Advice for a couple trying for a baby really needs to encompass an all round protocol, including optimum nutrition, tips to boost libido, and practical advice on when to try to conceive. You may be surprised at the huge number of individuals who have received detailed nutrition advice, take their prescribed multivitamins, abstain from drinking, however don’t realise that having intercourse twice a month doesn’t quite give them the best chance! Women are also most likely to seek help when it comes to fertility, though it’s not uncommon for their partner’s infertility to be preventing a successful pregnancy, so be sure to include advice for both men and women when it comes to libido and fertility.
If someone isn’t in ‘the mood’, the chances of getting pregnant is of course going to be much lower, so the first step is to make sure that sex drive is high enough for regular intercourse. Increasing someone’s libido is a complex goal, as general mood, stress levels, hormones and nutritional deficiencies all play a role. Media advice that the general public are presented with regarding libido may simply revolve around quick fixes such as aphrodisiac foods, however we know that there is a lot more to it. As a practitioner, you will therefore need to consider simultaneously supporting brain health, hormone production, circulation, the adrenal glands for regulating stress levels and last but not least, physical activity.
Brain health – getting in the mood
The affect of mood on libido is often undermined, yet its health is very influential on frequency of intercourse. The complex network of neurotransmitters in the brain is essential for good mood. If someone is anxious, stressed, or if they have difficulty sleeping, it is likely that they have low production or impaired function of neurotransmitters, which may be negatively affecting their libido. Optimising production and functioning of dopamine, for example, is important to provide heightened mood, feelings of pleasure, reward and relaxation.
Levels of neurotransmitters can be significantly affected by dietary intake of protein (1), therefore to support neurotransmitter synthesis, ensure to include an amino acid rich diet that provides the building blocks. For general wellbeing in a healthy individual, approximately 0.8 g of protein per kg body weight is considered suitable (2), however to optimise mood health for someone feeling down, levels may need to be slightly higher – around 1-1.5g per kg body weight. Important vitamins and minerals required by enzymes for neurotransmitter production should also be considered, including zinc, magnesium and vitamin B6.
As cell membranes are almost entirely made of fats, omega-3 EPA and DHA consumption needs to be sufficient in order to keep cell membranes elastic, fluid and responsive to these messages. Omega-3 EPA and DHA supplementation has shown very positive results in reducing anxiety (3) and depressive symptoms (4).
Also consider foods which specifically stimulate production of neurotransmitters; cocoa, for example, contains phenylethylamine, which may stimulate the brain, releasing serotonin and dopamine. A couple of squares of dark chocolate or cocoa powder in hot oat milk will be well received by your clients, and comes with an added boost of healthy nutrients including flavonoids and iron.
High fertility window
Teaching clients to recognise signs of ovulation to identify the window of high fertility for a woman is something to note. Ovulation is generally 12-14 days before menstruation starts, and the window of high fertility is around 6 days before this as sperm may survive for up to 7 days. Of course, every woman is different and periods are often irregular, therefore teaching a woman to understand how to read her body’s fertile signs is most relevant and useful. Advising women to check their temperature first thing in the morning with a thermometer is an easy way to test for ovulation, as temperature rises just after ovulation. This requires monitoring over at least a couple of months in order to establish timings of personal hormone fluctuations.
Another immediate method to identify the high fertility window is to be aware of consistency of cervical mucus. During times of high fertility, fluid becomes clear, slippery and stretchy, or watery, to allow for sperm to easily swim through.
If a woman is missing periods, or has significant mood swings and PMS symptoms, it is very likely that her hormones are out of balance. Of course the same can be said for men; however the symptoms are usually more prominent in women due to natural fluctuations throughout the month. Hormones not only have an effect on fertility, they also impact libido.
Follicle stimulating hormones (FSH) and luteinizing hormone (LH) are key hormones produced by the pituitary gland when considering fertility. FSH and LG help to stimulate the growth of follicles which mature eggs in women, and it stimulates sperm production in men. If the brain fails to stimulate significant FSH and LH production, menstrual irregularities may occur, resulting in reduced fertility in women. In men, sperm production may be reduced. Low production of FSH and LH, coupled with high testosterone, may also lead to other complications such as polycystic ovary syndrome (PCOS) and endometriosis in women. Such conditions may have a slight genetic predisposition, however diet plays a significant role in its development. If you have a client with symptoms including irregular menstruation, acne, excess hair, mood swings or painful or heavy periods, be sure to consider the possibility of these conditions.
If a woman is diagnosed with PCOS, ensure that refined carbohydrates are kept to a minimum to improve insulin sensitivity, which is commonly low and may lead to a host of other conditions. Reducing refined carbohydrates in those with PCOS has also shown to reduce high circulating testosterone level (5). It must be noted that lowering carbohydrate to a very low intake for men may have a negative affect by lowering testosterone too much. On the other end of the scale, if a woman has a very low testosterone level, her sex drive may be reduced. Testosterone is an important hormone for fertility, however it must be modulated to healthy levels, i.e. not too high and not too low. Zinc is required in the body to produce testosterone and therefore is required for sperm production.
Oestrogen dominance can also result in reduced fertility due to its effects on menstrual disturbances. Keeping refined carbohydrates to a minimum may help someone with elevated oestrogen. If someone has the opposite issue (low oestrogen levels), phytoestrogen foods such as linseeds, although they won’t actually increase oestrogen levels, have properties similar to oestrogen and may support fertility. Fibre intake is a great way to modulate oestrogen hormone levels as lack of fibre may result in the re-absorption of hormones in the large intestine.
When considering the complications of hormone levels, it might be an idea to suggest your client undergoes a diagnostic saliva test to measure hormone levels over a full monthly cycle. Such a test can be very useful in painting a clear picture of a hormone profile, allowing for the most effective nutritional protocol.
Maca root has been cited as increasing libido and fertility, therefore could be considered in a supplement regime. Studies are currently limited to animal observations, however results are promising, showing that feeding maca to mice actually increases LH serum levels (6). Preliminary evidence has also shown that yohimbine and ginseng may improve erectile dysfunction (7), therefore could be considered as a natural Viagra alternative for those who may need it.
A healthy circulation
Optimising circulation is a must for libido to ensure a healthy blood flow to sexual organs. Foods that increase circulation include garlic, chilli peppers and ginger. Garlic is particularly effective as it contains allicin, which dilates blood vessels and thins the blood. Supplementing with garlic is an option if regular food consumption is difficult.
Omega-3 EPA and DHA found in oily fish also help to thin the blood and increase elasticity of blood vessels, allowing for easier blood flow.
What to avoid or limit
Alcohol consumption is of course not ideal if someone is trying to become pregnant due to the negative effects on the unborn baby, even in the very early stages of pregnancy. Drinking alcohol to excess in the long run can also increase risk of depression due to plummeting levels of neurotransmitters after drinking. Studies have also shown that alcohol consumption can cause sperm abnormalities (8), therefore abstaining from or limiting alcohol is important for both women and men when trying to conceive.
Caffeine intake should be limited during pregnancy due to risk of miscarriage, therefore it may be wise to recommend limiting caffeine containing drinks to around two a day when trying to conceive. Most individuals tolerate moderate caffeine intake reasonably well, however insulin response in the body has shown to disrupt insulin sensitivity when caffeine is consumed in excess (9). Eliminating caffeine may therefore be beneficial for women with PCOS who may already have reduced insulin sensitivity. Elevated insulin in PCOS can stimulate high testosterone production.
Consider stress levels
Reducing stress is essential for a couple trying to conceive as cortisol production over the long term can significantly reduce fertility. Cortisol can affect production of luteinizing hormones, oestrogen and progesterone. I.e. when the body is in a state of stress, this can suppress signals required to stimulate ovulation as the body may at this time consider conception as low priority, and libido may also be reduced. We must also not forget the significant effect stress has on brain function and therefore mood.
It is always difficult giving advice to someone to help reduce stress levels, however a step in the right direction is to recommend reducing foods that increase the production of stress hormones. Refined carbohydrates are the biggest culprits, therefore suggest low GI foods to your clients. Increased cortisol production can also lead to decreased insulin sensitivity (10), further emphasising the importance of limiting refined carbohydrates during times of stress. Stimulants such as coffee, nicotine and alcohol also play havoc with the adrenal glands and can worsen stress in the long term.
Nutritionally, our adrenal glands and enzymes required for neurotransmitter synthesis require sufficient nutrients including vitamin C, aantioxidants, B vitamins, zinc, magnesium and much more, so recommending nutrient dense foods or tailored supplements is key. Supplementing with a B vitamin complex has shown to significantly lower personal strain and dejected mood, therefore reducing stress (11). Vitamin B6 combined with magnesium has shown to reduce anxiety related PMS symptoms (12).
Exercise can significantly impact fertility, libido and stress levels by affecting hormone production. Moderate exercise may help to reduce stress and, as physical activity actually increases available energy, (13) this can help people to feel more motivated by releasing the brain chemical endorphins, improving libido. Gentle exercise is most suitable for those suffering from stress and resistance training may be particularly beneficial for men trying to raise testosterone levels.
Watch out for client over doing it at the gym, however, as if exercise is too intense this can actually increase production of cortisol (14) and overtraining may result in lack of recovery, lack of energy and therefore reduced libido.
Leave on a positive note
Difficulties conceiving can be a very stressful time for couples, so ensure you leave your clients with positive thoughts flowing through their minds, giving them a sense of control and hope rather than a feeling of despair. With the right advice and positive changes, many couples are able to conceive naturally..
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