Chinese Herbal Medicine for Endometriosis

Misha Cohen, LAc

Endometriosis Defined

Endometriosis is a widely prevalent gynecological disease defined by the presence and growth of uterine glands and stroma outside the uterine cavity. While the cause of endometriosis is not well understood, the most widely accepted view of the etiology of endometriosis from a Western perspective is the theory of “retrograde menstruation”, described by JA Sampson in the 1920’s. Endometriosis affects about 10% of all reproductive-aged women and the prevalence rises to 20-50% in infertile women.

Endometriosis is a progressive disease that is often is often associated with infertility. It is estimated that the incidence of endometriosis is 30%-45% in women with infertility. The precise cause-effect relationship between endometriosis and infertility is controversial.

Both medical and surgical therapies have been offered for alleviation of symptoms associated with endometriosis and the treatment of infertility. Western treatment of endometriosis-associated pain has been well studied and all major medical therapies appear to be superior to placebo. However, in the treatment of infertility, medical therapy has not been shown to be of any benefit, in contrast to surgical treatment that may improve infertility outcomes in all stages of disease.

Non-steroidal anti-inflammatory drugs (NSAIDs), and various hormonal therapies are prescribed to alleviate pain associated with endometriosis. There are many side effects of the varying drug therapies from androgenic effects, endometrial atrophy, nausea, weight gain, hot flashes, vaginal dryness and more.

Surgery via laparotomy or laparoscopy is a common form of therapy used in endometriosis treatment to remove endometrial implants and adhesions as well as reduce pelvic pain and future adhesion formation. Surgery has its own after effects such as post-operative pain and scarring.

In this context, additional agents with higher efficacy and lower side effects are desirable. There is growing evidence that medicinal Chinese herbs with anti-inflammatory and pain-alleviating properties may be utilized in the treatment of endometriosis and infertility.

History of documented Use of Chinese Herbs

Records describing Chinese herbal treatment of infertility and miscarriage date back to 200 C.E. The first book devoted to obstetrics and gynecology, entitled “The Complete Book of Effective Prescriptions for Diseases of Women”, was published in 1237 C.E. Since then, Chinese herbs have been used by many generations in China and throughout the world.

Several herbal products are available on the market for treating endometriosis and infertility. Traditionally, Chinese herbalists prescribe combinations of herbal formulas with multiple ingredients. The idea is that each individual herb will work synergistically to treat the disease process. The design of the formula varies, but when treating endometriosis and infertility, certain ingredients overlap. Herbs may be consumed in a variety of forms including pills, tablets, granules, or decoctions (teas). While some formulas are taken once, others are taken regularly at various times and in particular combinations. Chinese herbs should be prescribed by a licensed health professional trained in Chinese herbal medicine who determines which formulas and regimens are best for a particular set of symptoms.

The practice of Chinese traditional medicine has been evolved for thousands of years as practitioners have optimized and updated therapy based on the raw and processed ingredients of plants and their derivatives. Historically, Chinese medicine has relied heavily on herbal treatment of many gynecological illnesses.

Endometriosis Theory in Chinese medicine

Within Chinese medicine, endometriosis is primarily viewed as a Blood (Xue) Stasis resulting in the formation of internal lumps. The condition of blood stasis is associated with a phenomenon where small vessels are not capable of carrying normal blood flow, thus causing clotting, bleeding, resulting severe lower abdominal pain, and infertility. There are multiple causes of Blood Stasis, particularly syndromes of (1) Qi Stagnation (2) Accumulation of Cold causing Blood Stasis, (3) Heat Congestion with Blood Stasis and (4) Qi and Blood Vacuity with Blood Stasis.

Infertility Theory in Chinese medicine

There are seven physically-based types of infertility in women according to several theories in Chinese medicine. These include Jing Deficiency, Qi and Xue Deficiency, Heat Injuring the Channels, Stagnation of Qi and Xue, Kidney and Liver Yin Deficiency, Cold Uterus/Yang Deficiency, and Extraordinary Channel Disturbances.

AAAOM Conference Workshop

Dr. Misha Cohen will be speaking at the AAAOM Conference on Sunday morning on “Chinese Herbal Medicine for Endometriosis”. Come learn more about the current research and the combined use of Western and Eastern medicine in treating this widely prevalent and chronic disease in women.