Endometriosis and Adenomyosis: How Acupuncture and Traditional Chinese Herbal Medicine Can Help Pelvic Pain
In Traditional Chinese Medicine (TCM), there is a saying: "Tong Zhi Bu Tong, Bu Tong Zhi Tong," which means "If there is free flow, there is no pain; if there is pain, there is no free flow." This phrase captures the heart of how TCM views conditions such as endometriosis and adenomyosis. Both conditions involve tissue growing where it should not, causing pain, heavy bleeding, and chronic inflammation. In TCM, these are seen as manifestations of stagnation.
When blood, energy (qi), or fluids do not move as they should, pain and disease can develop. Endometriosis occurs when tissue similar to the uterine lining grows outside of the uterus, while adenomyosis happens when this tissue grows into the uterine wall itself. In both cases, masses form, inflammation persists, and pain disrupts daily life. TCM does not stop at labeling stagnation. We ask why it is present, what type it is, and what underlying imbalances have allowed it to take hold.
The Wheel of a Woman
One way TCM practitioners view health is through the lens of a woman’s menstrual cycle, like a wheel turning month after month. Each phase should move seamlessly into the next. When something is out of balance—whether blood is insufficient, qi is blocked, or heat or cold interferes—the wheel catches and symptoms appear. Endometriosis and adenomyosis are clear examples of this imbalance, but the patterns behind them are never identical from one person to the next.
What Causes Stagnation?
TCM identifies several root causes of blood stagnation. Most patients present with a combination of excess and deficiency, which is why treatment is always individualized.
Heat: Excess heat thickens and clots the blood, similar to milk boiling into a sticky mess. Patients often feel flushed, irritable, or sweaty. Modern research has linked chronic inflammation in endometriosis and adenomyosis with elevated levels of pro-inflammatory cytokines, reflecting TCM’s concept of heat damaging the blood.
Cold: Cold contracts and slows circulation, and pain often worsens with exposure to cold. Modern parallels may include reduced pelvic blood flow or impaired immune clearance of misplaced endometrial cells.
Qi Stagnation: Stress, tension, and unexpressed emotions can physically block the smooth flow of energy and blood. Studies show that high cortisol and chronic stress worsen endometriosis symptoms, mirroring this ancient concept.
Blood Deficiency: Without sufficient blood to circulate, flow becomes sluggish. Poor diet, heavy bleeding, or impaired nutrient absorption can contribute.
Kidney Yang Deficiency: In TCM, the Kidneys provide the fire of reproduction. If their energy is weak, blood circulation falters and cold masses can form. Research also shows that women with endometriosis often have lower mitochondrial function, representing less "fire" at a cellular level.
Spleen Qi Deficiency: The Spleen governs digestion and the production of blood. Weak digestion prevents nutrients from being properly transformed, leading to fatigue, dampness, and sometimes masses. Modern studies have highlighted a gut-endometriosis connection, with dysbiosis driving systemic inflammation.
Treating Stagnation: Moving and Nourishing
The first step in TCM treatment is often to restore movement, increase circulation, reduce pain, and address masses. Equally important is addressing the root imbalance so stagnation does not return.
Herbal Medicine
Herbs are essential for long-term management. A formula typically combines four to twelve herbs, each serving a purpose: some move blood and break up stagnation, others nourish blood, guide the formula to the uterus, or temper side effects.
One patient may begin with a strong blood-moving formula. As symptoms improve, the practitioner shifts to tonifying herbs that strengthen the Kidneys or Spleen. Without this approach, there is a risk of depleting the body further.
Acupuncture and Moxibustion
Acupuncture helps regulate qi and blood flow, reduce inflammation, and calm the nervous system. Moxibustion, which involves burning the warming herb mugwort near the skin, can be especially helpful for cold-type endometriosis or adenomyosis by warming the uterus and restoring circulation.
Yoni Steaming
Yoni steaming is another therapeutic tool that complements acupuncture and herbs. Gentle heat and herbal steam delivered to the pelvic area can:
Increase circulation to the uterus and surrounding tissues
Help move blood and break up minor stagnation
Relax uterine and pelvic muscles, reducing cramps
Support the nervous system and promote stress relief
Common herbs used in steaming for endometriosis and adenomyosis include motherwort, safflower (Hong Hua), nettle, Tao Ren (peach kernel), Ku Shen, and Ai Ye (mugwort). Each herb has a specific role in moving blood, reducing inflammation, nourishing tissues, or warming the uterus.
Lifestyle and Stress Management
Since qi stagnation is often part of the picture, managing stress is key. Movement, breathwork, and rituals that activate the parasympathetic "rest and digest" mode allow circulation to flow more freely.
The Research Connection
Modern studies are beginning to support what TCM has observed for centuries. Acupuncture has been shown in meta-analyses to reduce endometriosis pain and improve quality of life. Herbal formulas that move blood and reduce inflammation have been studied for their potential to shrink lesions and ease pain. Stress reduction and gut health, long emphasized in TCM, are increasingly recognized as vital for managing endometriosis.
Acupuncture
Systematic Review on Acupuncture for Endometriosis: A 2023 systematic review concluded that acupuncture treatment for endometriosis demonstrated clinically relevant improvements in pelvic pain and should be considered as a potential treatment intervention. Read the study here.
Acupuncture's Effectiveness in Alleviating Dysmenorrhea and Pelvic Pain: A study published in 2023 found that acupuncture is effective in alleviating dysmenorrhea and pelvic pain associated with endometriosis, reducing serum CA-125 levels, decreasing the size of nodules, improving patients' quality of life, and lowering the recurrence rate. Read the study here.
Acupuncture and Moxibustion for Endometriosis: A 2023 article reviewed the efficacy of acupuncture and moxibustion in treating endometriosis-related pain, suggesting that these therapies are effective in managing symptomatic endometriosis. Read the study here.
Herbal Medicine
Salvia miltiorrhiza-Containing Chinese Herbal Medicine: A study published in 2022 investigated the efficacy and safety of Salvia miltiorrhiza-containing Chinese herbal medicine combined with gonadotropin-releasing hormone agonist (GnRH-a) for postoperative endometriosis management. The results showed significant superiority in decreasing endometriosis recurrence and increasing the pregnancy rate. Read the study here.
Plants as Source of New Therapies for Endometriosis: A 2021 review discussed various plant-based therapies for endometriosis, highlighting their potential as new treatments. Read the study here.
Every Body is Unique
No two people with endometriosis or adenomyosis present in the same way. Some experience stabbing pain relieved by warmth, others dull aching pain worsened by heat. Some experience heavy clotting, others almost no bleeding. This is why TCM relies on pulse-taking, tongue observation, and a full case history to identify each person’s unique pattern and treat accordingly.
How Long Does It Take to See Results?
Since endometriosis and adenomyosis often develop over years, treatment requires patience and a phased approach.
Stage One focuses on relieving pain and improving flow. Blood-moving herbs, acupuncture, yoni steaming, and lifestyle adjustments often bring noticeable relief within one to three cycles.
Stage Two emphasizes rebuilding. Tonifying the Kidneys and Spleen, supporting digestion, balancing hormones, and strengthening resilience helps prevent stagnation and pain from returning. Many patients notice improvement within weeks, but meaningful long-term change typically requires several months of consistent treatment.
Why Choose TCM Alongside Western Medicine?
TCM does not replace surgery or medication but complements them. Western medicine can remove lesions or suppress hormones but does not always address why stagnation formed or how to prevent recurrence. TCM looks at circulation, stress, digestion, hormones, and the unique way each body responds to imbalance. This whole-systems approach supports conception, pain management, and prevention of repeat surgeries.
The Bottom Line
Endometriosis and adenomyosis present differently in every person. Some experience inflammation and heat, others cold pain. Some bleed heavily, others barely at all. There is no one-size-fits-all plan. Through careful diagnosis, a TCM practitioner can uncover the unique pattern behind your symptoms and create a personalized treatment strategy.
With consistent support through acupuncture, herbal medicine, yoni steaming, and lifestyle adjustments, it is possible to move from stagnation into flow, relieve pain, and restore balance, resilience, and quality of life.
✨ If this resonates with you, consider connecting with a practitioner deeply trained in both acupuncture and Chinese herbal medicine.