Author: Dr. Maryam Mahanian, DTCM, RAc

In my clinical practice, the number of women coming in with Endometriosis is many and I would say rapidly increasing. These women are often wanting to conceive or wanting to ease their discomfort that painfully occurs every single month.

What is Endometriosis?
Endometriosis is a condition where the tissue that normally lines the uterus (called endometrium) grows outside of the uterus.

It sticks to other various pelvic organs such as the bladder, rectum, colon, and ovaries. Sometimes, but rarely, it can even go to further areas of the body outside of the pelvic region.

The tissue behaves just the same way as the tissue that lines the uterus. It responds to hormones that control the menstrual cycle and the tissue and blood slough off just like the lining of the uterus does. The problem is that this tissue and blood has nowhere to go in the pelvic cavity as the uterine lining normally does…so it accumulates and forms masses and lesions which over time can negatively affect organ function and even fertility. 

When a woman starts her period, this irregular tissue bleeds out into the pelvic cavity and causes pain, inflammation and sometimes scarring.

Endometriosis is most often diagnosed through laparoscopic procedure.

Some Clues that you may have endometriosis…


There are clues to show that you may suffer from endometriosis:

  • pain before and/or during the period – these are usually worse than normal menstrual cramps and are quite debilitating.
  • General pelvic pain
  • Spotting before menstruation
  • PMS
  • Pain during or after intercourse
  • Heavy or irregular menstrual bleeding
  • Infertility
  • Lower back pain with menstruation
  • Digestive complaints like diarrhea or constipation
  • Painful bowel movements with the period

Some women with endometriosis have no symptoms at all.

Something interesting about endometriosis is that the severity of the symptoms doesn’t necessarily reflect the severity of the endometriosis lesions in the pelvic cavity. Some women with severe endometriosis may not have any symptoms at all while women with severe symptoms such as severe debilitating pelvic pain may not have severe endometriosis lesions.

There are also secondary signs & symptoms of Endometriosis.

  • Depression and anxiety
  • Allergies
  • Yeast infections
  • Chronic fatigue and Fibromyalgia

What Causes Endometriosis?
The cause is unknown but there are some theories:

  • There is a genetic component to endometriosis so women whose mother or sisters have it do have a higher chance of having endometriosis. They are actually 6 times more likely to have it.
  • It’s more common in women who have never been pregnant.
  • Autoimmune conditions
  • Hormones – estrogen plays a role in the endometrial tissue
  • Previous abdominal surgeries

Current Therapies for Endometriosis

  • Hormone therapy to prevent the endometriosis from getting worse
  • Pain & anti-inflammatory medications to just ease the symptoms
  • Laparoscopic surgery to clean up the pelvic cavity of cysts, scar tissue and lesions
  • Hysterectomy – this is of course a last resort

Endometriosis can cause Infertility..but how?
There are a number of reasons why infertility can cause endometriosis. Here are some of them…

  • Irregular tissue formation can cause irregularities in the fallopian tubes like distorting the shape & position of the tubes
  • The egg can’t get through the fallopian tube because of the mucus that has been produced by the tissue which fills the fallopian tubes.
  • Endometrial cysts can develop in the ovaries (also called chocolate cysts) and damage the ovaries where eggs develop
  • The inflammation can cause an increase in the white blood cells which can then attack the sperm or embryos
  • Endometriosis is often associated with low progesterone which can cause difficulty for the embroyo to implant in the uterus

Can Chinese Medicine Help?
Chinese medicine can prevent endometriosis from getting worse

Chinese medicine helps to ease the uncomfortable symptoms of endometriosis like pelvic pain

Chinese medicine can increase one’s fertility and chances of getting pregnant while having endometriosis

Chinese medicine unfortunately can’t cure or rid someone entirely of endometriosis. Laparoscopic surgery is the best treatment to get rid of endometriosis and Chinese medicine can help to support a woman going through that procedure. Chinese medicine helps the recovery process from laparoscopic surgery and helps prevent the endometriosis from returning.

Chinese medicine can be extraordinary in the treatment of Endometriosis!

Chinese Medicine Perspective & Patterns of Endometriosis
Chinese medicine views Endometriosis as a condition where there is blockage and lack of free flow. There is a saying in Chinese medicine that says “when there is pain, there is no free flow”. There are a number of patterns or categories in which we place women suffering from Endometriosis, of which these are the three most common:

1. Qi and blood stagnation

Some of the symptoms that go along with this pattern are severe menstrual pain, emotional stress, clots with the menstrual blood.

2. Yang deficiency with blood stagnation

Some of the symptoms that go along with this pattern are a cold body temperature especially cold feet, menstrual pain is severe but better with warmth, low sex drive. The menstrual pain often extends to the lower back and inner thighs.

3. Qi sinking with blood stagnation

Profuse menstrual bleeding (often referred to as gushing), fatigue, menstrual blood can be pale but clots are dark and digestive complaints like loose stools and bloating.

If you notice, all the patterns above include Blood stagnation. Blood stagnation means that the small vessels don’t carry the blood properly. Blood stasis is defined as slowing or pooling of the blood as a result of blocked energy (qi) flow. In the case of endometriosis, blood is where it shouldn’t be and unable to escape from the body.

A woman can commonly have more than one of the above patterns. In my clinical practice, I spend a lot of time chatting with you on your first visit to be able to determine your underlying pattern. Diagnosing the correct pattern(s) is vital to the success of the treatment outcome and this customized treatment is what makes Traditional Chinese medicine so effective. 

Research on effectiveness of Chinese medicine for Endometriosis
According to current research, acupuncture promotes healthy blood circulation and regulates hormones. It also has an anti-inflammatory effect and is effective for pain relief because of it’s effect on blood chemistry and in particular endorphin levels.

In December 2002, The Journal of Traditional Chinese Medicine published a study of 67 women diagnosed who were suffering from menstrual pain due to endometriosis. Half of this group received acupuncture whilst the other half did not have treatment. In the acupuncture group 81% of the women had less painful periods after receiving the acupuncture treatments. Wow!!!

Some things to consider…

  • Get regular acupuncture treatments to improve blood flow, reduce inflammation and decrease pain.Try to find an acupuncturist that is specialized in women’s health issues.

  • Take Chinese herbs prescribed by a qualified board certified herbalist. Herbal medicine has been shown in clinical trials to reduce the pain associated with endometriosis and also prevent further proliferation of the tissue. The beauty of Chinese herbs (prescribed by a qualified tcm practitioner like myself) is that they are customized to the individual – they’re excellent to ease the symptoms of endometriosis and to also improve fertility if you’re trying to conceive.

  • A warm castor oil pack on the lower abdomen brings relief for many of my patients.

  • Regular exercise is great to promote blood flow. Try to move your body at least 30 minutes a day (walking, hiking, yoga etc)  

  • Limit alcohol and caffeine consumption to help support the liver. The liver is in charge of metabolizing estrogen so it’s essential for the liver to be functioning at its best to avoid estrogen dominance. Estrogen dominance is one of the reasons for endometriosis.

  • Have healthy fats like avocado, salmon, olives, nuts & seeds, coconut oil, olive oil and other fatty fish   
  • Avoid cold raw frozen foods and have more warm nourishing cooked foods (soups, stews, bone broth, steamed veggies)    
  • Avoid some of the common inflammatory foods like dairy products, sugar and gluten   
  • Limit coffee to no more than one cup a day    
  • Make sure your red meat is hormone-free    
  • Avoid saturated and hydrogenated fats    
  • Avoid having too much soy and soy-products   

  • Avoid sex & avoid wearing tampons during your period (it is important to let the menstrual blood out)    
  • Keep your feet, lower abdomen & lower back warm – especially during your period – to avoid cold constricting the blood flow in the uterus

If you’re struggling with your monthly periods because of endometriosis or are planning to try to conceive in the future, consider Chinese medicine. It shines in the area of women’s health and has been helping women with gynecological conditions for thousands of years…successfully!

Feel free to reach out to me if you have any questions!

With Love and Support,
Dr. Maryam

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