Integrative Treatment in Endometriosis


Jin Yu, Shanghai Kun-Tai Reproductive Medicine Center, Zhao Jia Bang Road 446, Room 1306. 200032, Shanghai, China


Proceedings of the Women's Health And Asian Traditional (WHAT) Medicine II Conference




Endometriosis, integrative treatment, estrogen dependent disease, herbal treatment


Endometriosis consists of the presence of functional endometrium outside the uterus. It is usually confined to the pelvis in the region of cul-de-sac, the ovaries, the uterosacral ligments, and the uterovesecal peridoneum, though remote sites may be affected as well. Being an estrogen dependent disease, the main manifestations of endometriosis are severe acquired dysmenorrhea, infertility, ovarian endometrial cysts, etc. Factors for these infertilities are 75% related to unruptured lutienized ovarian follicles (LUF) due to lowered ovarian function, and different degrees of fallopian tube occlusions are also other problems. As a most common disease in women, the incidence of endometriosis are 10~ 15% during recent years, and 40-50% in infertile women are related, though very little is known about its etiology. In modern medicine, analgesics including anti-prostaglandin drug, laparoscopic surgery, or endocrine therapies e.g. pseudo-pregnancy, pseudo-menopause, hormonal ovariectomy to suppress ovarian function have been temporarily administered to release symptoms, but disease continues to develop after these approaches due to its character of estrogen dependent. There is no terminology of endometriosis in TCM literature, though the pelvic pain usually refers to bloodstasis according to principles in TCM. With successful integrative treatment in ectopic pregnancy, primary dysmenorrhea, endometriosis and menorrhagia, herbs for activating blood flow were known to function on decreasing blood viscosity, endometrial PGF2a, TXB2, FDP, increasing fibrinogenolysis, and dually regulating endometrial PGE2. With decades of clinical experience and studies on TCM treatment in endometriosis, attention has been paid to improve ovarian function since 2001, and new formula were designed with much better results. From 2002 to 2003, herbal formula—Bei Tong An was administered in 48 patients with endometriosis including 20 infertile cases. 3 months after the treatment, scores of both menstrual pelvic pain assessed by VAS and VRS methods were significantly reduced (P < 0.01), diameters of ovarian endometrial cysts were obviously decreased (8.71 ± 2.18 cm vs 5.93 ± 1.75 cm, P< 0.01). As measurement on BBT and HPS score apparently improved (7.94 ± 2.03 vs 9.26 ± 1.29, P< 0.01), high serum PRL.