It is estimated that about one in ten women of reproductive age have some degree of Endometriosis.  Endometriosis is the condition that occurs when endometrial cells normally found in the lining of the uterus grow in other areas of the body causing pain, and in some cases great difficulty conceiving due to scarring and adhesions. 

Scarring of the Fallopian tubes can block the passage of eggs and sperm between the ovaries and the uterus.  Adhesions are bands of tissue that form with endometriosis, which act as the “tethers” connecting the “renegade” endometrial tissue to other structures.  These tethers can obstruct the Fallopian tubes by pulling on them.  They can also cause pain when they exert a pulling effect by anchoring organs and tissues found in the pelvis and abdomen.  This occurs primarily during the proliferative phase of a woman’s cycle, when both the normal uterine and renegade endometrial tissue becomes thickened and engorged with blood and changes it’s size and shape.  The adhesions pull when these structures change, causing in some cases extraordinary pain. 

When bleeding occurs during the normal cycle, bleeding also occurs wherever renegade endometrial tissue has taken root.  Within the pelvis or abdomen, blood is an irritant that can cause great discomfort and pain.

With endometriosis, endometrial cells can grow in areas around the ovaries, Fallopian tubes, the ligaments that support the reproductive organs, the area between the vagina and rectum, the rectum itself, the outside of the uterus, the lining of the pelvic and abdominal cavities, on the organs of the abdominal and pelvic cavities, and even in the lungs and respiratory tract.  Although with typical endometriosis, renegade cells grow and prosper within the pelvic and abdominal cavities only, endometrial tissue can crop up just about anywhere.

There are at least a half dozen theories for the development of endometriosis.  The theory that currently seems most plausible is that during menstruation, seed endometrial cells shed along with blood from the uterus during a woman’s period, rather than passing out of the vagina make their way backwards up through the Fallopian tubes into the pelvic and abdominal cavities where they take root, flourish and become pockets of endometrial tissue.  Renegade tissue goes through the same hormone driven changes of the menstrual cycle as the uterine endometrial tissue.  The renegade tissue proliferates, then sheds during a woman’s period, but does so in areas that are pain sensitive to the changes and to the presence of blood.

Western medicine treats endometriosis medicinally and with surgery. Surgical treatment removes renegade endometrial tissue and adhesions while attempting the protection of the ovaries and fallopian tubes as well as all other pelvic and abdominal tissues that may be effected.  Endoscopic surgery is used for removing renegade endometrial tissue, thereby reducing the amount of painful occult (hidden) bleeding within the abdominal and pelvic cavities, as well as for surgical resection of pain causing adhesions.  This is often a temporary and less than perfect solution, as over time the remaining cells often repopulate, and adhesions often reform, sometimes to a greater degree than before.   

Endometriosis can be treated with medications such as hormones that cause the cessation of the menstrual cycle, reducing or preventing the proliferation and shedding of renegade endometrial tissue that would occur during a normal cycle.  Thereby alleviating or reducing the symptoms that are caused during proliferation and shedding of the renegade endometrial tissue. 

As of 2018 there is a new FDA approved drug called Elagolix that works by suppressing the hormones that cause the endometrial tissue in the uterus, and in the case of endometriosis elsewhere in the body, to develop and enrich during a normal menstrual cycle.  Because there is a reduction in endometrial development, shedding of endometrial tissue is vastly reduced, leading to less painful occult bleeding from the renegade endometrial tissue and the painful pulling of adhesions. 

Suppressing the menstrual cycle prevents effective ovulation, so such treatments can not be used during the time a woman is trying to become pregnant.


Endometriosis and Acupuncture

Treatment of fertility impacted by endometriosis uses the “Pattern Discrimination” of Imbalances within the body according to the principles of Traditional Chinese Medicine.  The pattern discriminations most often associated with endometriosis are termed Blood Stasis and Qi Stagnation.  The treatment involves “moving” the improperly static Blood and Qi in order to resolve the imbalances causing the infertility and associated pain.  In addition the treatment can include reduction of the internal inflammation, balancing of the reproductive hormones, and regulation of the menstruation. 

For more information h
ere is a link to an excellent summary of endometriosis from Nurture Acupuncture in California, it’s symptoms and Western Treatment, and the use of Traditional Chinese Medicine to treat infertility associated with Endometriosis.