In traditional Chinese medicine (TCM), endometriosis is caused by what is known as blood stasis. In blood stasis, the normal circulation of blood is interrupted. This causes blockages within the body and results in symptoms such as menstrual disorders and pain.
There are a number of different reasons why your blood may not not be flowing as it should. The first, and most common, is a pattern called qi stagnation.
Qi Stagnation and Blood Stasis
Qi is one of the most important substances in TCM. It is often translated as “vital energy” or “life force” and is responsible for warming, nurturing and protecting our bodies. Qi and blood are closely related to one another. Blood is considered yin, and is responsible for nourishing qi. Qi is considered yang and is responsible for moving blood. So if, for some reason, your qi stops flowing as it should, your blood will soon follow suit.
The flow of qi around the body is controlled by the Liver. If the Liver is healthy, the flow of qi should be constant, consistent and smooth. But if the Liver becomes imbalanced, this can lead to problems. The flow of qi becomes erratic, it may stop and start, or may slow down to the point that it is barely moving at all. This, in turn prevents the blood from circulating as it should, and causes conditions such as endometriosis.
Having a healthy Liver with smooth flowing qi and blood is important for everyone. However, women are more likely to notice symptoms when things go wrong. This is due to the involvement of the Liver in the menstrual cycle.
In acupuncture, the Liver channel starts on the big toe. It then climbs up the inside of the legs, looping around the genitals and reproductive organs before finishing on the chest.
Because of its location and its relationship with qi and blood, the Liver plays a vital role in the menstrual cycle, and almost every menstrual disease in TCM will have some relationship to the Liver.
The Liver is badly affected by stress, so one of the best ways to look after your Liver is by making sure you have enough time to rest and relax. It is also important to go to bed at a reasonable time and get plenty of sleep. The Liver is said to be at its most active between 1am and 3am. At this time, you should be lying down in bed, allowing your blood to return to the Liver to be replenished and restored.
If your endometriosis is caused by qi stagnation and blood stasis, you may experience symptoms such as:
- Irregular or late periods
- Clotted menstrual blood
- Mood swings
- Breast tenderness
- Digestive issues
Blood Deficiency and Blood Stasis
Another reason why blood may not be circulating efficiently is that there simply may not be enough of it in the vessels to push it through. Blood deficiency is, very simply, a lack of blood. Imagine a stream which has dried up after a hot summer. There may be a small trickle of water at the bottom, struggling to flow and make its way to its destination. This is what blood stasis due to blood deficiency looks like.
Blood can become deficient due to imbalances in the Liver, Heart or Spleen, all of which play a vital role in blood production. Diet also plays an important part, as it is the nutrients from what we eat that go on to make up our qi and blood.
If you are blood deficient, one of the best ways to help is by eating a balanced and nutritious diet. Choose fresh, unprocessed foods and be sure to include plenty of iron-rich foods in your diet. Some of the best foods for nourishing blood are beef, liver, eggs, leafy greens and seaweed. Avoid drinking caffeinated drinks with meals as this can reduce your body's ability to absorb iron from food. Try switching to orange juice instead. It is high in vitamin C and is thought to aid iron absorption.
If your endometriosis is due to blood deficiency and blood stasis, your symptoms may include:
- Irregular or late periods
- Light menstrual bleeding
- Pale skin
- Dry, dull hair and skin
Cold and Blood Stasis
The free flow of blood can also be interrupted by an excess of cold in the body. This causes the blood to become thick and slow, meaning it can easily get stuck in the vessels.
Cold can invade the body from outside, for example spending too long outdoors in a cold climate, or eating too much cold or raw food. It can also come from deep within, stemming from a deficiency in Kidney-yang.
The Kidneys play an important role in menstruation in TCM. The ovaries are considered part of the Kidney system and healthy Kidneys are needed for a healthy cycle. The Kidneys have both a yin and a yang aspect. In many ways, Kidney-yin and Kidney-yang can be compared to the hormones estrogen and progesterone which are both necessary for a smooth monthly cycle.
Kidney-yin is responsible for nourishing the reproductive organs. It is what causes the lining of the womb to build up during the first half of your menstrual cycle. Kidney-yang provides heat for all of our bodily functions, including warming the reproductive organs and the uterus. It comes into play in the second half of your cycle and it is the switch from yin to yang which triggers ovulation.
Strong Kidney-yang is also needed for good circulation. If it is deficient, the blood becomes too cold and cannot flow freely.
If your endometriosis is due to cold and blood stasis, you may have symptoms such as:
- Irregular or late periods
- Dark, clotted menstrual blood
- Stabbing pain
- Cold hands and feet
- Loose bowels
Heat and Blood Stasis
Excess heat is a less common cause of blood stasis, but it is still possible. Excess heat may enter the body from various sources such as overexposure to heat, smoking, alcohol, caffeine and spicy food. It can also be generated internally as a result of long term stress.
When there is too much heat in the blood, one of two things can happen. The blood may dry up, resulting in blood deficiency and stasis. The blood may also try to “escape” in an attempt to cool itself down. This second scenario results in bleeding, for example nosebleeds, bleeding gums or heavy periods.
If this is the cause of your endometriosis, you may find that your symptoms include:
- Early periods
- Bleeding between periods
- Heavy menstruation which is bright red with clots
Diagnosing and Treating Endometriosis with Acupuncture and TCM
According to TCM, the cause of endometriosis is always blood stasis. However, it is important to identify the underlying reason for the blood stasis too so that it can be treated effectively.
This is why you will need to give your practitioner a lot of detailed information during your first consultation. They need to find out WHY your blood is not circulating as it should, and they can only do that by putting together all of the puzzle pieces. This is why it is always important to tell your practitioner about all of your symptoms, even if they seem unrelated.
Once you have a diagnosis, your treatment with acupuncture and/or Chinese herbs can begin. The aim of the treatment is to get blood flowing freely again.
If there is qi stagnation, acupuncture will be used to restore its movement and nourish the Liver.
If there is blood deficiency, acupuncture and herbs can be used to build your blood. Your practitioner will also give you personalized dietary advice so that you can be proactive between treatments.
Acupuncture and herbs may also be used to expel cold or heat, warm or cool the body, and restore the balance between Kidney-yin and Kidney-yang.
Other treatments which may be helpful to aid circulation and relieve pain are massage, cupping and moxibustion. You can also help yourself by eating well, taking regular, gentle exercise, getting enough sleep and keeping stress to a minimum. Together, these things will benefit your blood circulation and ensure that your menstrual cycle is smooth and symptom-free.