Endometriosis is a condition where Uterine tissue grows outside the Uterus, particularly on the ovaries or fallopian tubes and in the tissue lining the pelvis. In severe cases adhesions can occur on the intestines, bladder, vagina and abdominal surgery scars. It is believed to affect between 2–10% of woman of child-bearing age in the U.S. and is more common between the ages of 30–40. Around 50% of Infertile women have Endometriosis.

Symptoms include pain during menstruation, heavy menstruation, pain during intercourse, painful urination or defecation during menstruation, Infertility, and may also include nausea, diarrhea or irregular bowels. There is not a direct relationship between severity of pain and severity of disease as some woman with advanced endometriosis have little or no pain, while some with mild disease have severe pain.

In Traditional Medicine it is generally classed with Dysmenorrhea, or painful Menstruation. It can also fall under other headings such as Heavy Menstrual Bleeding. Some TCM doctors believe that when Dysmenorrhea has not responded to regular treatment, Endometriosis should be suspected.

Traditional treatment revolves around moving Blood and Qi and regulating Menstruation. If there is Damp/Phlegm or excess Heat, these should be treated also. In addition, deficiency of Qi or Blood should be treated simultaneously.

Most used TCM formula and Herbs

In a study of Taiwanese Databases in the treatment of ‘s of Endometriosis patients over a 5 year period (2008–2013) it was found that the most commonly used formula were:

• Gui Zhi Fu Ling Wan (28%)
• Dan Zhi Xiao Yao San
• Dang Gui Shao Yao San.

The most commonly prescribed herbs were:

• Cyperus rotundus Xiang Fu (18% of all formulas)
• Corydalis Yan Hu Suo (17%)
• Motherwort (Yi Mu Cao) (11%).

Acupuncture & Moxa

In a review of studies, the primary acupoints used for Endometriosis were: CV4 (30%), Sp6, CV6 and CV3, in descending order.. Needling with moxa (“warm needling”) was more effective (95%) than acupuncture alone (77%). Ginger Moxa on the above points along with ST36 and Zi Gong (Extra) had an effective rate of 95%. One study showed 100% effectiveness when Acupuncture and Chinese Herbal Medicine were combined.

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Special Formula

Dan’e Mixture
  Zedoary
  Salvia Dan Shen
This combionation was used in a clinical trial with an effective rate of 95%. (See research here)

Huangzhi Neiyi capsule
Rhubarb (Da Huang)   9 grams
Cyperus Xiang Fu  6 grams
Leech (Shui Zhi)  3 grams
This was formulated by a Professor of TCM for Endometriosis and has shown clinical efficacy. This has been compared to Gestrinone (a hormone commonly used in Endometriosis treatment) and found to be similarly effective. (see here)

Tong Jing Wan (Painful Menstruation Pills)
  Peach kernel (Tao Ren)
  Peony (Bai Shao)
  Salvia Dan Shen
  Typha Pu Huang
  Lindera Wu Yao
  Corydalis Yan Hu Suo 
  Dang Gui
  Cyperus Xiang Fu
  Ligusticum Chuan Xiong
  Safflower (Hong Hua)
  Panax notoginseng San Qi
Menstrual pain that is severe, sharp and stabbing in nature.

Dan’e-fukang soft extract
  Salvia Dan Shen
  Zedoary (E Zhu)
  Sparganum Sang Leng
  Bupleurum Chai Hu
  Dang Gui
  Licorice (Gan Cao)
  Corydalis Yan Hu Suo
  Paeonia Rubra Chi Shao Yao
  Cyperus Xiang Fu
It was the first TCM drug to receive National Drug Approval for the treatment of endometriosis in China.
Evaluation of Efficacy and Safety of Dan’e-Fukang Soft Extract in the Treatment of Endometriosis: A Meta-Analysis of 39 Randomized Controlled Trials Enrolling 5442 Patients

E Leng Capsule
  Zedoary (E Zhu)  2 parts
  Sparganium Sang Leng  2 parts
  Salvia Dan Shen   5 parts
  Paeonia Chi Shao   1 part
  Leech (Shui Zhi)  5 parts
  Turtle shell (Bie Jia)  5 parts
  Bitter Orange (Zhi Ke)  4 parts
  Dang Gui  3.4 parts
This is prepared as capules, each capsules containing extract equivalent to 1.6 grams. It is a prescription of the Guangdong Hospital of TCM and has been used for Endometriosis for a number of years.
Exploration of the Modulatory Property Mechanism of ELeng Capsule in the Treatment of Endometriosis Using Transcriptomics Combined With Systems Network Pharmacology

Fu Liu Pill
  Rhubarb (Da Huang)   90 grams
  Peach kernel (Tao Ren)  90 grams
  Dang Gui   80 grams
  Salvia Dan Shen   80 grams
  Notoginseng San Qi  60 grams
  Sparganium Sang Leng   60 grams
  Zedoary (E Zhu)   40 grams  
The herbs are powdered and formed into Honey pills. Dose is 6 pills three times daily. A course of treatment is 60 days. Within 1–6 courses of treatment, approximately 30% were cured, 26% markedly improved with a total effective rate of 92%.

Xiao Liu Fang
  fried Turtle shell (Bie Jia)
  Deer Horn (Lu Rong)
  Leech Shui Zhi
  Wingless Cockroach (Tu Bie Chong)
  Vaccaria Wang Bu Liu Xing
  Zedoary (E Zhu)
  steamed buns,
  Salvia Dan Shen
  China root (Tu Fu Ling)
  Codonopsis Dang Shen
  Ginger
Used for Endometriosis, Uterine Myone, Uterine Fibroids.

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Research:

1. Anti-Angiogenic Alternative and Complementary Medicines for the Treatment of Endometriosis: A Review of Potential Molecular Mechanisms
2. Novel Drug Targets with Traditional Herbal Medicines for Overcoming Endometriosis
3. Toxic Animal-Based Medicinal Materials Can Be Effective in Treating Endometriosis: A Scoping Review
4. Modular Characteristics and Mechanism of Action of Herbs for Endometriosis Treatment in Chinese Medicine: A Data Mining and Network Pharmacology–Based Identification
5. An Overview on the Conservative Management of Endometriosis from a Naturopathic Perspective: Phytochemicals and Medicinal Plants
6. The Complementary and Alternative Medicine for Endometriosis: A Review of Utilization and Mechanism
7. Complementary and Alternative Medicine for Dysmenorrhea Caused by Endometriosis: A Review of Utilization and Mechanism
8. The Formidable yet Unresolved Interplay between Endometriosis and Obesity
9. Phytoestrogens for the Management of Endometriosis: Findings and Issues
10. Length of Menstrual Cycle and Risk of Endometriosis: A Meta-Analysis of 11 Case–Control Studies
11. Possible therapeutic effect of royal jelly on endometriotic lesion size, pain sensitivity, and neurotrophic factors in a rat model of endometriosis
FORMULAS
12. Identifying Chinese Herbal Medicine Network for Endometriosis: Implications from a Population-Based Database in Taiwan
13. Meta-Analysis of Chinese Traditional Medicine Bushen Huoxue Prescription for Endometriosis Treatment
14. The Traditional Chinese Medicine Prescription Pattern of Endometriosis Patients in Taiwan: A Population-Based Study
15. A Review on the Mechanism and Application of Keishibukuryogan (Gui Zhi Fu Ling Wan)
16. Traditional Chinese medicine prescription Guizhi Fuling Pills in the treatment of endometriosis
17. Comparative efficacy and safety of traditional Chinese patent medicine for endometriosis
18. [Clinical and experimental study on the treatment of endometriosis with dan’e mixture].
19. Effect of Taoren Quyu Decoction on human endometrial cells and its anti-endometriosis activity in rats.