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Endometriosis, the formation of tissue outside of the endometrium (uterine wall), can create painful menstrual periods, premenstrual spotting, pain during intercourse, infertility, abdominal or diffuse pelvic pain, bloating, constipation or diarrhea. Symptoms may also include low back pain or pain radiating to the inner thigh, pain upon defecation, fatigue or sometimes nausea or vomiting. The severity of the pain may not truly disclose the severity of the disease, as some women may present without pain.

Western View
Western medications and treatments include:

• Birth control used continuously to suppress ovulation.
• Danazol, Provera, Lupron, Duphaston, Synarel or Zoladex, used to suppress ovulation and the regular course of hormones during the menstrual cycle.
• A laparoscopy conducted to drain fluids and remove small patches of tissue. The cysts or tissues are sometimes referred to as "chocolate cysts" due to their coloring.
• More extensive surgery to remove larger areas of displaced or scar tissue or to unblock fallopian tubes. Surgery is not the final answer because tissue can and oft en does, grow back, causing recurrent symptoms.

TCM Pathology

Difficult menstrual flow accompanied by pain and clotting of tissue or by pain that disrupts other channels (Liver, Spleen and Stomach) causes abdominal or back pain, bloating or indigestion, fatigue, or headaches. Kidney Yang deficiency is usually the primary cause, often accompanied by Spleen Qi deficiency or Liver Qi stagnation. This leads to Blood stagnation. In today's busy world, each of us carries an enormous amount of stress. Stress among professional and working women is frequently chronic and overwork disrupts the even flow of Qi and Blood. The obstruction of Blood flow restricts the normal cycle. Environmental toxins and poor nutrition also contribute, as do traumas and abdominal surgeries.

If menstrual spotting occurs, it is due to the Blood unsuccessfully trying to flow evenly within the channels. Symbolically, it is being pushed out of the channels because it has overfilled the Uterus without any available open exit valve. Regulation of Qi and Blood during the four phases of the menstrual cycle is required. Therefore, regulation of hormones is part of TCM treatment, as contrasted to the suppression of the normal function of hormones. What to expect from TCM treatment?

The goal is to correct the root problem during each of these phases by fine-tuning the TCM protocol.

TCM Pattern Differentiations-Your practitioner arrives at one or more of the following diagnostic patterns used to develop your treatment protocol. Qi Deficiency:

• Feeling exhausted and fragile.
• Dull, aching pain before, during or after menstruation.
• Overworked, overwhelmed.
• Cold hands and feet.
• Insomnia.
• Poor appetite.
• Tongue body may have scalloped, teeth-marked edges.
• Tongue may have no coating.

Qi stagnation:

• High-level or continuous stress.
• Tension or migraine headaches.
• High blood pressure, irritability, anger or repressed emotions.
• The sides of the tongue may be redder than the body of the tongue.
• Sharp, stabbing pain or pain prior to or during menstruation.

Blood stagnation:
• Pain prior to or during menstruation.
• Sharp, stabbing pain.
• Palpable lower abdominal masses.
• Clots.
• Purple- colored tongue body.

Coldness (Can be deficiency or excess):

Many texts use the term "Cold uterus." Cold is typically inhibiting, confining, cramping and stagnating. The Kidney channel starts on the feet and runs through the Uterus therefore, TCM theory believes that coldness in the feet runs up the Kidney channel through the uterus, inhibiting or confining Qi and blood flow. This affects fertility and the proper functioning of the reproductive system. Traditional advice: "Wear socks and keep your feet warm!"

• Generally, one who runs/feels cold and feels better with heat.
• Frequent urination.
• Cramping, severe pain prior to or during menstruation.
• Tongue coating may be white.

Heat:
• Heat in the channels can cause the Blood to "boil over," producing a heavy, painful menstrual flow.
• One who runs warm, sweats easily or has a facial flush.
• Yellow tongue coating.

Dampness/Phlegm:
Dampness, characterized as slow moving and congealing, causes sluggishness
or lethargy, producing mucus and leading to stagnation.

• Tongue coating may be white and appear slimy, greasy or thick.
• Abundance of phlegm or mucus.
• Thirst but no desire to drink fluids.
• Feeling "heavy" or having heavy sensations or lethargy.

Nutritional Tips for Better Health

Nutrition and Dietary Guidelines:
Aphrodite Women's Health (2004) reported the incidence of endometriosis is 40% less among females who consumed more fresh fruit and green vegetables. Females with a high intake of beef, ham or other red meat, increased their risk of endometriosis by 80-100%. There is a connection between diet and endometriosis!

1. Eat a high-fiber diet consisting of whole grains (wheat, oats, rye, spelt, quinoa) and legumes.
2. Vegetables high in antioxidants (Vitamins A, C, and E) and bioflavonoids - like carrots and yams, spinach, kale, broccoli, cauliflower, sweet potatoes, green and red peppers are beneficial.
3.Vitamin C and green foods (wheat grass, chlorella, spirulina) clean, nourish, move the blood, create circulation and remove stagnation.
4. Eat foods high in Vitamin B, selenium and zinc.
5. Eliminate caffeine, alcohol, salt and animal fats.

Pattern Differentiations:
If the menstrual pain is derived from Stagnant Blood, it can be ameliorated by:

1. Foods that move and clean the Blood, like wholesome organic fruits and vegetables.
2. Eating foods high in antioxidants and bioflavonoids (tomatoes, lemons, limes, apricots, grapes, beets, celery, strawberries, blueberries, blackberries).
3. Adding kelp, seaweed, spirulina and chlorella.
4. Adding onions, garlic, scallions to move and warm the Blood.
5. Eating whole grains like brown rice, quinoa and 100% whole wheat.
6. Consuming linoleic and alpha-linoleic fatty acids found in pumpkin seeds, flaxseed, primrose (gamma linolenic acid-omega 6) and olive oil.
7. Taking omega 3 fatty acids found in fish or linseed oil.
8. Avoiding refined and hydrogenated oils.
9. Avoiding animal products treated with steroids or antibiotics.

For Cold conditions, eat foods with properties that are neutral or warm in nature (beans, leeks, onions, carrots, garlic, ginger, wheat bran, millet, venison, beef, turkey, chicken, mangos, papaya, pineapple, figs, sweet potatoes, yams, red and green cabbage).

Liver Qi stagnation:
If you suffer from high stress, anger, tension or irritability try to:

1. Chew your food slowly, sit down and enjoy each meal without multi-tasking.
2. Eat smaller, more frequent meals.
3. Exercise.
4. Eat wholesome organic and nutritious foods rather than processed and refined foods containing chemicals and preservatives.
5. Yoga!
6. Let go of issues you have no control over and live the moment.
7. Avoid alcohol, cigarettes or caffeine.
8. Heat conditions react negatively to alcohol, caffeine and spicy or greasy foods.
9. Heat conditions respond favorably to foods with cool properties, which include ocean fish, shrimp, crab, milk, yogurt, strawberries, pears, persimmons, tomatoes, pearl barley, brown rice, wheat, tofu, mung, black or kidney beans, mint, green, or chamomile tea, cilantro, American ginseng, sprouts, kale, broccoli, alfalfa, cauliflower, watercress, winter squash, eggplant, asparagus, beets, bok choy or endive.
10. Damp conditions worsen with sugars, juices and over-consumption of fruits.
11. Eliminate dairy products, alcohol, spicy, or greasy foods. Eat more alkaline grains such as barley or brown rice, spinach, watercress, brussel sprouts, turnips, avocado, zucchini or green beans. TCM addresses endometriosis and should be considered in addition to western therapy.

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