Endometriosis Acupuncture Point Protocols
Endometriosis is marked by active endometrial tissue growing outside the uterus. Endometriosis can impact the ovaries, uterine walls, fallopian tubes, ureters, bladder, vaginal wall, rectum, colon and even abdominal scar tissue. 10% of those assigned female at birth were diagnosed by laparoscopy with endometriosis (Viganò et al., 2004). When using ultrasound, MRI or histopathology, the prevalence of endometriosis increases to 18% (Moradi et al., 2021). A systemic review and meta-analysis published in 2023 suggests that ‘acupuncture treatment for endometriosis demonstrated clinically relevant improvements in pelvic pain’ (Giese et al., 2023). Most common points used were: lower abdominal points, SP6, LV3, ST36, SP10, SP9, LV8, KI10.
TCM Pattern: Kidney Yang Deficiency with Blood Stasis and Dampness
Presentation: Painful periods, abdominal pain which is relieved by warmth, mid-cycle hypogastric pain, lower backache, scanty or heavy periods, dark blood with clots, vaginal discharge, feeling cold, low libido, tinnitus, infertility.
Tongue: Swollen, Pale with Purple sides.
Pulse: Deep-Weak-Slippery-Wiry
Treatment Plan: 1x/wk, 3 months, face up and face down treatments within 1 session
Phase 1 - Menstruation: Invigorate Blood to Move Stasis
Acupuncture Point Selection - Face Up
Spleen 6 - 3 Yin Crossing—Invigorates (and cools) blood, Nourishes KD Yin, Blood, used for gynecology and genital pain problems, supports the spleen to revolve dampness, support blood formation, prolapse, reducing technique
Spleen 8 - Earth Motivator - Xi-Cleft—Stops pain, particularly blood stasis pain, moves blood, reducing technique
Stomach 29 - The Return—Used for blood stasis, used to warm cold menstrual disorders, stops pain, reducing technique
Kidney 14 - Four Full—Regulates the Chong and CV, moves accumulation of blood, reducing technique
Conception Vessel 3 - Utmost Middle - Mu of Bladder - Intersecting Point: SP, LV, KD —Regulates blood stasis, resolves damp, use with needle moxa
Acupuncture Point Selection - Face Down
Bladder 17 - Diaphragm Shu - Influential Point of Blood—Regulates blood, add BL19 to tonify Qi and Blood of Whole body “Four Flowers, (could consider BL18, BL20 to Tonify Qi + Blood with Moxa “Magnificent 6”), reducing technique
Spleen 4 and Pericardium 6 - Opens the Chong mai, move blood stasis, tonification technique
Herbal Selection: Harmonizing the Moon- Used for blood stasis in the Lower Burner, dampness in the Lower Burner, Kidney deficiency
Phase 2: Post Menstrual: Warm and tonify Kidney Yang, tonify Spleen Qi
Acupuncture Point Selection - Face Up
Kidney 3 - Greater Mountain Stream - Source Point —Tonifies kidney yang, qi, yin, essence, regulates uterus, tonification technique + moxa
Kidney 7 - Returning Current Jing-River, Metal —Tonifies kidney yang, strengthens Jing, tonification technique + moxa
Stomach 36 - Leg 3 Mile - He-Sea, Earth, Heavenly Star, Sea of Grain—tonifies spleen qi, command point for abdomen, tonifies qi, blood, wei and yuan, tonification technique + moxa
Conception Vessel 4 - First Gate - Mu of Small Intestine, intersecting Point: SP, LV, KD —Tonfies yin and yang, tonifies kidney yang, qi, jing, tonifies yuan qi, warms uterus, moxa
Acupuncture Point Selection - Face Down
Bladder 23 - Kidney Shu—Tonifies the kidney yang, supports all yin organs, useful for back pain, tonification technique + moxa
Bladder 52 - Will Chamber—Reinforces Kidney Shu, tonifies kidney yang, supports the kidney on spiritual emotional level, supports fertility, tonification technique + moxa
Governing Vessel 4 - Gate of Life—Warms the ming men, tonifies kidney yang, benefits essence, warms uterus, tonification technique + moxa
Bladder 20 - Spleen Shu—Tonifies the spleen, resolves damp, tonification technique + moxa
Herbal Selection: Unicorn Pearl -Used to tonify and warm Kidney Yang, nourish the Essence, strengthen GV, Chong and Dai Mai
Phase 3: Mid Cycle / Ovulation: Warm and tonify Kidney-Yang, tonify Spleen-Qi, resolve Dampness
Acupuncture Point Selection - Face Up - continue with phase 2 points as appropriate, but add accordingly to resolve damp
Conception Vessel 9 - Water Division—Promotes transformation of fluids, moves water stagnation, draining technique
Spleen 9 - Yin Mound Spring - He Se, Water—Resolves damp in lower jiao, regulates water passages, draining technique
Stomach 28 - Water Path—Opens water passages, moves fluid stagnation, regulates lower jiao, benefits uterus
Stomach 40 - Abundant Splendor - Luo—master point of phlegm, draining technique
Conception Vessel 5 - Stone Gate - Front Mu San Jiao—Benefits fertility, regulates water metabolism and utilization, superficial
Acupuncture Point Selection - Face Down - continue with phase 2 points as appropriate, but add accordingly to resolve damp
Bladder 22 - San Jiao Shu—Water metabolism and utilization to drain damp, draining technique
Lung 7 and Kidney 6 - tonify the Ren
Herbal Selection: Clear the Palace-Resolves phlegm, drains damp, invigorates blood
Phase 4: Pre-Menstrual - Invigorate Blood, eliminate stasis, resolve Dampness
Points from Phase 1 and 3 can be considered for Phase 4
Acupuncture Point Section - Face Up
Spleen 4 and Pericardium 6 - Opens the Chong mai, move blood stasis, tonification technique
Kidney 13 - Qi Hole—Moves qi, regulates Chong and CV, tonifies kidney and uterus, intersecting point of kidney and Chong, tonification technique
Kidney 14 - Four Full—Regulates the Chong and CV, moves accumulation of blood, resolves phlegm, intersecting point of kidney and Chong tonification technique
Kidney 16 - Vitals Correspondence—Harmonizes heart and uterus (bao mai), intersecting point of kidney and Chong, tonification technqiue
Liver 3 - Supreme Rushing - Shu-Stream, Earth, Source —Tonifies liver blood, spreads liver qi, moves stagnation, tonification technique
Herbal Selection: Harmonizing the Moon- Used for blood stasis in the Lower Burner, dampness in the Lower Burner, Kidney deficiency
References:
Viganò, P., Parazzini, F., Somigliana, E., & Vercellini, P. (2004). Endometriosis: epidemiology and aetiological factors. Best Practice & Research Clinical Obstetrics & Gynaecology, 18(2), 177–200. https://doi.org/10.1016/j.bpobgyn.2004.01.007
Moradi, Y., Shams-Beyranvand, M., Khateri, S., Gharahjeh, S., Tehrani, S., Varse, F., Tiyuri, A., & Najmi, Z. (2021). A systematic review on the prevalence of endometriosis in women. Indian Journal of Medical Research, 154(3), 446–454. https://doi.org/10.4103/ijmr.IJMR_817_18
Giese, N., Ki Kyung Kwon, & Armour, M. (2023). Acupuncture for endometriosis: A systematic review and meta-analysis. Integrative Medicine Research, 12(4), 101003–101003. https://doi.org/10.1016/j.imr.2023.101003
Lyttleton, J. (2004). Treatment of infertility with Chinese medicine. Churchill Livingstone.
Maciocia, G. (2011). Obstetrics and gynecology in chinese medicine. Churchill Livingstone.
Kim, H. (2007). Handbook of Oriental Medicine.
Su Wen Herbs | Herbal Formulas by Giovanni Maciocia®. (2018, August). Su Wen Herbs®. https://suwenherbs.com