Part 6 of 6 in the "Can I see a TCM practitioner while preparing for pregnancy" series. The first five parts are listed at the foot.

"Does this need a doctor first?" That is the hardest thing to judge alone. This part lists seven see-a-doctor-first situations, with the reason its own page gives for several of them — what the sign can indicate, and why it is checked.

The short version

• Trying for a while without a pregnancy: this is assessed and managed by an O&G or a fertility specialist, including investigation of both partners (section I, item 2).
• Periods absent for a long stretch, or a marked change in the cycle: get this checked. The NHS states that periods can also sometimes stop as a result of a medical condition.
• Bleeding between periods, or after sex: get this checked — the reason is in section I, item 4.
• Severe abdominal pain, heavy bleeding, or fever with lower abdominal pain: call 999 now, or go to the nearest hospital emergency department.
• TCM and Western medicine complement each other; it is not a choice between them. If you are under medical treatment, never stop a prescription on your own.

I. See a doctor first in these situations

• The routine pre-pregnancy checks have not been done. Pre-pregnancy screening and the related blood tests should be arranged by a family doctor or an O&G. The full table of items is in part 2.
• You have been trying for a while without a pregnancy. That falls under infertility. Infertility is assessed and managed by an O&G or a fertility specialist, including investigation of both partners. It is not what a TCM consultation handles — see a specialist first. The threshold for "a while" is in part 1. The World Health Organization defines infertility as a disease of the male or female reproductive system; the NHS states that there are many possible causes of infertility and that fertility problems can affect either partner — which is why the assessment is done as a couple.
• Periods have been absent for a long stretch, or the cycle has changed markedly. Get this checked. The NHS's missed-or-late-periods page states that periods can also sometimes stop as a result of a medical condition, such as heart disease, diabetes, or an overactive or underactive thyroid; the same page says a GP will ask about your health and may do some blood tests to find out the cause.
• Bleeding between periods, or after intercourse. Get this checked. Vaginal bleeding that is unusual for you — including bleeding between your periods, and during or after sex — is listed by the NHS among the symptoms of cervical cancer; cervical cancer is a cancer found in the cervix, and the cervix is the opening between the vagina and the womb.
• You are under reproductive medicine care, or taking hormone medication. Consult your treating doctor first. Medication needs checking on both sides, and never stop a prescription on your own.
• You suspect or have confirmed a pregnancy. Antenatal care leads from here, and any medication, supplement or herb should be run past your doctor first. The manual's advice is that a pregnant woman and her partner attend an antenatal clinic before 12 weeks of gestation.
• 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 describes pelvic inflammatory disease as an infection that affects the womb, fallopian tubes and ovaries, usually caused by sexually transmitted infections like chlamydia and gonorrhoea but also by common bacteria that live in the vagina; that 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.

TCM and Western medicine complement each other; it is not a choice between them. Much of this stage needs tests, ultrasound or a specialist assessment to confirm, and a TCM consultation does not substitute for those.

If you are under medical treatment, TCM care is a layer added on top — not a layer swapped in — and never stop a prescription on your own.

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. Better not to

1. Read this series as a guide to "how to conceive more easily" — it makes no such promise, and be careful of anyone who does.
2. Stop medication your doctor prescribed because you have started TCM care.
3. Keep putting off specialist investigation once you are past the threshold in part 1.

Fitting it into life in Malaysia

• Confinement plans. The subject gets raised at this stage. On what the sayings around it actually mean: the TCM view of confinement practices.
• Make notes beforehand. A few months of cycle records, your routine, and a list of medication and supplements — see what to prepare before an online consultation.

Frequently asked

What does TCM look at when preparing for pregnancy? This stretch of life: sleep and routine, eating and digestion, stress and mood, a few months of cycle records, and existing diagnoses and medication. The theory's direction is attending to the cycle, nourishing blood and settling the spirit (see part 5). From the three options — acupuncture, herbs, lifestyle direction — the practitioner explains which fit this stage. It does not diagnose or address conditions of fertility.

Can I have acupuncture while preparing for pregnancy? It can be discussed. The practitioner first asks whether you could already be pregnant, then decides whether it suits this stage and which points to use — TCM theory holds certain points to be used with caution in pregnancy, so tell the practitioner as soon as a period is late. It is one option in practice, not a promise of a result.

The words in this part

• Infertility (不孕) — the World Health Organization's definition: a disease of the male or female reproductive system, defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. It is assessed and managed by an O&G or a fertility specialist.
• Pelvic inflammatory disease (PID, 骨盆腔发炎) — the NHS's description: an infection that affects the womb, fallopian tubes and ovaries, usually caused by a sexually transmitted infection but also by common bacteria that live in the vagina.
• Cervical cancer (子宫颈癌) — the NHS's description: a cancer found in the cervix, the cervix being the opening between the vagina and the womb. The NHS lists vaginal bleeding that is unusual for you among its symptoms.

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.

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 4: The advice that applies to both partners, and the options a consultation raises
• Part 5: How TCM theory reads this stage — 天癸 and 冲任

👉 If you are not sure "whether my situation needs a doctor first or can start with TCM", 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; if anything in section I applies, see a doctor first. 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

• World Health Organization, Infertility fact sheet, 28 November 2025 — https://www.who.int/news-room/fact-sheets/detail/infertility
• NHS (UK), Infertility, page last reviewed 9 August 2023 — https://www.nhs.uk/conditions/infertility/
• NHS (UK), Missed or late periods, page last reviewed 12 June 2026 — https://www.nhs.uk/conditions/stopped-or-missed-periods/
• NHS (UK), Cervical cancer — Symptoms, and What is cervical cancer?, page last reviewed 4 September 2024 — https://www.nhs.uk/conditions/cervical-cancer/symptoms/ · https://www.nhs.uk/conditions/cervical-cancer/what-is-cervical-cancer/
• NHS (UK), Pelvic inflammatory disease, page last reviewed 17 December 2025 — https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
• 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

本文是「备孕期间可以看中医吗」系列的第 6 篇，共 6 篇。前五篇的清单在文末。

「这个情况要不要先去看医生？」这是最难自己判断的一件事。这一篇把七项请先就医的情况列出来，并为其中几项写上对应页面给的理由——这个征兆可能是什么，为什么要查。

一分钟看完

• 已经尝试一段时间仍未怀孕：这要由妇产科或生殖医学专科医生评估与处理，包括双方的检查（第一节第 2 项）。
• 月经长时间没有来，或周期出现明显改变：请就医检查。NHS 写明，经期有时也可能因为某些疾病而停止。
• 非经期出血，或性行为后出血：请就医检查——理由见第一节第 4 项。
• 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。
• 中医与西医是互相补位的关系，不是二选一。正在西医治疗中的，切勿自行停药。

一、这些情况请先看医生

• 孕前的例行检查还没做：孕前检查与相关的血液检验，请先由家庭医生或妇产科医生安排。完整的项目表在第 2 篇。
• 已经尝试一段时间仍未怀孕：这属于不孕的范畴。不孕需要由妇产科或生殖医学专科医生评估与处理，包括双方的检查。这不是中医问诊的处理范围，请先看专科医生。「一段时间」的门槛，见第 1 篇。世界卫生组织把不孕定义为男性或女性生殖系统的一种疾病；NHS 写明不孕有许多可能的原因，而生育方面的问题可能出在任何一方——这就是评估要两个人一起做的原因。
• 月经长时间没有来，或周期出现明显改变：请就医检查。NHS 的「经期延迟或不来」页写明，经期有时也可能因为某些疾病而停止，例如心脏病、糖尿病，或甲状腺功能过高或过低；同一页说明医生会先问您的健康状况，并可能安排验血来找出原因。
• 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，以及性行为期间或之后的出血——NHS 把它列在子宫颈癌的症状里；子宫颈癌是长在子宫颈的癌症，而子宫颈是阴道与子宫之间的开口。
• 正在接受生殖医学相关的治疗，或在服用荷尔蒙药物：请先咨询您的主治医生。用药需要两边一起把关，切勿自行停药。
• 已经怀疑或确认怀孕：请以产检为主。此时任何药物、保健品与药材，都请先问过医生。手册的建议是孕妇与伴侣在怀孕 12 周之前到产科门诊登记。
• 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 的骨盆腔发炎页说明，骨盆腔发炎是一种影响子宫、输卵管与卵巢的感染，通常由披衣菌、淋病等性传播感染造成，也可能由阴道里常见的细菌造成；该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。

中医与西医是互相补位的关系，不是二选一。这个阶段有许多事需要检验、超音波或专科评估才能确认，中医问诊不能取代这些检查。

若您正在西医治疗中，中医是加上去的一层，不是拿来替换的那一层，切勿自行停药。

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、这几件事不要做

1. 不要把这一系列当成「怎样比较容易怀孕」的指南——它没有这个承诺，任何人给的这种承诺都要小心。
2. 不要因为开始看中医就自行停掉医生开的药。
3. 不要在已经过了第 1 篇那个门槛的情况下，把专科的检查一直往后推。

大马生活里怎么安排

• 坐月子的安排：这件事在这个阶段就会被提起。关于坐月子说法的整理，可参考：坐月子：中医观点下的常见说法与医师会了解的 5 件事。
• 问诊前先做记录：几个月的周期记录、作息，以及一份用药与补品清单。准备方式可参考：线上问诊前该准备什么。

常见问题

中医备孕看什么？ 看这段生活：睡眠作息、饮食消化、压力情绪、几个月的周期记录，以及已有的诊断与用药。理论的方向是调经、养血、安神（见第 5 篇）。医师会从针、药、生活方向三个选项里说明哪些适合现阶段。它不诊断、也不处理生育方面的疾病。

备孕期间可以针灸吗？ 可以谈。医师会先问是否可能已怀孕，再决定这个阶段适不适合、用哪些穴位——中医理论中有孕期慎用的穴位，所以月经一延迟就要告诉医师。它是做法的选项之一，不是结果的承诺。

这篇出现的几个词

• 不孕（infertility）——世界卫生组织的定义：男性或女性生殖系统的一种疾病，指规律、无避孕的性生活 12 个月或以上仍未怀孕。它由妇产科或生殖医学专科医生评估与处理。
• 骨盆腔发炎（pelvic inflammatory disease, PID）——NHS 的说明：一种影响子宫、输卵管与卵巢的感染，通常由性传播感染造成，也可能由阴道里常见的细菌造成。
• 子宫颈癌（cervical cancer）——NHS 的说明：长在子宫颈的癌症；子宫颈是阴道与子宫之间的开口。NHS 把对您来说不寻常的阴道出血列在它的症状里。

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。

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 4 篇：对双方都适用的建议，以及看诊会提出哪些选项
• 第 5 篇：中医理论怎么看这个阶段——天癸与冲任

👉 如果您不确定「我这个情况要先看医生，还是可以先看中医」，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；若有本文第一节列出的情况，请先就医。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

• 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
• NHS（英国），Infertility，页面最后审阅 2023 年 8 月 9 日 — https://www.nhs.uk/conditions/infertility/
• NHS（英国），Missed or late periods，页面最后审阅 2026 年 6 月 12 日 — https://www.nhs.uk/conditions/stopped-or-missed-periods/
• NHS（英国），Cervical cancer — Symptoms 与 What is cervical cancer?，页面最后审阅 2024 年 9 月 4 日 — https://www.nhs.uk/conditions/cervical-cancer/symptoms/ · https://www.nhs.uk/conditions/cervical-cancer/what-is-cervical-cancer/
• 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/
• 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