million women experience a diminished capability to become pregnant or carry to term. For heterosexual couples, the inability to conceive may be due to male infertility, usually caused by sperm abnormalities. Women may have a hormonal or mechanical cause to infertility. Hormonal causes of infertility include a variety of ovulatory dysfunctions, including weight-related amenorrhea (irregular or absent menstrual periods due to low body weight) and polycystic ovarian syndrome (insulin-induced hormonal changes, producing excessive androgens). Mechanical causes of infertility include uterine lesions, fallopian tube occlusion, PID, endometriosis, and prior pelvic surgeries (C-sections, appendectomy, cervical procedures).
Adhesions are abnormal connective tissue bridges between structures caused by inflammation and surgical intervention. Small bowel obstruction and infertility are associated with pelvic adhesions. Adhesions may decrease ovarian blood supply and disrupt the mechanism of the ovum delivery into the fallopian tube by creating abnormal lines of pull on the tissue. Adhesions may form along the uterine ligaments, cervix, inside the fallopian tube (causing occlusion and increasing likelihood of an ectopic pregnancy), and at the end of the fallopian tube (fimbria).
Physical therapists (PTs) trained in visceral mobilization perform gentle manual techniques to restore mobility and motility of the uterus, cervix, and fallopian tubes. Soft tissue manual therapy can be performed before intrauterine insemination and in vitro fertilization, creating a more optimal environment for implantation. PTs perform manual techniques to correct alignment of the pelvic girdle. PTs prescribe exercise programs to increase core stabilization and neuromuscular re-education, which reduces holding patterns by retraining specific muscles to engage prior to movement.
Physical therapists who specialize in pelvic floor physical therapy and are trained in visceral mobilization offer a unique skill set to women working with mechanical infertility problems, especially combined with acupuncture. Women’s health specialists perform myofascial release of the connective tissue both internally and externally to create optimal mobility and motility of the organs and tissues. These techniques are gentle and do not cause pain. For a listing of pelvic floor physical therapists, visit the American Physical Therapy Association’s Section On Women’s Health or Herman & Wallace Pelvic Rehabilitation Institute, making sure that the PT has additional training in visceral mobilization.
About the contributor: Dustienne Miller is a physical therapist with an advanced board certification as a women’s health clinical specialist. She combines her yoga teaching and professional dance background in her physical therapy practice, encouraging her clients to flourish. Dustienne is the creator of two pelvic yoga DVDs “Relieving Pelvic Pain” and “Optimizing Bladder Control: Strengthening the Pelvic Floor”. Her clinical practice, Flourish Physical Therapy is located in Copley Square.