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Endometriosis

endometriosis-plaster-2.pngTraditional Chinese medicine (TCM) has been used to manage associated symptoms of gynecological disorders for the last 3,000 to 4,000 years. Endometriosis has not been clearly diagnosed specific disease until recent times, but Chinese Medicine has long been used to treat many types of dysmenorrhea such as pelvic pain, irregular menstruation, pain during intercourse, intestinal irregularity, low back pain, infertility, spotting before periods, absent periods, and other endometriosis-related symptoms and conditions.

Endometriosis is a condition of the cells of the endometrium that line the wall of the uterus travel outside of the uterus and implant themselves in areas where they should not be located. This can cause a host of symptoms, but is difficult to diagnose because it does not always present with pain. Many women only find out that they have endometriosis when they are trying to assess why they are unable to conceive. Endometrial tissue rarely structurally blocks the physical structures related to pregnancy, rather endometriosis is a systemic cause of infertility.

There can be multiple underlying causes of one disease in Chinese medicine; one or more root causes can be involved as the imbalances tend to be interrelated; herbal formulas can be combined as needed. The length of herbal therapy depends on the severity of endometriosis, but developing endometriosis implicates a long-standing imbalance that will take many months to address.

Blood and Qi Stasis in the Lower Jiao and Endometriosis
Abdominal masses often indicate Blood and Qi Stagnation. The likely path of imbalance with endometriosis often begins with Qi Stagnation due to Liver Qi Stagnation explained below. In Chinese medicine, where Qi goes, Blood goes, and eventually Blood Stagnation would develop due to the Qi Stagnation. It important to facilitate the full shedding of the endometrium so that fresh new endometrial lining can develop.

Causes of Blood Stasis may include trauma due to surgery, improper sexual activity such as having sex during menstruation, prior use of IUD, and heavy blood loss during childbirth. Fixed stabbing pain would likely develop with Blood Stagnation and pain relief after passing blood clots can occur. A woman may also have bearing-down pain before her period with Blood Stagnation.

Liver Qi Stagnation Leading to Endometriosis

In Chinese medicine, the Liver organ system is closely related to Uterine Blood and the menstrual cycle and governs over the movement of menstrual Blood. The Liver energetic organ system in Chinese medicine influences the movement of all Qi throughout the body, and thus any stagnation of Qi and Blood can have an element of Liver Qi Stagnation, but especially in gynecological imbalances. Soothing the Liver with Chinese herbs is a rather straight forward therapy, but utilizing guided Qi Gong meditations to release suppressed anger and resentment can also be especially beneficial. Liver Qi Stagnation would be especially indicated in a person easily angered or frustrated, abdominal pain that comes and goes, and pain along the lower ribs. 

Kidney Yang Deficiency Leading to Menstrual Irregularities and Gynecological Disorders
True Cold in the body may be due to Kidney Yang Deficiency and is often indicated with cramping pain. This is a typical pattern of imbalance with Endometriosis. With Yang Deficiency there would be an aversion to cold conditions, coldness in the body and limbs, cold achy back during period, pain relieved by the application of heat, dark clots, bearing-down pain after menstrual cycle, and a desire for warm drinks. Kidney Yang tonic formulas contain warming herbs.

Related article: Yin-Yang Theory

Blood Deficiency and Endometriosis

Nourishing Blood is central in building the endometrial lining, aid the ripening of follicles, and increase receptivity of the womb. Blood is a Yin Substance in the body, and building Yin can assist with building Blood in some cases depending on the herbs used. Blood Deficiency can lead to Blood Stagnation; think of how difficult it is to move water swiftly through a dry river bed; if you do not have sufficient of Blood, it is hard to move Blood. Additionally, according to Chinese medicine, if Blood is not moving the body does not make more Blood. Always build Blood before moving Blood aggressively to avoid side effects. Kidney Yang deficiency and Spleen Qi Deficiency can also give rise to Blood Deficiency according to TCM theory.

Spleen Qi Deficiency, Internal Dampness and Endometriosis

When the Spleen energetic organ system (TCM) is not functioning optimally, Internal Dampness will accumulate. This type of pathogenic Dampness blocks the free flow of Qi, Blood, and functional fluids of the body. Non-pigmented lesions are more common with Spleen Qi Deficient-type endometriosis, but this pattern is one of the most common underlying culprits of endometriosis according to Chinese medicine. Kidney Yang Deficiency can give rise to Dampness by the fact that the Kidneys are the root of all Yang of the body and must support Spleen Yang.

Endometriosis and Damp Heat-Spleen Qi Deficiency

Prolonged Internal Dampness will cause stagnation; these stagnant fluids tend to heat up. As they do, they become more viscous and sticky. This thick mucus can affect fallopian tube patency preventing the smooth passage of the egg. Extreme examples of this would be completely blocked fallopian tubes, but simply hindering and slowing the movement of the egg can interfere with fertility.

Endometriosis and Toxic Heat

Toxic heat would be indicated with inflammation in the body where an overzealous immune response produces tissue damage. Toxic Heat can then cause Blood Stasis and pain.

Endometriosis and Wei Qi Imbalances

There is a high incidence of autoimmune disorders among women who develop endometriosis leading many to speculate that an under active immune response allows the foreign endometrial cells to locate outside of the uterine walls. The trick is to moderate and normalize the immune response; luckily, this is exactly what Chinese medicine does well.

Stress and Endometriosis

Endometriosis is often called "the modern working woman's disease" because there are so many demands on women today that cause stress. Women with endometriosis tend to have higher cortisol levels due to prolonged chronic stress prompting the adrenal glands to secrete cortisol. 

Hormonal Imbalances and Endometriosis

High estrogen and low progesterone is common with Endometriosis. Estrogen dominance with low progesterone prevents the body from holding the pregnancy and makes the lining of the uterus less receptive to implantation in the first place. Endometriosis is estrogen dependent; therefore, menopause ends the syndrome. Some western medical treatments include medicines that will starve the endometriosis of estrogen, or produce a menopausal condition.

In Chinese medicine there is no "endocrine system"; never-the-less, TCM is very effective at addressing all types of gynecological disorders. This is accomplished by bringing the energetic organ systems in to balance as described above; the most import being the Liver and Kidney energetic systems.

Risk Factors with Endometriosis

  • Prior use of an IUD
  • Chronic stress
  • History of sexual abuse

Endometrial tissue can end up anywhere in the body, so the possible symptoms and complications are endless.

Lifestyle Practices and Endometriosis

It is very important to manage your life well when addressing endometriosis. Anti-inflammatory food choices are critical and sugar and alcohol consumption is simply throwing gas on the fire for endometriosis patients.

References