excerpt from “Acupuncture and Chinese Herbal Medicine for Women’s Health: Bridging the Gap Between Western and Eastern Medicine”

Endometriosis, the formation of tissue outside of the endometrium
(uterine wall), can create painful menstrual periods, premenstrual spotting,
pain during intercourse, infertility, abdominal or diff use pelvic pain, bloating,
constipation or diarrhea. Symptoms may also include low back pain or pain
radiating to the inner thigh, pain upon defecation, fatigue or sometimes nausea
or vomiting. The severity of the pain may not truly disclose the severity of
the disease, as some women may present without pain.
Western View
Western medications and treatments include:
• Birth control used continuously to suppress ovulation.
• Danazol, Provera, Lupron, Duphaston, Synarel or Zoladex, used to
suppress ovulation and the regular course of hormones during the
menstrual cycle.
• A laparoscopy conducted to drain fluids and remove small patches
of tissue. The cysts or tissues are sometimes referred to as “chocolate
cysts” due to their coloring.

• More extensive surgery to remove larger areas of displaced or scar tissue
or to unblock fallopian tubes. Surgery is not the final answer because
tissue can and oft en does, grow back, causing recurrent symptoms.

TCM Pathology
Difficult menstrual flow accompanied by pain and clotting of tissue or
by pain that disrupts other channels (Liver, Spleen and Stomach) causes abdominal or back pain, bloating or indigestion, fatigue, or headaches. Kidney
Yang deficiency is usually the primary cause, often accompanied by Spleen Qi
deficiency or Liver Qi stagnation. This leads to Blood stagnation.
In today’s busy world, each of us carries an enormous amount of stress.
Stress among professional and working women is frequently chronic and
overwork disrupts the even flow of Qi and Blood. The obstruction of Blood
flow restricts the normal cycle. Environmental toxins and poor nutrition also
contribute, as do traumas and abdominal surgeries.
If menstrual spotting occurs, it is due to the Blood unsuccessfully trying to
flow evenly within the channels. Symbolically, it is being pushed out of the channels because it has overfilled the Uterus without any available open exit valve.
Regulation of Qi and Blood during the four phases of the menstrual cycle
is required. Therefore, regulation of hormones is part of TCM treatment, as
contrasted to the suppression of the normal function of hormones.
What to expect from TCM treatment?
The goal is to correct the root problem during each of these phases by
fine-tuning the TCM protocol.

TCM Pattern Differentiations
Qi Deficiency:
• Feeling exhausted and fragile.
• Dull, aching pain before, during or after menstruation.
• Overworked, overwhelmed.
• Cold hands and feet.
• Insomnia.
• Poor appetite.
• Tongue body may have scalloped, teeth-marked edges.
• Tongue may have no coating.

Qi stagnation:

• High-level or continuous stress.
• Tension or migraine headaches.
• High blood pressure, irritability, anger or repressed emotions.
• The sides of the tongue may be redder than the body of the tongue.
• Sharp, stabbing pain or pain prior to or during menstruation.

Blood stagnation:
• Pain prior to or during menstruation.
• Sharp, stabbing pain.
• Palpable lower abdominal masses.
• Clots.
• Purple- colored tongue body.

Coldness (Can be deficiency or excess):

Many texts use the term “Cold uterus.” Cold is typically inhibiting, confining,
cramping and stagnating. The Kidney channel starts on the feet and runs
through the Uterus therefore, TCM theory believes that coldness in the feet
runs up the Kidney channel through the uterus, inhibiting or confining Qi
and blood flow. This affects fertility and the proper functioning of the reproductive
system. Traditional advice: “Wear socks and keep your feet warm!”
• Generally, one who runs/feels cold and feels better with heat.
• Frequent urination.
• Cramping, severe pain prior to or during menstruation.
• Tongue coating may be white.
• Heat in the channels can cause the Blood to “boil over,” producing a
heavy, painful menstrual flow.
• One who runs warm, sweats easily or has a facial flush.
• Yellow tongue coating.

Dampness, characterized as slow moving and congealing, causes sluggishness
or lethargy, producing mucus and leading to stagnation.
• Tongue coating may be white and appear slimy, greasy or thick.
Abundance of phlegm or mucus.
• Thirst but no desire to drink fluids.
• Feeling “heavy” or having heavy sensations or lethargy.

Healthy Living Pointers for Better Health

Nutrition and Dietary Guidelines:
Aphrodite Women's Health (2004) reported the incidence of endometriosis
is 40% less among females who consumed more fresh fruit and
green vegetables. Females with a high intake of beef, ham or other red
meat, increased their risk of endometriosis by 80–100%. There is a connection
between diet and endometriosis!
1. Eat a high-fiber diet consisting of whole grains (wheat, oats, rye,
spelt, quinoa) and legumes.
2. Vegetables high in antioxidants (Vitamins A, C, and E) and bioflavonoids – like carrots and yams, spinach, kale, broccoli, cauliflower, sweet potatoes, green and red peppers are beneficial.
•3.Vitamin C and green foods (wheat grass, chlorella, spirulina) clean,
nourish, move the blood, create circulation and remove stagnation.
4. Eat foods high in Vitamin B, selenium and zinc.
5. Eliminate caffeine, alcohol, salt and animal fats.

Pattern Differentiations:
If the menstrual pain is derived from Stagnant Blood, it can be ameliorated
1. Foods that move and clean the Blood, like wholesome organic
fruits and vegetables.
2. Eating foods high in antioxidants and bioflavonoids (tomatoes,
lemons, limes, apricots, grapes, beets, celery, strawberries, blueberries,
3. Adding kelp, seaweed, spirulina and chlorella.
4. Adding onions, garlic, scallions to move and warm the Blood.
5. Eating whole grains like brown rice, quinoa and 100% whole wheat.
6. Consuming linoleic and alpha-linoleic fatty acids found in pumpkin
seeds, flaxseed, primrose (gamma linolenic acid-omega 6) and olive
7. Taking omega 3 fatty acids found in fish or linseed oil.
8. Avoiding refined and hydrogenated oils.
9. Avoiding animal products treated with steroids or antibiotics.

For Cold conditions, eat foods with properties that are neutral or
warm in nature (beans, leeks, onions, carrots, garlic, ginger, wheat
bran, millet, venison, beef, turkey, chicken, mangos, papaya, pineapple,
figs, sweet potatoes, yams, red and green cabbage).

Liver Qi stagnation:
If you suffer from high stress, anger, tension or irritability try to:
1. Chew your food slowly, sit down and enjoy each meal without
2. Eat smaller, more frequent meals.
3. Exercise.
4. Eat wholesome organic and nutritious foods rather than processed
and refined foods containing chemicals and preservatives.
5. Yoga!
6. Let go of issues you have no control over and live the moment.
7. Avoid alcohol, cigarettes or caffeine.
8. Heat conditions react negatively to alcohol, caffeine and spicy or
greasy foods.
9. Heat conditions respond favorably to foods with cool properties,
which include ocean fish, shrimp, crab, milk, yogurt, strawberries,
pears, persimmons, tomatoes, pearl barley, brown rice, wheat, tofu,
mung, black or kidney beans, mint, green, or chamomile tea, cilantro,
American ginseng, sprouts, kale, broccoli, alfalfa, cauliflower,
watercress, winter squash, eggplant, asparagus, beets, bok choy or
10. Damp conditions worsen with sugars, juices and over-consumption
of fruits.
11. Eliminate dairy products, alcohol, spicy, or greasy foods. Eat more
alkaline grains such as barley or brown rice, spinach, watercress,
brussel sprouts, turnips, avocado, zucchini or green beans.

~In Her Own Words~ My Patient Stories

“I responded “so-so” to my 3 IVF cycles. I became pregnant twice
but miscarried both times. I am sensitive to medications, but the
doctors didn’t seem to hear me! With endometriosis, my cycles were
regular every 28 days with 2-3 days of heavy flow and 1-2 days
of light flow. I had severe cramps, moodiness and disturbed sleep.
Also diagnosed with irritable bowel syndrome, I was extremely
anxious! I was overweight and fatigue was my middle name! It
wasn’t until I tried acupuncture and herbal medicine that the IBS
resolved and my energy returned. I slept better and had the courage
and strength to start exercising. I stopped my fertility treatments
for 3 months so I could pull myself together. I relaxed more and
focused on eating the right nutritional choices for my TCM pattern.
I returned to the fertility clinic for one last try.
At 42 years old, I delivered a healthy baby girl.
I believe TCM gave me the grounding I
needed and fixed the root of my imbalances.
I never felt as calm and peaceful as when I was having treatment. I try to carry that goodness with me today. What
would have happened if I had started
sooner?” Ellen

Research Supports its Effectiveness! Read on!
• Endometriosis — CHM better?
Andrew Flower, PhD, conducted a randomized controlled study with
CHM following laparoscopic surgery in endometriosis patients. The
CHM patients achieved better symptom control compared to the conventional
medication, Danazol and were comparable to gestrinone. Patients
taking CHM reported fewer side effects. The pregnancy rate was similar
with either treatment (Wiley-Blackwell, 2009).

• Effective Treatment of 48 cases of endometriosis
The duration of their disease had lasted from as short as six months to as long as 18 years. The total amelioration rate was 89.5% (B. Flaws, Trans. 1997).

• Effective Treatment of 38 cases of endometriosis

Thirty eight women were treated with a protocol
that utilized herbs that resolved abdominal pain. Twenty-six were cured,
which meant that their symptoms disappeared and that their ultrasound
exam was normal. Another five cases experienced some improvement and
seven cases had no results. Treatment lasted from as short as one course
to as long as six courses of herbal treatments. The cure rate was 68.4% and
the total amelioration rate for this group was 81.6%.(B. Flaws, Trans. 1997).

• The treatment of 40 cases of endometriosis by He Shu-ying

Ages ranged in this study from 24-48 years old. The course of disease
ranged from one year to as long as 18 years. Among the 40
women included in the study, 25 were infertile. Thirty-one had had previous
surgery for ectopic pregnancies, artificial abortions and other such
surgical procedures. Thirty-seven cases experienced occasionally intense
abdominal and menstrual pain. Twelve had pain with intercourse. Twenty eight
had pelvic pain. Eighteen had a heavy, tugging, distended, anal tension.
33 women experienced marked improvement and seven conceived afterwards.
Four cases experienced some improvement and three cases had no
results. Thus, the combined amelioration rate was 92.5% (B. Flaws, Trans.
• Women ranged in age from 21-53 years old, with the average age of
36.9 years. Thirty-four cases had painful menstruation and menstrual irregularity.
Seven women were infertile. Twenty-seven of the women had
so-called chocolate ovarian cysts. Gynecological examination found
painful nodulations in 20 cases and one third of the women had
retroverted uteri. Two different formulas were administered.
Complete cure consisted of disappearances of the symptoms and the
infertile patients becoming pregnant. Marked improvement consisted of
disappearance of the symptoms with the cysts or nodules reduced in size
by half or more. Also, those who were infertile conceived. Some improvement
meant that the symptoms were stabilized somewhat but the majority
of symptoms were not eliminated. Four cases or 11.4% were cured, 20 (57.15%) were markedly improved
and eight or (22.9%) had some improvement. Thus, the combined amelioration
rate was 91.4%. Since the Kidney system is crucial to menstruation
and reproduction, the herbs chosen in this particular study benefited
the Kidney system among other criteria (B. Flaws, Trans. 1997).

• Clinical study of the treatment of 68 cases of endometriosis by
Chang Nuan & Ma Ping-chong
The women ranged in age from 27 to 43 with a median age of 35.3
years. All were married and the course of their disease had lasted from six
months to 12 years with a median duration of 3.8 years.
The total effectiveness rate for this protocol was 94.1%.
(B. Flaws, Trans. 1997).

• Clinical success in the treatment of 89 cases of
The women ranged in age from 23 to 46. Their disease course had lasted from three months to 11 years. After 1-3 courses of treatment, 31 cases (34.8%) were cured. Thirty-seven
cases (41.6%) had marked effect. Sixteen cases (17.9%) had some
effect. And five cases (5.6%) experienced no effect. Thus 76.4% had
marked effect or better and the total effectiveness rate was 94.4% (B.
Flaws, Trans. 1997).

Clinical studies show Positive Treatment of Endometriosis with herbs:
• A control group of 349 women treated with CHM (Dane mixture)
had a total effective rate of 95% (Cai, Shu, & Xie, 1999).

• In a controlled study of 65 cases of endometriosis and ovarian masses
treated with CHM (fu Liu Pill), 30 cases (29.2%) were cured.
Thirty cases (23.1%) were markedly effective, fifty-two (40%) of the
cases were effective and 10 cases showed no improvement. The total
effective rate was 92.3% (Chu, 1996).
• In a randomized controlled study of 103 subjects with western
medication vs. CHM (Neiyixiao), there were no significant differences in treatment results, meaning the herbs worked as well for endometriosis as the Western treatment (Liu, Li, & Hu, 1998).
• A control group of 53 treated with CHM produced a pregnancy rate
of 45% (Zhu & Cheng, 1993).

Author's Bio: 

Gentle and caring practitioner of acupuncture and Chinese Herbal Medicine for 15 years.
Author of "Acupuncture and Chinese Herbal Medicine for Women's Health: Bridging the Gap Between Western and Eastern Medicine"
Herbal Consultations by phone or SKYPE
PhD Holistic Nutrition