Part 4 of 6 in the "Can I see a TCM practitioner while preparing for pregnancy" series. Part 1 covers what this stage is; part 5, the angle TCM theory takes.

Preconception care is, by definition, provided to women and couples — the World Health Organization definition Malaysia's Ministry of Health manual adopts. This part finishes the "both of you" thought: what public health bodies advise the two of you, and what a practitioner raises at a consultation.

The short version

• Smoking and alcohol: all men and women in reproductive age should avoid smoking, consuming alcohol and other types of drug abuse — that is the manual.
• Weight and age are both two-person matters. Singapore's HealthHub states that being underweight, overweight or obese may cause ovulation- or sperm-related issues, and notes that for men sperm quality deteriorates with age.
• At the start of a consultation the practitioner checks what you are taking, and whether a period is late.
• Three options: acupuncture, herbal medicine, a direction for routine and eating — options in practice, not promises of a result.
• Tonics, si wu, a tonic packet from family: have the practitioner look at them before you start. If your doctor prescribed it, never stop it on your own.
• Severe abdominal pain, heavy bleeding, or fever with lower abdominal pain: call 999 now, or go to the nearest hospital emergency department.

I. Advice that applies to both partners (the sourced part)

• Smoking and alcohol. All men and women in reproductive age should have a healthy lifestyle; avoid unhealthy habits like smoking, consuming alcohol and other types of drug abuse — that is how the Ministry of Health manual's pre-pregnancy health education puts it. The World Health Organization says the same: lifestyle factors such as smoking, excessive alcohol intake and obesity can affect fertility.
• Weight. Being underweight, overweight or obese may cause ovulation- or sperm-related issues — Singapore's HealthHub states it plainly. That is a two-person matter, not one side's.
• Sleep and movement. Six to eight hours of sleep a day to ensure adequate rest; regular exercise decreases stress — both sentences are in the manual's pre-pregnancy health education.
• Age. For men, sperm quality deteriorates with age — the note on the same HealthHub page. "Only the woman's age matters" does not hold.

Not one of the four is addressed to a single person. The manual says it directly too: husband and wife must be supportive and actively participate in enhancing each other's health.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

II. What the practitioner asks first, and the options raised

The medication list and "could you already be pregnant" come first. At the start of a consultation the practitioner checks what you take — medication, supplements, tonics — and whether a period is late, because the direction changes accordingly. Keep taking what your doctor prescribed; never stop it on your own. If you take anticoagulant or antiplatelet medication, have both your doctor and your practitioner review any herb or tonic before you start; see "Can You Take Chinese Herbs With Western Medication?".

Three options: acupuncture, herbs, lifestyle direction. Acupuncture, concentrated herbal granules, and a direction for routine and eating — the practitioner explains which fit this stage and which do not. How acupuncture is handled at this stage is in part 6.

These are options in practice, not promises of a result. No part of this series says "what the effect will be" — that belongs to an individual assessment, not to an article.

III. Tonics, si wu, and that number on the packaging

Declare it, then start. Some Chinese herbs may have untoward influences on pregnant women or fetuses — that is Hong Kong's Chinese Medicine Regulatory Office. So at this stage, have the practitioner look at any tonic packet from family, si wu, or red date tea before you start, and stop and ask the moment a pregnancy is suspected.

The list is not only prescriptions. What the manual's antenatal history asks for is "drug history (traditional medication and other self-prescribed medicines)" — traditional and self-prescribed medicine in the same breath. So whatever came from a counter, from family or from direct sales goes on it too, one copy for the doctor and one for the practitioner (the last item on the part 2 table).

There is a number on the packaging you can check first. In Malaysia, registered medicines, traditional and proprietary Chinese medicines included, carry a registration number beginning with MAL and a Meditag hologram on the packaging — that is the Ministry of Health's Pharmaceutical Services Programme. Products and remedies of unknown origin, or with no registration number, sit outside that review.

But a number does not mean "suitable to take now": it says whether the product went through registration review, and whether it suits you is for the doctor and the practitioner to judge.

First, the things that cannot wait

Severe abdominal pain, heavy bleeding, or fever with lower abdominal pain — call 999 now, or go to the nearest hospital emergency department. The NHS's pelvic inflammatory disease page puts pelvic pain that is severe or getting worse, pelvic pain with heavy bleeding from the vagina, and a very high temperature at the call-999 tier; the same page describes pelvic inflammatory disease as an infection that affects the womb, fallopian tubes and ovaries.

Periods absent for a long stretch or a marked change in the cycle, bleeding between periods or after sex — get this checked. Vaginal bleeding that is unusual for you, including bleeding between periods and during or after sex, is listed among the symptoms of cervical cancer by the NHS.

The full list, and the reason for four of them, are in part 6. TCM and Western medicine complement each other; it is not a choice between them.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

Fitting it into life in Malaysia

• Kopi, teh tarik and eating out. No need to fix it first and then report it. How many cups, at what time, how much of the week is eaten out — say it as it is. It is information.
• A tonic packet from family, a soup pack from the medical hall, a direct-sales supplement. Mention those too, and look for a MAL registration number on the packaging. The practitioner needs to know what you are actually taking.

Frequently asked

Can I drink si wu while preparing for pregnancy? Ask first; there is no blanket yes. Si wu is a formula that TCM theory files under "nourishing blood", but whether it suits you, and whether it suits now, is the practitioner's judgement after seeing your situation. Hong Kong's Chinese Medicine Regulatory Office states that some Chinese herbs may have untoward influences on pregnant women or fetuses, so the moment a pregnancy is suspected, stop and ask both sides. What "nourishing blood" means inside the theory is in part 5.

The words in this part

• Anticoagulant / antiplatelet medication (抗凝血与抗血小板类药物) — two classes of prescription medicine that affect how blood clots. If you take either, have both your doctor and your practitioner review any herb or tonic before you start.
• Concentrated herbal granules (浓缩中药粉) — one of the forms a practitioner may raise, taken dissolved in water.
• Si wu (四物) — a formula TCM theory files under "nourishing blood", sold in Malaysia most often as a soup pack. Whether it suits you, and whether it suits now, is the practitioner's judgement.
• MAL registration number and Meditag hologram — the two things on the packaging of a registered medicine in Malaysia. The Ministry of Health's Pharmaceutical Services Programme states that registered medicines must carry both.

The other five parts

• Part 1: Can I see a TCM practitioner while preparing for pregnancy — what this stage is, and how long before you see a doctor
• Part 2: What the pre-pregnancy checks usually include, and where each belongs
• Part 3: What three of those checks are looking for — thalassaemia, rubella, folic acid
• Part 5: How TCM theory reads this stage — 天癸 and 冲任
• Part 6: When to see a doctor first

👉 If you are not sure "where the two of us should start sorting out our routine", you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you. For questions about fertility itself, see an O&G or a fertility specialist first.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• Ministry of Health Malaysia, Perinatal Care Manual 4th Edition (released May 2023), Appendix 1-8 Pre Pregnancy Health Education — https://hq.moh.gov.my/bpkk/images/PERINATAL_CARE_MANUAL_4th_Edition_2020_11Mei2023.pdf
• World Health Organization, Infertility fact sheet, 28 November 2025 — https://www.who.int/news-room/fact-sheets/detail/infertility
• Singapore MOH HealthHub, Debunking 5 Myths of Fertility Health, last reviewed 4 May 2026 — https://www.healthhub.sg/well-being-and-lifestyle/sexual-health/debunking-5-myths-of-fertility-health
• Hong Kong Department of Health, Chinese Medicine Regulatory Office, Adverse Reactions of Chinese Medicines — https://www.cmro.gov.hk/html/eng/useful_information/public_health/pamphlet/Adverse_Reactions_of_CM.html
• Ministry of Health Malaysia, Pharmaceutical Services Programme FAQ, How to identify medicines that are registered with MOH — https://pharmacy.moh.gov.my/en/faq/how-identify-medicines-are-registered-moh.html
• NHS (UK), Pelvic inflammatory disease, page last reviewed 17 December 2025 — https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
• NHS (UK), Cervical cancer — Symptoms, page last reviewed 4 September 2024 — https://www.nhs.uk/conditions/cervical-cancer/symptoms/

本文是「备孕期间可以看中医吗」系列的第 4 篇，共 6 篇。第 1 篇讲这段时间是什么，第 5 篇讲中医理论的角度。

孕前照护从定义上就是向女性与伴侣双方提供的——卫生部手册引用世界卫生组织的说法。这一篇把「双方」说完：公共卫生机构给两个人的建议，以及看诊时医师会提出什么。

一分钟看完

• 烟与酒：所有育龄的男性与女性都应避免吸烟、饮酒与其他药物滥用——手册写的。
• 体重与年纪都是双方的事。新加坡 HealthHub 写明体重过轻、过重或肥胖可能造成排卵方面或精子方面的问题，也提醒男性的精子质量会随年龄下降。
• 看诊一开始，医师会核对您在吃什么，以及月经是否延迟。
• 三个选项：针灸、中药、作息与饮食的方向——是做法的选项，不是结果的承诺。
• 补品、四物、家里给的补包：开始前先让医师看过。医生开的药，切勿自行停药。
• 剧烈腹痛、大量出血、发烧伴随下腹痛：请立刻拨打 999，或前往最近的医院急诊部。

一、对双方都适用的建议（有来源的部分）

• 烟与酒。 所有育龄的男性与女性都应有健康的生活方式，避免吸烟、饮酒与其他药物滥用——卫生部手册的孕前健康教育这样写。世界卫生组织的说法一致：吸烟、过量饮酒与肥胖等生活因素会影响生育能力。
• 体重。 体重过轻、过重或肥胖，可能造成排卵方面或精子方面的问题——新加坡 HealthHub 写明。这是双方的事，不是一方的事。
• 睡眠与运动。 每天六到八小时睡眠以确保足够休息；规律运动可减压——手册的孕前健康教育这两句都在。
• 年纪。 男性的精子质量也会随年龄下降——HealthHub 同一页的提醒。「只有女方要看年纪」不成立。

四项没有一项是只对一个人说的。手册自己也写得直接：夫妻双方应互相支持，并积极参与提升彼此的健康。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

二、看诊时医师会先问什么，会提出哪些选项

先问药单与是否可能已怀孕。 问诊一开始会核对您正在服用的药物、保健品、补品，以及月经是否延迟——因为处理方向会因此不同。医生开的药请照常服用，切勿自行停药。若您正在服用抗凝血或抗血小板类药物，开始任何中药或补品前，请先让您的医生与中医师都看过；详见〈中药和西药可以一起吃吗〉。

三个选项：针、药、生活方向。 针灸、浓缩中药粉、作息与饮食的调整方向——医师会说明哪几项适合现阶段，也会说明哪几项不适合。针灸在这个阶段怎么谈，见第 6 篇。

这些是做法的选项，不是结果的承诺。这一系列不写「会有什么效果」——那属于个人评估，不属于文章。

三、补品、四物，与包装上那串编号

先说清楚，再开始。 有些中药或会对孕妇或胎儿造成影响——香港卫生署中医药规管办公室写明的。所以在这个阶段，家里给的补包、四物、红枣茶，请在开始前先让医师看过，一旦怀疑怀孕就停下来问。

清单不只是处方药。 手册的产检病史栏问的是「药物史（传统药物与其他自行服用的药）」——传统药与自行服用的药一起问。所以柜台买的、家里给的、直销买的，一并写进去，医生一份，中医师一份（见第 2 篇那张表的最后一项）。

包装上有一串编号可以先看。 在马来西亚，注册药品（包括传统药与中成药）的包装上有以 MAL 开头的注册编号与 Meditag 防伪标签——这是卫生部药剂服务计划的说明。来源不明、没有注册编号的产品与偏方，不在这个审查范围内。

但有编号不等于「适合现在吃」：编号说的是有没有经过注册审查，适不适合您由医生与医师判断。

先说不能等的几件事

剧烈腹痛、大量出血、发烧伴随下腹痛——请立刻拨打 999，或前往最近的医院急诊部。NHS 的骨盆腔发炎页把剧烈或持续加剧的骨盆疼痛、骨盆疼痛伴随大量阴道出血，以及很高的体温，都列在立刻拨打 999 那一级；该页说明骨盆腔发炎是一种影响子宫、输卵管与卵巢的感染。

月经长时间没有来或周期出现明显改变，非经期出血或性行为后出血——请就医检查。对您来说不寻常的阴道出血，包括非经期与性行为期间或之后的出血，NHS 把它列在子宫颈癌的症状里。

完整清单，以及其中四项的理由，见第 6 篇。中医与西医是互相补位的关系，不是二选一。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

大马生活里怎么安排

• kopi、teh tarik 与外食：不必先「改好」再来说。一天几杯、几点喝、外食占多少，如实说就好——那是资料。
• 家里给的补包、药材铺的汤包、直销保健品：请一并说明，并看包装上有没有 MAL 注册编号。医师需要知道您实际吃进去的是什么。

常见问题

备孕可以喝四物吗？ 先问，不要一概而论。四物是中医理论里归在「养血」一类的方剂，但适不适合您、适不适合现在，是医师看过您的情况之后的判断。香港卫生署中医药规管办公室写明有些中药或会对孕妇或胎儿造成影响，所以一旦怀疑怀孕就停下来问两边。「养血」在理论里是什么意思，见第 5 篇。

这篇出现的几个词

• 抗凝血与抗血小板类药物（anticoagulant / antiplatelet）——影响血液凝结的两类处方药。若您正在服用，开始任何中药或补品前请先让医生与中医师都看过。
• 浓缩中药粉（concentrated herbal granules）——医师可能提出的用药形式之一，冲水服用。
• 四物（si wu）——中医理论里归在「养血」一类的方剂，在马来西亚常以汤包形式出现。适不适合您、适不适合现在，由医师看过之后判断。
• MAL 注册编号与 Meditag 防伪标签——马来西亚注册药品包装上的两样东西。卫生部药剂服务计划写明注册药品必须同时带这两样。

这个系列的另外五篇

• 第 1 篇：备孕期间可以看中医吗——这段时间是什么，多久没怀上该看医生
• 第 2 篇：孕前检查通常包括什么、该往哪里
• 第 3 篇：这三项检查在查什么——地中海贫血、风疹、叶酸
• 第 5 篇：中医理论怎么看这个阶段——天癸与冲任
• 第 6 篇：什么时候要先看医生

👉 如果您不确定「我们两个人该从哪里开始整理作息」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。生育方面的疑问，请先看妇产科或生殖医学专科医生。

无论身在何处，与持证中医师对坐。

汉方现代中医

资料来源

• 马来西亚卫生部，《围产期护理手册》第 4 版（2023 年 5 月发布），附录 1-8 Pre Pregnancy Health Education — https://hq.moh.gov.my/bpkk/images/PERINATAL_CARE_MANUAL_4th_Edition_2020_11Mei2023.pdf
• 世界卫生组织，Infertility 事实清单，2025 年 11 月 28 日 — https://www.who.int/news-room/fact-sheets/detail/infertility
• 新加坡卫生部 HealthHub，Debunking 5 Myths of Fertility Health，最后审阅 2026 年 5 月 4 日 — https://www.healthhub.sg/well-being-and-lifestyle/sexual-health/debunking-5-myths-of-fertility-health
• 香港卫生署中医药规管办公室，中药的不良反应 — https://www.cmro.gov.hk/html/b5/useful_information/public_health/pamphlet/Adverse_Reactions_of_CM.html
• 马来西亚卫生部药剂服务计划，How to identify medicines that are registered with MOH — https://pharmacy.moh.gov.my/en/faq/how-identify-medicines-are-registered-moh.html
• NHS（英国），Pelvic inflammatory disease，页面最后审阅 2025 年 12 月 17 日 — https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
• NHS（英国），Cervical cancer — Symptoms，页面最后审阅 2024 年 9 月 4 日 — https://www.nhs.uk/conditions/cervical-cancer/symptoms/