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Acupuncture and Endometriosis

June 16, 2025

What is endometriosis?

 

Endometriosis is a gynaecological disorder characterised by endometrial-like tissue growing outside the uterus cavity, most commonly on the ovaries, fallopian tubes, pelvic peritoneum, and other pelvic organs. These lesions cause inflammation, scarring and pain. They tend to respond to hormonal changes in the menstrual cycle and are oestrogen dependent.

Endometriosis affects about 8.8% of women aged 26-31 years and 14% of women aged 44-49 years (Australian Institute of Health and Welfare, 2023). It is also one of the leading causes of infertility.

 

What are the symptoms of endometriosis?

 

Endometriosis can significantly reduce the quality of life of individuals diagnosed, and impact them both physically and psychologically. The symptoms include:

TCM_EndometriosisPhysical:

  • Chronic pelvic pain
  • Dysmenorrhea (painful periods)
  • Dyspareunia (pain during or after sexual intercourse)
  • Infertility
  • Ovulation pain
  • Painful bowel movements or urination
  • Bloating (aka ‘endo belly’)
  • Fatigue
  • Lower back pain or leg pain
  • Heavy menstruation
  • Nausea or gastrointestinal discomfort

Psychological:

  • Depression (due to chronic pain, fertility concerns and reduce quality of life)
  • Anxiety
  • Stress
  • Cognitive difficulties (due to fatigue)
  • Low self-esteem
  • Social withdrawal or reduced participation in activities
  • Socioeconomic impact on work, productivity and career

 

Current conventional treatments of endometriosis

 

The first line treatments are pharmacological and often associated with many unacceptable side effects, therefore, leading to poor compliance by patients. These include the following:

  • Oral contraceptives – Used to regulate and suppress menstruation. The common side effects include nausea, breast tenderness, headaches, weight changes and blood clots.
  • Progestins – Used to thin the endometrium and suppress ovulation. The common side effects include weight gain, bloating, acne, depression, irregular bleeding and decreased libido.
  • Gonadotropin-Releasing Hormone (GnRH) Agonists/Antagonists – Used to induce a temporary, reversible menopausal state by suppressing oestrogen. The common side effects include hot flushes, night sweating, vaginal dryness,
    mood swing, insomnia, bone mineral density loss, headaches and fatigue.
  • Levonorgestrel-Releasing Intrauterine System (e.g. Mirena IUD) – The common side effects include irregular bleeding, amenorrhoea, acne, mood changes and not suitable for patients trying to fall pregnant due to long-term contraception.
  • Non-steroidal Anti-inflammatory Drugs (NSAIDs) – Used for pain relief but not lesion suppression. The common side effects are gastrointestinal disorders, heartburn and increased risk of gastric bleeding.

The second-line treatments are surgical removal of lesions, cysts and adhesions with a laparoscopy. This is effective with improving pain and enhancing chances of fertility. However, the recurrence rate is high at 40-50% post-surgery (Su et. al.).

Especially, for younger females that still have high levels of oestrogen which can cause the endometrioma to grow back and possibly more aggressively than prior to surgery.

 

Untitled Design (17)Traditional Chinese Medicine (TCM) and Gynaecology

 

TCM has been used to treat gynaecological conditions since as early as the 2nd to 3rd century BCE. These early practices were documented in the Huangdi Neijing, the first known medical textbook in China. The text outline foundational concepts such as the seven-year developmental cycle of women and the interrelationship between Qi, Yin, Blood, and Essence in regulating menstruation and fertility.

In contemporary practice, these principles continue to inform clinical approaches. For instance, Jane Lyttleton dedicates an entire chapter to the treatment of endometriosis-related infertility in her textbook Treatment of Infertility with Chinese Medicine, which is widely used by practitioner students to integrate classical theory with modern clinical application.

 

 

Research on acupuncture reducing endometriosis related pain

 

A systematic review conducted by Chen et al. (2024) analysed data from 14 high-quality randomised controlled trials conducted in Australia, Brazil, China, and the United States. The review found that acupuncture was significantly more effective than placebo (sham acupuncture) in improving pain outcomes. The meta-analysis reported a large effect size (SMD = 1.10, p 0.001), and patients in the acupuncture group demonstrated a 25% higher response rate, indicating a greater likelihood of experiencing therapeutic benefits compared to those receiving placebo treatment.

Current literature highlights the potential of acupuncture as an effective intervention for managing endometriosis-related pain, particularly dysmenorrhoea. According to TCM pain arises when the flow of Qi and Blood is obstructed. Acupuncture works by
stimulating specific acupoints to restore the smooth flow of Qi and Blood, thereby alleviating pain and promoting balance within the body.

If you have been diagnosed with endometriosis and are experiencing pain, infertility or other symptoms, feel free to contact our clinic to discuss whether acupuncture may be a suitable option for you. You can call us on 0414 067 874 or if you would like to make a booking you can do so here.

 

This blog post was written by Dr. Wendy Le (TCM).

 

References:

Australian Institute of Health and Welfare. (2023). Endometriosis in Australia. https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia-2023/contents/summary

Chen, C., Li, X., Lu, S., Yang, J. & Liu, Y. (2024). Acupuncture for clinical improvement of endometriosis-related pain: A systematic review & meta-analysis. Archives of Gynaecology Obstetrics.

Su, C., Yang, J., Ding, J. & Ding, H. (2023). Factors that increase the likelihood of ovarian endometriosis relapsing after surgical excision: A systematic review and meta-analysis. Clinical and Experimental Obstetrics & Gynaecology.