Treating Endometriosis with the help of TCM

Link copied! Endometriosis is a condition where tissue similar to the lining of the uterine wall (endometrium) grows outside of the uterus, typically in the abdomen and pelvic area.[1] This tissue, similar to the uterine lining, thickens and breaks down with each menstrual cycle. However, because it grows outside of the uterus, it cannot exit the body through the usual pathways, leading to irritation, inflammation, and bleeding in the pelvic region. Over time, this can result in severe menstrual cramps, pelvic pain, and, in some cases, infertility.[2] Other common and life-impacting symptoms include abnormal or heavy bleeding, pain during intercourse, bowel movements, and urination, as well as abdominal bloating and fatigue. Endometriosis affects up to 10% of reproductive women between the ages of 15 and 44.[3] Up till now, there is no known cure for endometriosis but the current treatments are usually targeted at symptom relief [3]. Conventional treatments of endometriosis are prescribed based on a few factors – the severity of the condition and symptoms experienced, the patient’s age and plans for future pregnancies. This includes medications for pain relief like over-the-counter painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) or hormone therapies. In some severe cases, the doctor might recommend surgery [4]. These treatments might help relieve symptoms for a period of time, but often the effect is not long-lasting. Long-term usage of drugs might also cause harmful side effects like increased risk of peptic ulcer, acute renal failure, etc [5]. Additionally, hormone therapies which aim to relieve symptoms by stopping menstruation are not suitable for people who are actively planning to conceive during the treatment period. Hence, many women who suffer from endometriosis or painful menstrual cramps are exploring alternative treatments like TCM for a more holistic approach. TCM views menstrual cramps, including endometriosis, primarily as a result of Blood stasis (血瘀). This stagnated blood obstructs the flow in and out of the womb and affects the growth and shedding of the endometrial lining due to poor circulation of essential nutrients that are transported by the blood. Blood stasis often results from poor circulation of Qi and Blood, which can have several underlying causes. These include coldness in the womb (宮寒) due to over-consumption of cold drinks and cooling foods, deficiency of Yang in the Kidney (腎陽虛弱) often associated with family history or genetic predisposition, and stagnation of Liver Qi, frequently triggered by high stress or emotional factors. Therefore, TCM’s approach to endometriosis is centred on addressing the different root causes that contribute to Blood stasis, ultimately restoring the smooth circulation of Qi and Blood in the body Treating endometriosis with traditional TCM Several TCM treatment options are available to manage symptoms of endometriosis and potentially curb its progression. In our clinic, physicians prescribe traditional treatments like herbal medications, acupuncture, cupping, or moxibustion based on the patient’s body constitution and their comfort level with these approaches. At Oriental Remedies Clinic, our physicians are also well-versed in utilising tech-enhanced therapies available in the clinic, which can boost recovery, complementing traditional treatments. Therefore, depending on the patient’s suitability, our physicians may recommend Electro-Lymphatic Drainage Therapy (ELT), Cell Pro Therapy (CPT), or Far-Infrared Therapy (FIR) for those with endometriosis. Regardless of the chosen treatment method, the primary objective remains consistent: promoting blood circulation and alleviating Blood stasis. Given that endometriosis inherently leads to increased inflammation and pain, the treatment approach also targets the reduction of inflammation and the invigoration of Qi to reduce pain. i. Herbal medications[6] The unique approach of TCM herbal medications in managing endometriosis is evident in the tailored treatment at different stages of the menstrual cycle (分期治療). This approach primarily focuses on the pre- and post-menstrual stages. Pre-menstruation medication begins approximately 5-7 days before the onset of the period and can also continue during the period if menstrual cramps persist. This medication aims to regulate menstrual flow and relieve cramps by addressing specific imbalances in the body to help eliminate blood clots. Cold womb / Yang deficiency in Kidney(accompanied by coldness in extremities and lower belly, severe menstrual cramps and lower back pain)陽虛寒凝 溫經湯 Wen Jing Tang concoction Warms the womb, dissipates coldness and eliminates Blood stasis 吳茱萸 Wu Zhu Yu (Evodia fruit) Relaxes uterine muscles and relieves pain[7] 肉桂 Rou Gui (Cinnamon) Excellent warming properties for the Kidney and Liver, invigorates Qi and relieves pain 小茴香 Xiao Hui Xiang (Dried fennel) 烏藥 Wu Yao (Lindera root)   Liver Qi stagnation(accompanied by severe menstrual cramps with noticeable amount of period clots)氣滯血瘀 少腹逐瘀汤 Shao Fu Zhu Yu Tang concoction Invigorates Qi and promotes blood circulation, eliminates Blood stasis 延胡索 Yan Hu Suo (Corydalis Rhizome) Relieve Qi stagnation in Liver, invigorates Blood and relieves pain 川芎 Chuan Xiong (Szechuan Lovage Root) 蒲黃 Pu Huang (Typha Pollen)[8] Reduce clotting and menstrual bleeding, alleviates cramps 五靈脂 Wu Ling Zhi (Squirrel’s Droppings) In addition to tailored herbs and concoctions for different body constitutions, herbs like 红藤 Hong Teng (Sargentodoxa Stem) and 川牛膝 Chuan Niu Xi (Cyathula Root) are also commonly incorporated in herbal medication to direct medicinal action to lower part of the body and eliminating blood clots. Post-menstruation concoctions are typically consumed over an extended period, from 1 week after the period to 1 week before the next one. Taking these herbs post-period ensures their strong action would not conflict with the heavy bleeding during menstruation and enables better clearance of abnormal endometrial growth. Examples of herbs used in post-menstruation herbal medication are 三棱 San Leng (Sparganium Rhizome) and 莪术 E Zhu (Curcuma Rhizome). 桂枝茯苓丸 Gui Zhi Fu Ling Wan concoction also also commonly used throughout the whole treatment of endometriosis due to its blood-promoting and stasis removal properties, as well as its ability to address dampness or inflammation commonly associated with abnormal uterine lining growth. ii. Acupuncture Acupuncture helps to improve blood circulation in the womb area and regulates the Qi that runs through different channels/meridians corresponding to different organs. The main channels are the Spleen, Liver, Kidney and Ren meridian which govern the reproductive and menstruation function. Certain acupuncture