Endometriosis affects an estimated 1 in 10 people around the world and can show up differently for each person affected by it. The symptoms can range from bloating and discomfort, chronic pelvic pain, pain with menstruation (dysmenorrhea), pain or cramping with intercourse, discomfort or pain with urination and bowel movements, to challenges with fertility. The severity and number of symptoms a person may experience may not be related to the size or proliferation of endometriotic lesions they have. Often times they will have an ultrasound or pelvic x-ray that appears to be okay, but yet they have symptoms.
Treatment often involves medication to manage pain, hormone therapy to control the growth of the endometriotic tissue and regulate or suspend menstruation, as well as surgical removal of lesions. Long term use of pain medications and hormone therapy is often associated with unwanted side effects. Acupuncture and Chinese herbal medicine can serve as a complement, and in some cases, an alternative to these interventions, both as a way to decrease the dose required for symptom relief and to help mitigate unwanted side effects.
There have been several studies investigating the efficacy of Chinese herbal medicine for the treatment of Endometriosis and its related symptoms. Several years ago, there was a comprehensive review done comparing common treatments for Endometriosis and drawing parallels between these interventions and the herbal medicine formulas that have been commonly used and studied in trials in China. One particular discussion point that I wanted to highlight was the authors calling attention to adolescents with endometriosis, mentioning that they would be the most likely to benefit from disease prevention, preservation of fertility and pain relief with innovative herbal treatments.
The National Center for Complementary and Integrative Health (NCCIH) in the United States has funded a research trial looking at Chinese medicine and Acupuncture intervention for the treatment of Endometriosis related symptoms. What is different about this research trial, from many previous studies, was the use of Chinese medicine diagnosis patterns to separate the participants into sub-groups for treatment that best fits their pattern. This way of studying the efficacy is more reflective of how we practice in the clinic, which is patient focused and allows for differentiation subtlety within a broader disease classification.
•Wieser et al. 2007, Evolution of medical treatment for endometriosis: back to the roots? Human Reproduction Update, Vol.13, No.5 pp. 487–499, 2007