Poking Into Fertility

Poking Into Fertility: An Interview with Miriam Pineles and Sally Shamah, Fertility Newsletter Volunteer

Tell us a bit about yourself and your line of work.

I am licensed and trained in Acupuncture and Chinese herbal medicine, which I use to treat a variety of symptoms and syndromes. One of my specialties has been women’s health, so I do a lot of work with women experiencing any sort of gynecological issues as well as women facing fertility challenges. I am also a trained doula, furthering my education in the realm of fertility and childbirth. Thankfully, I have developed relationships with many fertility specialists while working in Manhattan, allowing me to work alongside them to assist women on their fertility journeys.

How would you define your role in terms of treating women with infertility?

I see my role as tending to all parts of a person to help them with what they particularly find challenging. For women who have trouble conceiving, my role as a practitioner is to find out what’s happening – why hasn’t she achieved her goal? Oftentimes, women are not just experiencing a medical issue, so the treatment plan cannot just be focused on medicine. That’s why I think acupuncture has gotten such a name in the field – we can see that there’s more to the journey besides creating eggs. There may be anxiety and depression that need to be treated in tandem. In addition, I help those experiencing allergies, headaches, physical pain, and insomnia. 

I understand that you treat your patients with a very holistic approach, focusing on body, mind, and spirit. Can you please elaborate on this concept? 

When I speak with an individual, especially at that first intake (which is a very lengthy visit), we go through her medical history in its entirety. I want to learn a lot about her menstrual cycle in very intricate detail. Concepts like the length of her cycle, how long she bleeds and the quality of her blood is all very important information to give me clues to find the potential problem. I review many aspects of a patient’s everyday life, because oftentimes, bad habits may contribute to the issue at hand.

It seems very simple, but I have to make sure a person is sleeping through the night, eating well, etc. It’s a lot of very basic things that often get lost in our very busy lives; things that we think we can just put aside. I also ask about any chronic health conditions and medications that a patient may take. 

And then there’s the mental and emotional piece. There is a lot to say about how stress may affect fertility. Being frustrated and not achieving one’s goal is enough of a stress, and then layer on the challenges of the times we are living in, the cost and stress of treatments, social aspects, perhaps some shame or embarrassment that takes place. I always ask a woman, “How is this impacting your body?” It impacts sleep, it impacts appetite, it causes neck pain…the list can go on. I often do a lot of reframing for women, because staying in a negative mindset is not going to help.

Finally, there’s the spiritual piece, which has to be taken into account as Jewish people. There’s man and woman, and there’s Hashem, and the Torah says that they are all involved in creating a child. And so there’s always a spiritual conversation that takes place so that we can be sure that all of the pieces are aligning to help a person achieve that wholeness, that balance, and that fertile self that they’re looking for. 

Once all those things are addressed, we can start with interventions to bring health and healing. Within my scope of practice, that’s going to include acupuncture, herbal medicines, some dietary changes, and sometimes I’ll recommend certain vitamins and supplements that I think are deficient. I even guide women back to finding their faith in G-d. A positive outlook is so important because it’s very easy to get negative and be down, especially after what looks like repeated failure. So, all of these different pieces get addressed. 

At what stage in her journey would you recommend a woman come to you?

Women who have been told by a medical practitioner about issues that could be a barrier to conception should come in as soon as possible. Someone who is having active symptoms for something like endometriosis or PCOS, or someone who knows she has polyps or fibroids. Also women who have a hormonal imbalance, who know their luteal phase is too short or are ovulating too early, who need support to balance and regulate their cycles. There are methods to clear the uterus, to make it a more hospitable environment. We can shrink and eliminate fibroids up to a certain size, we can help with blood flow in women with endometriosis and alleviate the physical pain they are going through. 

I’ve had many patients who have experienced a loss who have come in to see me after they felt they’d done all that they could or when they felt like medicine hadn’t helped enough. Sometimes, it’s just a matter of a little nurturing, whether with herbs, with food, with advice, that strengthens her enough to prepare her for her next pregnancy. 

I also see women who are in active fertility treatment. There is research to show that acupuncture can help success rates of IVF procedures. Some women find it helpful in dealing with the stress of the treatment itself, whereas others find that it helps relieve tension in the cervix. Women who have a very constricted cervix and have trouble with gynecological procedures find that coming in for acupuncture beforehand helps things to go more smoothly. To use the metaphor of a garden, take time to pull out the weeds and till the soil, not just plant and go and see what happens. 

Lastly, women who have extremely uncomfortable PMS or extremely painful periods should know that that’s not a normal thing and that they don’t need to suffer. This pain can often be a sign of subadequate blood flow to the pelvis, which can often present itself as a fertility issue. 

How long does treatment usually take?

Usually what we see in this work is that it takes about 3 to 4 months to work on regulating cycles or eliminating fibroids. 

How often do patients come for treatment? 

I see most patients once a week. Once they are in a better, more balanced place, I can wean them down to every 2 weeks. I like to see patients through 8 weeks of pregnancy just to keep the stress down and help them with nausea. Then it’s up to them if they want to continue throughout the pregnancy. 

How does acupuncture work?

Western perspective has shown and explained through medical imaging that acupuncture is actually enhancing blood flow, reducing inflammation, and regulating the endocrine system. We choose points on different parts of the body when we want to manipulate the blood flow in that spot. Within the realm of fertility, there are certain places I’ll choose so that I can adjust the uterus or the lower back. I want to clean that area, enhance the blood flow, and build up that lining. Sometimes I focus on other areas like the head and the ears, as these points help other areas in the body. Essentially, I work to restore the body’s natural balance, something it knows how to do.

Do you treat men?

In my practice, I don’t see many men, though they can absolutely be helped. There are herbal remedies that can be helpful with sperm count, motility, and morphology. Certainly, men need the same kind of intake and guidance – body, mind and spirit. I try to make sure that they are doing their all to keep their physical, emotional and spiritual selves well and strong.  

Is acupuncture covered by insurance?

Yes, it can be! It depends on the practitioner. I happen to take insurance, so it really just depends on the plan. Herbs will always be an out-of-pocket cost. 

What would you say to those who feel unsure or skeptical about acupuncture?

Ultimately they have to have a little bit of openness to make that first appointment. Within that appointment, they’ll hopefully learn and understand more. Also, a person should see results very quickly, which helps to understand that there’s a purpose and an effect. There’s thousands of years of history behind this. I find that you don’t have to believe in it, it just works.  

For more information on Miriam and her practice, please visit: Conscious Health & Wellness – Acupuncture & Herbal Medicine

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