Endometriosis and chinese medicine

By definition endometriosis is the presence and growth of the glands and stroma of the lining of the uterus in an aberrant or heterotopic location. Adenomyosis is the growth of endometrial glands and stroma into the uterine myometrium to a depth of at least 2.5 mm from the basalis layer of the endometrium. Adenomyosis is sometimes termed internal endometriosis. The prevalence of pelvic endometriosis in the general female population has been suggested to be 6% to 10%, many patients are diagnosed during surgery for other indications. Conservative estimates find that endometriosis is present in 5% to 15% of laparotomies performed on reproductive-age females. The prevalence of active endometriosis is 33% in women with chronic pelvic pain, and 30% to 45% in women with infertility.
Endometriosis has many different clinical presentations, with one of every three women being asymptomatic. Classic symptoms include; pelvic pain, secondary dysmenorrhea infertility, dyspareunia, and presence of endometrium tissue, chocolate cyst or endometrima with laproscopy.
The etiology of endometriosis is not clear, and may involve retrograde menstruation, vascular dissemination, metaplasia, genetic predisposition, immunologic changes, and hormonal influences; in addition, there is increasing evidence that environmental factors may also play a role, including exposure to dioxin and other endocrine disruptors.
In Chinese medicine, endometriosis is a result of blood stasis caused by the cyclical bleeding of ectopic endometrial tissue, which causes fibrosis of the surrounding tissues. The location of the disorder is in the lower jiao, uterus, and uterine collaterals. When the patient is weak, especially in case of kidney deficiency, pathogenic factors can easily invade the body. The kidney is the root of yin and yang; it stores essence and governs reproduction and it has a close relationship to the body’s defensive and reproductive capabilities and it is also involved in the regulation of menstruation. Lack of proper care of the body during menstruation, after childbirth, over-indulgence in sexual activity, or abortions will give pathogenic factors a chance to invade the body; this can lead to blood stasis due to the retention of cold, heat or dampness.
Pattern differentiations of endometriosis in TCM are:
1- Qi stagnation& blood stagnation
2- Cold stagnation and blood stasis
3- Qi deficiency and blood stagnation
4-Phlegm& heat binding
5- Kidney deficiency and blood stasis