Endometriosis is a condition suffered by women, in which endometrial tissue develops outside the endometrium or uterine wall. This can lead to symptoms such as diarrhea or constipation, bloating, diffuse pelvic or stomach pain, infertility, pain during intercourse, premenstrual spotting, and painful menstruation as well as, although at times, vomiting, nausea, fatigue, pain when defecating, pain traveling to the inner thigh or low back pain. The degree of the pain may not reflect the seriousness of the condition, as the disease may also manifest without pain.

Western View

Western therapies and medications include:

-Laparoscopy to extract small tissue patches. Affected tissues or patches are called “chocolate cysts due to their coloring
-Further surgery to unblock fallopian tubes or extract scar tissue. Surgery may not cure the disease as tissue often grows back, causing repetitive symptoms.
-Synarel, Danazol, Zoladex, Provera, Duphaston or Lupron to help inhibit ovulation as well as the regular hormone cycle during menstruation
-Birth control used repeatedly to inhibit ovulation.

TCM Pathology

Difficult menstruation coming with pain and tissue clotting that affects the Stomach, Spleen and Liver meridians causing back or stomach pain, headaches, fatigue, or indigestion or bloating. Kidney Yang deficiency is often the main cause, usually accompanied by Liver Qi stagnation or Spleen Qi deficiency leading to Blood stagnation. Stress among working women is often long-term and too much work can affect Blood and Qi flow. Blood flow blockage weakens the body. Contributing factors include poor nutrition and environmental as well as stomach surgeries and traumas.

Poor Blood flow within the meridians causes menstrual spotting. Symbolically, blood is being forced out of the meridians because it has overfilled the Uterus with no exit to flow through. Blood and Qi normalization during the four phases of menstruation is essential and so, hormone normalization/regulation is one of the goals of TCM therapy.

What to expect from TCM treatment?

TCM aims to resolve the underlying problem during each of the phases of menstruation.

TCM diagnostic patterns

Phlegm /Dampness:
-Dampness, marked as congealing and slow, causing lethargy or sluggishness, creating mucus that leads stagnation.
-Having lethargic feelings or feeling “heavy”
-Thirst with no desire to drink
-Abundance of mucus or phlegm
-Tongue coating thick or greasy while tongue appears slimy and white


-Yellow tongue coating
-Facial flush, sweats easily and feels warm
-Heat in the meridians can cause “boil over” of Blood causing painful and heavy menstruation

Coldness (caused by excess or deficiency):

Sometimes referred to as “Cold uterus,” Cold usually causes stagnation, cramping, confinement and inhibition. The Kidney meridian begins on the feet and travels to the Uterus. This means in TCM viewpoint that coldness in the feet travels through the Kidney meridian via the uterus, confining or inhibiting blood and Qi flow and this impairs fertility as well as the normal functioning of the reproductive system. Wearing socks and keeping the feet warm helps.

-White tongue coating
-Severe pain or cramping just before or during menstruation
-Frequent urination
-Feeling or running cold and feels better with heat

Blood stagnation:

-Purple-colored tongue
-Palpable lower stomach masses
-Stabbing sharp pain
-Pain just before or during menstruation

Qi stagnation:

-Stabbing sharp pain just before or during menstruation
-Tongue sides are redder compared to the tongue’s body
-Repressed emotions, anger, irritability, high blood pressure
-Migraine or tension headaches
-Chronic or severe stress

Qi Deficiency:

-May have no tongue coating at all
-Body of tongue has teeth marks and may have scalloped
-Poor appetite
-Cold hands and feet
-Overwhelmed or overworked
-Aching dull pain prior to or after menstruation
-Feeling fragile and exhausted

Nutritional Tips for Better Health

1. Avoid anima fats, salt, alcohol, and caffeine.
2. Consume foods rich in selenium, vitamin B and zinc.
3. Eat green foods and foods high in vitamin C (chlorella, wheat grass, spirulina). Remove stagnation, augment circulation and nourish, clean and move the blood.
4. Eat foods rich in bioflavinoids and antioxidants (vitamins C, A and E). These include red and green peppers, sweet potatoes, cauliflower, broccoli, kale, spinach, yams and carrots.
5. Consume a high-fiber diet of whole grains (quinoa, wheat, spelt, rye, oats) as well as legumes.

Pattern Differentiations:

If Stagnant Blood is the cause of menstrual pain, it can be alleviated by:

1. Avoiding animal products given antibiotics or steroids
2. Avoiding hydrogenated or refined oils
3. Taking omega 3 fatty acids derived from linseed oil or fish
4. Consuming olive oil, primrose, flaxseed, pumpkin seeds and other foods rich iin alpha-linoliec and linoleic fatty acids
5. Consuming pure whole wheat, quinoa, brown rice and other whole grain foods
6. Warming and moving the blood by adding scallions, garlic and onions to your diet
7. Adding chlorella, spirulina, seaweed and kelp to your diet
8. Consuming foods rich in bioflavinoids and antioxidants (blackberries, blueberries, strawberries, celery, beets, grapes, apricots, limes, lemons and tomatoes)
9. Foods that clean and move the Blood. These can include wholesome organic vegetables and organic fruits.

Consume foods that have warm or neutral attributes if you manifest Cold conditions. These can include green and red cabbage, yams, sweet potatoes, figs, pineapple, papaya, mangoes, chicken, turkey, beef, venison, millet, wheat bran, ginger, garlic, carrots, onions, leeks and beans.

Liver Qi stagnation:

For irritability, tension, anger or severe stress, try to:

1. Avoid greasy or spicy foods, and dairy products. Consume alkaline gains such as green beans, zucchini, avocado, turnips, Brussels sprouts, watercress, spinach, brown rice or barley.
2. Avoid dampness as it can worsen your condition. Avoid dampness by not over consuming fruits, or eating sugar or juices.
3. Eat foods with cool attributes if you have heat conditions. These foods can include endive, bok choy, beets, asparagus, eggplant, winter squash, watercress, cauliflower, alfalfa, broccoli, kale, sprouts, American ginseng, cilantro, chamomile or green tea, kidney, black or mung beans, tofu, wheat, brown rice, pearl barley, tomatoes, persimmons, pears, strawberries, yogurt, milk, crab, shrimp, and ocean fish.
4. Avoid greasy or spicy foods, caffeine and alcohol if you suffer from heat conditions
5. Avoid caffeine, cigarettes and alcohol
6. Live the moment and leave your issues behind (let go of them!)
7. Practice yoga
8. Consume nutritious, organic and wholesome foods instead of refined and processed foods laden with preservatives and chemicals
9. Exercise
10. Consume smaller more frequent meals
11. Chew food slowly, sit down and enjoy your meal without doing anything else.

TCM can resolve endometriosis and needs to be considered as a complement modality to western treatment.


Scott Paglia is a licensed and board certified acupuncturist in Bellingham, WA and provides master level pulse diagnosis, Chinese herbal medicine and acupuncture in Whatcom County, WA.