Whilst Chinese medicine has no specific disease categorisation of endometriosis per se, it does recognise  many of the signs and symptoms associated with the disease. More than this, we look at the mechanism behind the symptoms ( from a TCM perspective). We talk about treating your Yin, Blood, Qi and Yang.

As TCM practitioners, through our long held theories on physiology and pathology, we are able to explain why each of these signs and symptoms arise in a particular woman at a particular time.

“In Chinese medicine we see you as more than just a biological being. We take into account your past and current emotional state, your past and present living environment and your past and present relationships”

This concept stems from the four pillars of diagnostic methods for us: “Observation”, “Palpation”, “Listening” and “Smelling”.

How we see Endometriosis in TCM:
Before we look at the disease as seen from the view point of TCM, its useful to have a very quick look at some of the methods we use to help come to a diagnosis.

To help make a diagnosis in Chinese Medicine, we use what we know as the ‘four diagnostic methods’.   They are –

• Observation – looking and observing the patient – size, colour, walk, posture etc)
• Listening and Smelling – listening  to their speech, listening for rattles and rails etc within their lungs, smelling their breath)
• Palpation – including abdominal palpation and by taking the pulse felt at the radial position of each wrist, and finally,
• Questioning – asking questions which allow us to ‘code’ symptoms and attribute them to disharmony in one of the organ systems, such as the liver, spleen, heart etc.

To make a diagnosis in Chinese Medicine, we most often will start with a disease classification, such as ‘Headache’ for example. From here we want to find out what type of headache it is – this is where we differentiate your headache between say a full and hot headache (with a red face and throbbing distending pain), or an empty cold headache (which is mild, constant and better for rest).

This is called pattern differentiation.

In the case of endometriosis, the disease itself has no classification  (such as Headache or Nausea), so mostly we will begin with a classification such as Painful Periods – given painful periods is the most common presenting symptom. From here, we are able to use the four diagnostic methods in order to differentiate the type of pain you are experiencing, and the source of the internal imbalance that is creating the pain.

The most common cause of the type of pain involved when there is endometriosis present is sharp pain – represented as a ‘blood stagnation’ type of pain in TCM.  Recent research that we can have a positive affect on pain reduction (2,3).

So what is blood stagnation and why has your blood become stuck?!  In order to understand this, lets quickly talk about the relationship between your energy, Qi,  and your blood.

Qi is seen as a lighter, mobile type of energy and is closely associated with your Yang energy. The free flow of Qi throughout your body and organs is mostly under the direction of the Liver. It is the Livers role to deal with frustration, anger, resentment and emotional stress and to allow these emotions to be dealt with in such a way that doesn’t tie up your Qi. Easier said than done huh! We all to some degree have an element of stuck Qi – living in a western world with all of its demands on us sees our Liver Qi put to the test every day.

One of the most important tenets of Chinese medicine is that Qi leads the blood. If Qi becomes a little stuck, blood becomes a little stuck. Qi stagnation leads to blood stagnation. Blood stagnation equals sharp pain.

This is not to say that every case of endometriosis is caused by emotional stress ( although there is often a component of this due to the pain that it brings ), but it is an aspect that we as TCM practitioners, take note of  and strive to resolve through acupuncture and Chinese herbs. There are other aspects of your energy that can also cause the qi and blood to stagnate.

“Blood deficiency can also contribute to endometriosis in Chinese Medicine – a factor that we treat routinely with acupuncture and Chinese Medicine “

Blood deficiency is a common cause;  how can I be deficient in blood? Does this mean that I am anaemic? Well sometimes, yes. But not always. The Chinese construct of blood-levels is quite different to that of Western medicine.  We see blood as part of your Yin energy – cooling, nourishing, supporting and calming. It relies heavily on the spleen, heart and kidneys for its manufacture. A deficiency in any one of these organs can lead to a relative state of blood deficiency. When there is not enough blood to flow, blood stagnation can sometimes result. It’s a bit like seeing a river that was once flowing full of water which now only flows along parts of the river bed, with puddles of water cut off from the main flow of water.  This is another fairly common cause of endometriosis from a TCM point of view.  Common blood deficiency signs and symptoms are things like – floaters in the vision, brittle nails, postural dizziness, pale lack lustre skin, dry or lifeless hair, scanty menstrual blood, heart palpitations and anxiety. Any of these symptoms is a clue to me that we need to start asking questions as to why your blood levels are low enough to cause symptoms.