(202) Endometriosis

[HB KIM]

Edonmetriosis & Herbal Formulas

DEFINITION AND SYMPTOMS
Endometriosis is a condition in which endometrial tissue, which normally lines the uterus becomes attached to other organs in the abdomen.  AGE: It is most common between the ages of 30 and 45.  GENETICS: Sometimes runs in families.  LIFESTYLE: Not having had children is a risk factor.  In endometriosis, pieces of the lining become attached to organs in the pelvic cavity such as, the ovaries and the lower intestines.  The pieces of lining react to the hormones of the menstrual cycle and bleed during menstrual periods.  Endometriosis is a common condition affecting as many as 1 out of 5 women of childbearing age.  Women who delay having children until they are in their 30s and those who do not have children are more likely to develop this condition.  Severe endometriosis often causes problems with fertility in women.

Endometriosis may not produce any symptoms.  If symptoms do develop, their severity varies from woman to woman.  Symptoms may also vary depending on which organs are affected by the condition.  Symptoms may include:

1. Pain in the lower abdomen, which is often most severe immediately before and during menstrual periods
2. Irregular menstrual periods or very heavy menstrual bleeding
3. Pain during sexual intercourse
4. Painful urination
5. Diarrhea or Constipation (If the endometrium grows on the lower intestines)
6. Bleeding from the rectum during mensturation (in rare cases)


DIFFERENTIAL DIAGNOSIS
In Oriental Medicine, Endometriosis is categorized under "Dysmenorrhea".  There are two main differential diagnoses.
1. Qi stagnation with Blood stasis : sharp pain of lower abdomen before the period, dark and clotted menses, purple tongue, wiry and choppy pulse
2. Kidney deficiency with Blood stasis : chronic, low back pain, abdominal pain, scanty menstrual blood, dark and clotted menses, thready and wiry pulse


HERBAL FORMULAS
1. Qi stagnation with Blood stasis, you can use the following classic formula or empirical formulas.
(1) Huo Luo Xiao Ling Dan (Classic formula):  Dang Gui 15g,  Dan Shen 15g,  Ru Xiang 15g,  Mo Yao 15g
(2) Empirical formula 1:  Xue Jie 5g,  Ru Xiang 5g,  Mo Yao 5g,  Dang Gui 10g,  Chi Shao 10g,  Bai Shao 10g,  Yan Hu Suo 10g,  Chuan Lian Zi 10g,  Shan Zha 10g,  Shu Di 9g,  Tao Ren 6g,  Gan Cao 5g,  E Zhu 12g
(3) Empirical formula 2:  Dang Gui 9g,   Niu Xi 9g,  Ru Xiang 9g,  Yan Hu Suo 9g,  Su Mu 9g,  Dan Shen 12g,  Chuan Xiong 5g,  Xue Jia 3g,  Ru Xiang 6g,  Mo Yao 6g,  Pu Huang 8g,  Wu Ling Zhi 8g

2. Kidney deficiency with Blood stasis, you can use the following classic formula or empirical formulas.
(1) Wen Jing Tang modified (Classic formula):  Dang Gui 9g,  Chuan Xiong 9g,  Bai Shao 9g,  Rou Gui 9g,  Mu Dan Pi 9g,  E Zhu 9g,  Ren Shen 18g,  Gan Cao 18g,  Niu Xi 18g
(2) Empirical formula: Tu Si Zi 12g,  Liu Ji Nu 12g,  Ba Ji Tian 12g,  Chuan Xiong 12g,  Gui Zhi 6g,  Tao Ren 6g,  Shu Di 6g,  Er Zhu 9g,  Lu Jiao 7g,  Huang Qi 18g