How TCM looks at women’s health through the years

A Taiwanese insurance study found that 96 per cent of women diagnosed with infertility had also used TCM, a finding that the authors saw as evidence of strong demand for TCM in fertility care.

For Ngan, the first question is where a woman is in the process. Someone trying to conceive, preparing to freeze eggs or about to begin IVF may have different needs from someone already taking fertility medication. In the months before egg retrieval, Ngan focuses on sleep, digestion and stress. She sees the roughly three months during which eggs mature as a window to help a patient feel better prepared for stimulation.

Once treatment begins, Ngan asks how the patient is coping. Bloating, mood swings, headaches and fatigue can make an already demanding process harder, and she may offer acupuncture to help with sleep and comfort. After egg retrieval or embryo transfer, her focus shifts to recovery. If a cycle has not worked, she says, that may include preparing for the next attempt.

“My rule is coordination, not competition,” Ngan says. She wants to know the fertility clinic’s protocol and medication schedule before planning care, and is especially careful with herbs during stimulation and around embryo transfer. Her training in reproductive medicine and clinical embryology helps her fit her approach around the clinic’s treatment.

Ngan shares that the women she sees often feel steadier and more comfortable, though she acknowledges that evidence on live births is mixed. In one large randomised IVF trial, women receiving acupuncture reported slightly less anxiety immediately after embryo transfer than those receiving sham acupuncture. Live-birth rates did not differ significantly between the groups. Anyone considering TCM care can ask what a treatment is intended to help with and make sure the fertility clinic knows about it.

TCM’s approach to the weeks after childbirth is closely associated with rest, warmth and food prepared for the new mother. Those principles sit behind many confinement traditions, though the accompanying rules can be hard to follow in a modern home or working life.

Ngan favours understanding why a practice developed before deciding whether to keep it. Older advice about cold air or washing, for example, came from homes and living conditions very different from many today. “Whether a woman ‘should wash her hair’ matters far less than whether she is eating, sleeping and being supported.”

This turns the conversation to the help a new mother has around her. Who can cook? Who can take on the housework? What happens when she goes back to work? The care TCM gives to recovery can be useful without leaving a woman feeling she has failed if she cannot spend a month resting.

As with fertility treatment, everyone involved in her care should know what she is taking. The safety of many herbal products during pregnancy and breastfeeding is uncertain, so any remedy is worth raising with her usual healthcare team.

As patients move into perimenopause and menopause, Ngan says her emphasis shifts again. She asks about hot flushes, night sweats, dryness, restlessness and sleep. In TCM, yin describes cooling, moistening and calming qualities. Ngan interprets some of these symptoms through a decline in yin.

The description guides how she chooses a treatment. It does not tell a patient what her hormone levels are, or settle which medical options she should consider. Ngan supports women who choose menopausal hormone therapy and says many of her patients use TCM alongside it. Before suggesting herbs, she asks what each patient is taking.

She also steers clear of handing anyone an ambitious new routine. “I ask a woman to name the one symptom that most affects her day, and we start there,” she says. It is a good place to begin whether her next conversation is with a TCM practitioner, a menopause clinician or both.

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The two approaches often begin with different kinds of information. Blood tests, scans and clinical assessments can identify a hormonal or structural problem and guide treatment. A TCM consultation looks for patterns in the menstrual cycle and in a woman’s sleep, digestion and energy. Ngan also examines the tongue and pulse. Two women with similar test results may have very different experiences of their symptoms.

Ngan’s training in reproductive medicine allows her to understand what a clinic has measured, while her assessment remains rooted in Chinese medicine. “My diagnosis is always Chinese medicine: tongue, pulse, cycle history,” she says. That wider account of how a woman feels may give her concerns a place in the conversation, including during the stretches between tests and appointments.

The approaches also use different language. A TCM pattern describes a finding within its own framework; it cannot establish a hormone level or replace a scan or medical diagnosis. Likewise, a test result alone may say little about how a woman is sleeping or coping. Understanding what each practitioner means gives a patient a clearer basis for asking what a proposed treatment is meant to address.

Chain’s work brings these two approaches together. A registered Chinese medicine practitioner, she holds a doctorate in integrated Chinese and Western clinical medicine from Southern Medical University and a master’s degree in acupuncture from Hong Kong Baptist University. She has spent more than two decades working with patients who use both approaches. “Integration works best when it begins with the woman rather than the medicine,” she explains. In practice, that could mean reading results her doctor has already obtained before suggesting care, or adapting acupuncture and herbs around an existing treatment plan. “Integration works well when each side respects what the other can see—and it falls short when either becomes a matter of pride.”

That respect is something a patient can look for. In Hong Kong, Chain suggests checking that a practitioner appears on the Chinese Medicine Council’s register, and asking about their training in women’s health. She would also look for someone “curious about your Western results and happy to work alongside your doctor, rather than asking you to choose.”

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The consultation itself matters just as much. Fertility treatment, recovery after birth and menopause can bring worries that are difficult to raise. Chain believes a woman should feel comfortable speaking openly about what frightens her. She should be able to ask a question and receive a plain answer, without leaving with a long list of rules.

Her suggested questions are direct: “Ask them how they would work with your gynaecologist or fertility clinic. Ask what they would refer you for.” A practitioner’s response can tell a woman a great deal about how the two approaches would work together in her own care. “A good practitioner will welcome those questions,” Chain says.

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