Oligomenorrhea

Definition

Medical dictionaries define oligomenorrhea as infrequent or very light menstruation. But physicians typically apply a narrower definition, restricting the diagnosis of oligomenorrhea to women whose periods were regularly established before they developed problems with infrequent flow. With oligomenorrhea, menstrual periods occur at intervals of greater than 35 days, with only four to nine periods in a year.

Description

True oligomenorrhea can not occur until menstrual periods have been established. In the United States, 97.5% of women have begun normal menstrual cycles by age 16. The complete absence of menstruation, whether menstrual periods never start or whether they stop after having been established, is called amenorrhea. Oligomenorrhea can become amenorrhea if menstruation stops for six months or more.

It is quite common for women at the beginning and end of their reproductive lives to miss or have irregular periods. This is normal and is usually the result of imperfect coordination between the hypothalamus, the pituitary gland, and the ovaries. For no apparent reason, a few women menstruate (with ovulation occurring) on a regular schedule as infrequently as once every two months. For them that schedule is normal and not a cause for concern.

Women with polycystic ovary syndrome (PCOS) are also likely to suffer from oligomenorrhea. PCOS is a condition in which the ovaries become filled with small cysts. Women with PCOS show menstrual irregularities that range from oligomenorrhea and amenorrhea on the one hand to very heavy, irregular periods on the other. The condition affects about 6% of premenopausal women and is related to excess androgen production.

Other physical and emotional factors also cause a woman to miss periods. These include:

* emotional stress

* chronic illness

* poor nutrition

* eating disorders such as anorexia nervosa

* excessive exercise

* estrogen-secreting tumors

* illicit use of anabolic steriod drugs to enhance athletic performance

Professional ballet dancers, gymnasts, and ice skaters are especially at risk for oligomenorrhea because they combine strenuous physical activity with a diet intended to keep their weight down. Menstrual irregularities are now known to be one of the three disorders comprising the so-called "female athlete triad," the other disorders being disordered eating and osteoporosis. The triad was first formally named at the annual meeting of the American College of Sports Medicine in 1993, but doctors were aware of the combination of bone mineral loss, stress fractures, eating disorders, and participation in women's sports for several decades before the triad was named. Women's coaches have become increasingly aware of the problem since the early 1990s, and are encouraging female athletes to seek medical advice.

Causes and symptoms

Symptoms of oligomenorrhea include:

* menstrual periods at intervals of more than 35 days

* irregular menstrual periods with unpredictable flow

* some women with oligomenorrhea may have difficulty conceiving.

Oligomenorrhea that occurs in adolescents is often caused by immaturity or lack of synchronization between the hypothalamus, pituitary gland, and ovaries. The hypothalamus is part of the brain that controls body temperature, cellular metabolism, and basic functions such as eating, sleeping, and reproduction. It secretes hormones that regulate the pituitary gland.

The pituitary gland is then stimulated to produce hormones that affect growth and reproduction. At the beginning and end of a woman's reproductive life, some of these hormone messages may not be synchronized, causing menstrual irregularities.

In PCOS, oligomenorrhea is probably caused by inappropriate levels of both female and male hormones. Male hormones are produced in small quantities by all women, but in women with PCOS, levels of male hormone (androgens) are slightly higher than in other women. More recently, however, some researchers are hypothesizing that the ovaries of women with PCOS are abnormal in other respects. In 2003, a group of researchers in London reported that there are fundamental differences between the development of egg follicles in normal ovaries and follicle development in the ovaries of women with PCOS.

In athletes, models, actresses, dancers, and women with anorexia nervosa, oligomenorrhea occurs because the ratio of body fat to weight drops too low.

Diagnosis

History and physical examination

Diagnosis of oligomenorrhea begins with the patient informing the doctor about infrequent periods. The doctor will ask for a detailed description of the problem and take a history of how long it has existed and any patterns the patient has observed. A woman can assist the doctor in diagnosing the cause of oligomenorrhea by keeping a record of the time, frequency, length, and quantity of bleeding. She should also tell the doctor about any recent illnesses, including longstanding conditions like diabetes mellitus. The doctor may also inquire about the patient's diet, exercise patterns, sexual activity, contraceptive use, current medications, or past surgical procedures.

The doctor will then perform a physical examination to evaluate the patient's weight in proportion to her height, to check for signs of normal sexual development, to make sure the heart rhythm and other vital signs are normal, and to palpate (feel) the thyroid gland for evidence of swelling.

In the case of female athletes, the doctor may need to establish a relationship of trust with the patient before asking about such matters as diet, practice and workout schedules, and the use of such drugs as steroids or ephedrine. The presence of stress fractures in young women should be investigated. In some cases, the doctor may give the patients the Eating Disorder Inventory (EDI) or a similar screening questionnaire to help determine whether the patient is at risk for developing anorexia or bulimia.

Laboratory tests

After taking the woman's history, the gynecologist or family practitioner does a pelvic examination and Pap test. To rule out specific causes of oligomenorrhea, the doctor may also do a pregnancy test and blood tests to check the level of thyroid hormone. Based on the initial test results, the doctor may want to do tests to determine the level of other hormones that play a role in reproduction.

As of 2003, more sensitive monoclonal assays have been developed for measuring hormone levels in the blood serum of women with PCOS, thus allowing earlier and more accurate diagnosis.

Imaging studies

In some cases the doctor may order an ultrasound study of the pelvic region to check for anatomical abnormalities, or x rays or a bone scan to check for bone fractures. In a few cases the doctor may order an MRI to rule out tumors affecting the hypothalamus or pituitary gland.

Treatment

Treatment of oligomenorrhea depends on the cause. In adolescents and women near menopause, oligomenorrhea usually needs no treatment. For some athletes, changes in training routines and eating habits may be enough to return the woman to a regular menstrual cycle.

Most patients suffering from oligomenorrhea are treated with birth control pills. Other women, including those with PCOS, are treated with hormones. Prescribed hormones depend on which particular hormones are deficient or out of balance. When oligomenorrhea is associated with an eating disorder or the female athlete triad, the underlying condition must be treated. Consultation with a psychiatrist and nutritionist is usually necessary to manage an eating disorder. Female athletes may require physical therapy or rehabilitation as well.

Alternative treatment

As with conventional medicial treatments, alternative treatments are based on the cause of the condition. If a hormonal imbalance is revealed by laboratory testing, hormone replacements that are more "natural" for the body (including tri-estrogen and natural progesterone) are recommended. Glandular therapy can assist in bringing about a balance in the glands involved in the reproductive cycle, including the hypothalmus, pituitary, thyroid, ovarian, and adrenal glands. Since homeopathy and acupuncture work on deep, energetic levels to rebalance the body, these two modalities may be helpful in treating oligomenorrhea. Western and Chinese herbal medicines also can be very effective. Herbs used to treat oligomenorrhea include dong quai (Angelica sinensis), black cohosh (Cimicifuga racemosa), and chaste tree (Vitex agnus-castus). Herbal preparations used to bring on the menstrual period are known as emmenagogues. For some women, meditation, guided imagery, and visualization can play a key role in the treatment of oligomenorrhea by relieving emotional stress.

Diet and adequate nutrition, including adequate protein, essential fatty acids, whole grains, and fresh fruits and vegetables, are important for every woman, especially if deficiencies are present or if she regularly exercises very strenuously. Female athletes at the high school or college level should consult a nutritionist to make sure that they are eating a well-balanced diet that is adequate to maintain a healthy weight for their height. Girls participating in dance or in sports that emphasize weight control or a slender body type (gymnastics, track and field, swimming, and cheerleading) are at higher risk of developing eating disorders than those that are involved in such sports as softball, weight lifting, or basketball. In some cases the athlete may be given calcium or vitamin D supplements to lower the risk of osteoporosis.

Many women, including those with PCOS, are successfully treated with hormones for oligomenorrhea. They have more frequent periods and begin ovulating during their menstrual cycle, restoring their fertility.

For women who do not respond to hormones or who continue to have an underlying condition that causes oligomenorrhea, the outlook is less positive. Women who have oligomenorrhea may have difficulty conceiving children and may receive fertility drugs. The absence of adequate estrogen increases risk for bone loss (osteoporosis) and cardiovascular disease. Women who do not have regular periods also are more likely to develop uterine cancer. Oligomenorrhea can become amenorrhea at any time, increasing the chance of having these complications.

Prevention

Oligomenorrhea is preventable only in women whose low body fat to weight ratio is keeping them from maintaining a regular menstrual cycle. Adequate nutrition and a less vigorous training schedules will normally prevent oligomenorrhea. When oligomenorrhea is caused by hormonal factors, it is not preventable, but it is often treatable.

Key Terms

Anorexia nervosa
A disorder of the mind and body in which people starve themselves in a desire to be thin, despite being of normal or below normal body weight for their size and age.

Cyst
An abnormal sac containing fluid or semi-solid material.

Emmenagogue
A medication or herbal preparation given to bring on a woman's menstrual period.

Female athlete triad
A combination of disorders frequently found in female athletes that includes disordered eating, osteoporosis, and oligo- or amenorrhea. The triad was first officially named in 1993.

Osteoporosis
The excessive loss of calcium from the bones, causing the bones to become fragile and break easily. Women who are not menstruating are especially vulnerable to this condition because estrogen, a hormone that protects bones against calcium loss, decreases drastically after menopause.



For Your Information

Resources

Books

* American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., revised. Washington, D.C.: American Psychiatric Association, 2000.

* Beers, Mark H., MD, and Robert Berkow, MD, editors. "Menstrual Abnormalities and Abnormal Uterine Bleeding." Section 18, Chapter 235 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

* Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part II, "CAM Therapies for Specific Conditions: Menstrual Symptoms, Menopause, and PMS." New York: Simon & Schuster, 2002.

Periodicals

* Barrow, Boone, MD. "Female Athlete Triad." eMedicine June 17, 2004.

* Chandran, Latha, MBBS, MPH. "Menstruation Disorders." eMedicine August 9, 2004.

* Hopkinson, R. A., and J. Lock. "Athletics, Perfectionism, and Disordered Eating." Eating and Weight Disorders 9 (June 2004): 99-106.

* Klentrou, P., and M. Plyley. "Onset of Puberty, Menstrual Frequency, and Body Fat in Elite Rhythmic Gymnasts Compared with Normal Controls." British Journal of Sports Medicine 37 (December 2003): 490-494.

* Milsom, S. R., M. C. Sowter, M. A. Carter, et al. "LH Levels in Women with Polycystic Ovarian Syndrome: Have Modern Assays Made Them Irrelevant?" BJOG 110 (August 2003): 760-764.

* Nelson, Lawrence M., MD, Vladimir Bakalov, MD, and Carmen Pastor, MD. "Amenorrhea." eMedicine August 9, 2004.

* Suliman, A. M., T. P. Smith, J. Gibney, and T. J. McKenna. "Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients Before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia." Clinical Chemistry 49 (September 2003): 1504-1509.

* Webber, L. J., S. Stubbs, J. Stark, et al. "Formation and Early Development of Follicles in the Polycystic Ovary." Lancet 362 (September 27, 2003): 1017-1021.

Organizations

* American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Avenue, NW, Washington, DC 20016-3007. (202) 966-7300. Fax: (202) 966-2891.

* American College of Sports Medicine (ACSM). 401 West Michigan Street, Indianapolis, IN 46202-3233. (317) 637-9200. Fax: (317) 634-7817.

* Polycystic Ovarian Syndrome Association. P.O. Box 80517, Portland, OR 7280. (877) 775-7267.

Other

* Clinical Research Bulletin. vol. 1, no. 14.




Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group The Essay Author is Tish Davidson, A.M..

Herbal Supplements - Evening Primrose

he Benefits Of Evening Primrose Oil In Treating Acne

The Native Americans were the first to discover the medicinal use of Evening Primrose. And then, the Europeans eventually brought the plant to their home countries and cultivated it there, where it became a type of food. The whole plant which includes the roots, to the leaves and to the flowers are edible.

The oil of the Evening Primrose flower can be extracted from the seeds, where it is most used as a supplement. Evening Primrose oil has been known for ceasing the discomfort of PMS or symptoms of menopause. Although there is no strong evidence for this, the anecdotal evidence is strong.

GLA, which is a type of fatty acid contained in the oil, contains a lot of beneficial properties. With the essential fatty acid, it is useful for the prevention of heart disease, eczema, hardening of the arteries, and multiple sclerosis. Since it has a positive effect on sex hormones (estrogen and testosterone), this may be the reasons why women have traditionally used it for PMS. This type of essential fatty acid also has anti-inflammatory properties and in fact, a mask made from the ground stems of the plant can help to soothe irritated skin.

There are several other benefits of Evening Primrose oil, such as treating acne and rosacea, preventing diabetes-related nerve damage, help easing joint pain in arthritis patients, protect signs of aging, as well as the symptoms of alcohol withdrawal.

The Evening Primrose oil supplements come in capsule, softgel, or oil form and dosage and drug interactions can be advised by a healthcare professional. It may take up to six months to see signs that Evening Primrose oil is working, so be patient!

Evening Primrose Oil Benefits and Side Effects

Evening primrose is a wildflower that grows throughout North America, Europe and some parts of Asia. The seeds of this plant, whose flowers open in the evening, contain oil that is rich in essential fatty acids and is touted among nutritionists for its healing powers.

Evening primrose oil is one of the most concentrated sources of gamma-linoleic acid (GLA), an essential fatty acid with anti-inflammatory properties. The body converts the GLA in evening primrose oil into prostaglandins, substances that function like hormones and help to regulate body processes. Cell membranes depend on GLA.

Evening primrose oil is used for a variety of conditions, including skin problems, premenstrual symptoms and inflammation. Many women that suffer from premenstrual syndrome have low levels of GLA, which is why evening primrose oil supplements may help to alleviate symptoms of the condition.

Evening primrose oil is often recommended to reduce breast tenderness and pain caused by fibrocystic breasts, and it can also help to ease menstrual cramps, endometriosis and mood swings related to the menstrual cycle. As an anti-inflammatory agent, evening primrose oil is also effective in treating flare-ups of irritable bowel syndrome, and studies show that it may be useful in treating rheumatoid arthritis pain as well.

The GLA in evening primrose oil may also help to prevent and even repair nerve damage caused by diabetes. At least one study has shown that symptoms like tingling, numbness and loss of sensation associated with diabetic neuropathy improved when patients took supplements of evening primrose oil. In addition, inflammation in kidneys, joints and skin associated with lupus may improve with the use of evening primrose oil.

Further, damage caused by inflammation in people multiple sclerosis, as well as other inflammatory processes may be reduced or prevented with evening primrose oil supplements. Evening primrose oil is also thought to be capable of encouraging transmission of nerve impulses, making it of possible use in treating memory problems associated with Alzheimer’s disease. It can also help compensate for deficiencies in GLA associated with aging.

One of the most proven benefits of evening primrose oil appears to be its ability to treat dry, scaly, or itchy skin conditions, such as rosacea, acne and atopic dermatitis. It appears that the prostaglandins produced by evening primrose oil contract blood vessels that become inflamed with these skin conditions. Evening primrose oil may also help prevent pores from becoming clogged, and it may reduce reliance on corticosteroids by patients with certain skin conditions as well.

Evening primrose oil is available in capsules and in liquid form. The usual dosage is about three grams per day for most conditions. Side effects are uncommon but may include bloating and abdominal discomfort in a small percentage of people.

To minimize any unpleasant side effects from the use of evening primrose oil capsules, it is best to take them with food. This will also help to ensure adequate absorption of GLA. Other nutrients that are important for the body to utilize the GLA in evening primrose oil are zinc, vitamin C, B vitamins and magnesium. When evening primrose oil is used to treat skin conditions, it may take several months to notice positive effects.

How to get pregnant

Wondering how to get pregnant? Understand when you're most fertile, how often to have sex — and when to seek help.

Some couples seem to get pregnant simply by talking about it. For others, it takes plenty of patience and a bit of luck. If you're wondering how to get pregnant, start the old-fashioned way. Here's what you need to know — and when to seek help.
Baby-making basics

Conception is based on an intricate series of events.

Every month, hormones from your pituitary gland stimulate your ovaries to release an egg, or ovulate. This often happens around day 14 of the menstrual cycle, although the exact timing may vary among women or even from month to month.

Once the egg is released, it travels to the fallopian tube. If you want to conceive, now's the time. The egg has about 24 hours to unite with a sperm. Since sperm cells can survive in your reproductive tract for two to three days, it's best to have regular sex during the days leading up to ovulation.

If the egg is fertilized, it'll travel to the uterus two to four days later. There it'll attach to the uterine lining. You're pregnant! Your periods will stop as your body begins to support the embryo.

If the egg isn't fertilized, it'll break down and you'll have your next period as usual.
Understanding when you're most fertile

Learning how ovulation works is one thing. Determining when it's actually happening is something else. For many women, it's like hitting a moving target.

Keep an eye on the calendar
Use your day planner or another simple calendar to mark the day your period begins each month. Also track the number of days each period lasts. If you have a consistent 28-day cycle, ovulation is likely to begin about 14 days after the day your last period began.

If your cycles are somewhat long, subtract 18 from the number of days in your shortest cycle. When your next period begins, count ahead this many days. The next week is a reasonable guess for your most fertile days.

* Pros. Calendar calculations can be done simply on paper. And they're free!
* Cons. Many factors may affect the exact timing of ovulation, including illness, stress and exercise. Counting days is often inaccurate, especially for women who have irregular cycles.

Watch for changes in cervical mucus
Just before ovulation, you might notice an increase in clear, slippery vaginal secretions — if you look for it. These secretions typically resemble raw egg whites. After ovulation, when the odds of becoming pregnant are slim, the discharge will become cloudy and sticky or disappear entirely.

* Pros. Changes in vaginal secretions are often an accurate sign of impending fertility. Simple observation is all that's needed, particularly inside the vagina.
* Cons. You have to check your vagina for the secretions. And judging the texture or appearance of vaginal secretions can be somewhat subjective.

Track your basal body temperature
This is your body's temperature when you're fully at rest. Ovulation may cause a gradual rise in temperature or even a sudden jump — typically between 0.5 and 1.6 degrees Fahrenheit. You'll be most fertile during the two to three days before your temperature rises. You can assume ovulation has occurred when the slightly higher temperature remains steady for three days or more.

Use an oral thermometer to monitor your basal body temperature. Try the digital variety or one specifically designed to measure basal body temperature. Simply take your temperature every morning before you get out of bed. Plot the readings on graph paper and look for a pattern to emerge.

* Pros. It's simple. The only cost is the thermometer. It's often most helpful to determine when you've ovulated and judge if the timing is consistent from month to month.
* Cons. The temperature change may be subtle, and the increase comes too late — after ovulation has already happened. It can be inconvenient to take your temperature at the same time every day, especially if you have irregular sleeping hours.

Try an ovulation monitoring kit
Over-the-counter ovulation kits test your urine for the surge in hormones that takes place before ovulation. For the most accurate results, follow the instructions on the label to the letter.

* Pros. Ovulation kits can identify the most likely time of ovulation. They can even provide a signal before ovulation actually happens. They're available without a prescription in most pharmacies.
* Cons. Ovulation kits often lead to excessively targeted sex — and timing sex so precisely can invite being too late. The tests can also be expensive, often ranging from $20 to $50 each.

Maximizing fertility

When you're trying to conceive, consider these simple do's and don'ts.

Do:

* Have sex regularly. If you consistently have sex two or three times a week, you're almost certain to hit a fertile period at some point. For healthy couples who want to conceive, there's no such thing as too much sex. For many couples, this may be all it takes.
* Have sex once a day near the time of ovulation. Daily intercourse during the days leading up to ovulation may increase the odds of conception. Although your partner's sperm concentration will drop slightly each time you have sex, the reduction isn't usually an issue for healthy men.
* Make healthy lifestyle choices. Maintain a healthy weight, exercise regularly, eat healthy foods and keep stress under control. The same good habits will serve you and your baby well during pregnancy.
* Consider preconception planning. Your doctor can assess your overall health and help you identify lifestyle changes that may improve your chances for a healthy pregnancy. Preconception planning is especially helpful if you or your partner have any health issues.
* Take your vitamins. Folic acid (vitamin B-9) plays an essential role in a baby's development. Taking a prenatal vitamin or folic acid supplement beginning at least one month before conception through the first trimester of pregnancy can reduce the risk of spina bifida and other neural tube defects by up to 70 percent.

Don't:

* Smoke. Tobacco changes the cervical mucus, which may keep sperm from reaching the egg. Smoking may also increase the risk of miscarriage and deprive your developing baby of oxygen and nutrients. If you smoke, ask your doctor to help you quit before conception. For your family's sake, vow to quit for good.
* Drink alcohol. Alcohol is off-limits if you're pregnant — or hope to be.
* Take medication without your doctor's OK. Certain medications — even those available without a prescription — can make it difficult to conceive. Others may not be safe once you're pregnant.

*Source taken from http://www.mayoclinic.com

Infertility

Women are waiting longer to have children. This naturally decreases the opportunity for spontaneous pregnancy, especially for women in their mid- to late-thirties, but statistics also confirm that more couples are seeking treatment for infertility.

Approximately one in six couples is infertile–defined as the inability to conceive a child after one year of unprotected intercourse. The cause of infertility appears to vary between the sexes but can be related to a number of things including structural abnormalities, hormonal imbalance, or nutritional deficiencies.

Fertility statistics in Canada show that about 50 percent of infertile couples decide against medical treatment and of those that go ahead with treatment, about 80 to 90 percent undergo medications or surgery that are not without complications or future risk of side effects. Only about five percent use advanced methods like in vitro fertilization (IVF), which offers a 20 percent success rate.

Fortunately, there are viable, safe, and effective natural options for men and women that have long-lasting, health-promoting effects and prove little to no risk for future health concerns.

Traditional Chinese Medicine (TCM)

TCM focuses on harmonizing energy flow and achieving a balance of yin and yang energies. It has been used for thousands of years to assist with male and female fertility. Interestingly, TCM philosophies purport that the vitality of the mother and the father at the point of conception helps to form the foundation of the baby’s wellness for life. Acupuncture treatments stimulate the flow of qi (energy), while Chinese herbs work to strengthen and nourish vital body fluids and the function of internal organs.

TCM can be particularly useful for endometriosis, menstrual irregularities and pain, and to improve sperm production and motility. Acupuncture has also been proven to be of benefit with IVF treatments. A German study (Highlights in Fertility and Sterility, April 2002) indicated that adding acupuncture to the treatment protocol of IVF patients greatly enhanced their chance of becoming pregnant.

Nutrition

Good nutrition is essential for optimal body function, hormonal balance, sperm and egg production, and the process of reproduction. Hormonal balance for fertility and for stress management can be achieved by eating a balance of healthy fats, lean protein, and low glycemic carbohydrates with each meal and snack. Processed foods, caffeine, trans fatty acids, excess saturated fats, and larger fish that may be high in mercury should be avoided.

Herbal Medicines

Herbs can help regulate the menstrual cycle, increase ovulation, and improve hormonal balance. Men can also use herbal medicines to improve hormone profiles. In some cases, saw palmetto, oats, and tribulus are beneficial. It is always best to consult a professional.

A perfect lunch and dinner plate could have one-third salad with homemade organic olive oil dressing; one-third grilled, steamed, baked, or stir-fried vegetables; and one-third lean protein (or a serving about the size and width of your palm).

TCM can be particularly useful for endometriosis, menstrual irregularities and pain, and to improve sperm production and motility. Acupuncture has also been proven to be of benefit with IVF treatments. A German study (Highlights in Fertility and Sterility, April 2002) indicated that adding acupuncture to the treatment protocol of IVF patients greatly enhanced their chance of becoming pregnant.

The most commonly used herbs to enhance fertility in women:

* donq quai
* wild yam
* black cohosh
* chaste tree
* false unicorn
* licorice
* red raspberry leaf

Natasha Turner, BSc, ND, VP of Natural Medicine at Truestar Health Inc., practises in Toronto, specializing in hormonal issues, preventive health, and digestive complaints, and can be reached at drturner@truestarhealth.com.

*Source taken from www.alive.com

What herbs help boost fertility in women?

Fertility Enhancing Herbs

Naturopathy is gaining a lot of popularity these days. It is no doubt the safest way to manage diseases and symptoms. Here are some useful herbs that help to boost fertility in men and women. Used individually or as a fertility blend, they can help you increase your chances of getting pregnant significantly and with very few side effects. However, it is advised to use caution when combining herbs with prescription or over-the-counter medications, as some react adversely together. Most of the time, if you are taking fertility drugs, it is very advisable to NOT take herbal remedies at the same time. Always seek the advice of your health care provider or naturopathic doctor before taking anything.

The herbs listed below are among the most popular for enhancing female fertility:

Black cohosh - this is an antispasmodic which relieves cramping. You may take this herb in the first half of your cycle from menstruation to ovulation.

Dong Quai - considered a female hormone regulator and an effective toner for the uterus. It should be taken in the first half of the cycle and in others the second half. It is advised to check the label for dosage information and consult with your healthcare provider or physician before taking Dong Quai at all.

Evening Primrose Oil - helps to increase fertile quality cervical fluid and also contains essential fatty acids which are good for the brain. You may take this EPO from menstruation to ovulation and switch to Flax Seed Oil after ovulation. Flax Seed Oil contains the fatty acids needed to maintain a healthy lifestyle. Evening Primrose Oil causes uterine contractions - which is why you should not take it after ovulation in the event that conception did occur.

False Unicorn- helps with ovarian pain and female infertility. You may take this herb in the first half of cycle from menstruation to ovulation.

Red Raspberry Leaf - You may take this herb during the entire cycle as it strengthens the uterine lining, thus helping to lengthen the luteal phase. But do ask your healthcare provider about continuing red raspberry leaf once pregnancy occurs. Usually, it should only be taken in the last trimester of pregnancy, because it �tones� the uterus.

Vitex (Chaste Berry)- Known as the female herb, it helps to regulate hormones and should be taken either the entire cycle or the first half from menstruation to ovulation.

It is certainly not necessary to take ALL of these herbs at once. Pick and choose which ones you may need and which ones will benefit you the most. Some cover the same areas of fertility enhancement while others offer a more general supplementation. These herbs come in different forms - tablets, capsules, tinctures - and in many different brands. They also come as fertility blends where you can benefit for the synergized effects of all herbs in the right dosage. Choose the formula you prefer and choose a brand that is reputable and pure. Read related articles on how the use of Green tea and Evening Primrose Oil can affect your fertility.

Evening Primrose Oil (EPO) - Its Role In Trying to Conceive

What is Evening Primrose oil or EPO?
Evening Primrose Oil is the oil derived from a North American wildflower called Evening Primrose. Evening Primrose is not really a primrose, but it gets its name from that flower because the plant looked similar to an English Primrose. The oil is rich in Vitamin E just like olives and nuts are. In addition, evening primrose oil also has gamma linolenic acid (GLA), an essential fatty acid. People that have difficulty creating in this fatty acid in their own bodies can benefit from its use.

The Europeans were one of the first to make it popular. They brought it back to their native soil and crowned this oil a "King's cure-all" because of its many useful properties that can cure a large number of diseases. In England, the oil is approved for use with eczema and high cholesterol. In women, it can especially be helpful for relieving breast pain, menstrual pains and improving the quality and fertility of cervical mucus.

How does Evening Primrose Oil help you in getting pregnant?
Evening Primrose Oil or EPO lowers cholesterol, helps to alleviate premenstrual syndrome symptoms and aids in the production of fertile quality cervical fluid. Evening Primrose Oil or EPO does a world of good in treating aliments of all sorts. Evening Primrose Oil or EPO is an essential fatty acid that contains gamma linolenic acid (GLA). This gamma linolenic acid (GLA) is converted to a hormone-like substance called prostaglandin E1 which has anti-inflammatory properties and may also act as a blood thinner and blood vessel dilator. These anti-inflammatory properties of evening primrose oil help people suffering from pains, aches and cramps.

Evening Primrose Oil or EPO also has effects on premenstrual syndrome symptoms and cervical mucus. If you suffer from premenstrual syndrome, it could be because you are deficient in the fatty acid, gamma linolenic acid (GLA). Evening Primrose Oil or EPO can help your body to alleviate the premenstrual syndrome symptoms by replacing the gamma linolenic acid (GLA).

Evening Primrose Oil or EPO helps women to produce more fertile quality cervical fluid also known as "egg white cervical mucus". This type of cervical fluid is fertile, thin, watery, clear and "stretchy" and easily aids the sperm to swim through the uterus and into the fallopian tube, and to the egg. Also, this type of fluid helps the sperm to stay alive for up to five days inside the fallopian tube, thus enabling conception to happen even if you don't have intercourse again by the time ovulation occurs.

If your cervical fluid is thick, brown or dry, it can obstruct or prevent fertilization. Some women are very dry, and have problems in producing an adequate amount of fertile quality cervical fluid. Drinking a lot of water and taking the Evening Primrose Oil or EPO can certainly help in the production of fertile cervical fluid in these women.

What is the dosage for Evening Primrose Oil or EPO?
Evening Primrose Oil or EPO should only be taken from menstruation to ovulation. This is because Evening Primrose Oil or EPO can cause uterine contractions in pregnancy. The dosage taken should be 1500mg to 3000mg per day. Since essential fatty acids are necessary, you can take flax seed oil in place of Evening Primrose Oil or EPO after ovulation. This may be taken throughout pregnancy as well.

There are many remedies out there to help with fertility, but few are as good as Evening Primrose Oil or EPO. Evening Primrose Oil or EPO is excellent for women because of the help it gives in alleviating premenstrual syndrome symptoms, and even menopausal women can benefit from taking it. There are a large number of women who will vouch for Evening Primrose Oil or EPO as a great agent to increase the fertile type cervical fluid.

Like all herbs, the use of Evening Primrose Oil or EPO can take a month or two to build up, and produce the results you are looking for. It is essential that you chart your fertility symptoms and signs, so you can know when you have ovulated. By knowing this information, you can discontinue the Evening Primrose Oil or EPO after ovulation and start the flax seed oil. Unless you are very regular, charting your fertility signs is the best tool to determine where you are in your cycle.