For generations, women with endometriosis suffered behind closed doors.
Marilyn Monroe lived with severe endometriosis at a time when women’s pelvic pain was rarely discussed publicly. Her experience has recently been brought into the light through the documentary End of the Cycle, connecting her largely hidden struggle with the experiences of women today.
The contrast with 2026 could hardly be greater.
Actress Lili Reinhart recently shared photographs from her hospital bed following laparoscopic surgery for endometriosis. She described years of pain, conflicting diagnoses and medical dismissal before finally finding a specialist who listened. Her statement that “believing women’s pain shouldn’t be revolutionary” captures something far bigger than one celebrity’s diagnosis.
Lena Dunham has also written with extraordinary openness about severe endometriosis, repeated operations and eventually undergoing a hysterectomy at 31. Her memoir Famesick places chronic illness inside the broader story of what it cost her to live and work in a body under relentless pressure.
This is more than an awareness campaign. It feels like a modern rebellion.
Women are angry. They are tired of being told that debilitating pain is simply part of having a period. They are tired of missing school, work, relationships, exercise and entire days of their lives, while being told their scans are “normal.” They are frustrated by fighting so hard to prove that something is wrong.
Endometriosis affects an estimated 10% of women of reproductive age worldwide, which is around 190 million people. It can cause severe menstrual pain, chronic pelvic pain, heavy bleeding, bloating, nausea, painful sex and infertility. Yet diagnosis and access to appropriate care remain painfully delayed and uneven.
The cultural shift we are seeing now is not simply about making endometriosis more visible. It is a demand for women to be seen as whole people, not as a troublesome collection of symptoms.
Entering the inner garden
Modern medicine has an essential role in endometriosis care. Specialist imaging, medication, hormonal treatment and skilled surgery can be enormously important. For some women, surgery is completely life-changing.
But many women emerge from the diagnostic and treatment process asking another question:
What can I do to support the health of my whole body while living with this condition?
This is where the Chinese medicine perspective can add something different.
Western medicine identifies the lesions, inflammation and anatomical changes. Chinese medicine also asks about the internal environment in which the symptoms are occurring.
How is the blood moving? Is the body warm enough? Is there enough energy to circulate, repair and recover? How is digestion functioning? What happens to the pain when a woman is exhausted, stressed or cold? Is the menstrual blood dark, bright, scanty, heavy, watery or clotted? Does the pain improve with warmth or become worse with pressure?
Chinese medicine does not see the body as a collection of separate departments. The pelvis is connected to digestion, sleep, circulation, stress, nourishment and the nervous system.
I often describe this as looking at the body’s inner garden.
A garden does not become healthy simply because we cut off the visible weeds. We also need to examine the soil, moisture, temperature, circulation, nourishment and changing seasons. In the same way, Chinese medicine asks what is happening within the body’s underlying terrain.
Importantly, Chinese medicine patterns are not literal biomedical explanations for endo lesions. They are a traditional framework used to understand the particular way pain and illness are presenting in an individual person.
The misplaced seed: Blood Stasis
Endometriosis occurs when tissue similar to the lining of the uterus grows elsewhere in the body, most commonly within the pelvis. It is a chronic inflammatory condition, not simply “period blood in the wrong place.”
In Chinese medicine, however, the severe pain, fixed location, dark menstrual blood and clots frequently associated with endometriosis may be understood as signs of Blood Stasis, or Xue Yu.
Blood is meant to move smoothly, like a river. When its movement becomes obstructed, it can begin to pool and stagnate.
Blood Stasis may produce:
- Fixed or stabbing pelvic pain
- Pain that is worse with pressure
- Dark or purple menstrual blood
- Large clots
- A dark or purplish tongue
- Pain in the same location each month
Blood Stasis is one of the central Chinese medicine patterns associated with endometriosis, but it is rarely the entire picture. The next question must always be: Why has the blood stopped moving properly?
The frozen river: Cold in the uterus
There is a well-known Chinese medicine principle:
If there is free flow, there is no pain. If there is no free flow, there is pain.
Cold contracts.
Think of water freezing in a hose or frost tightening the soil. Within the traditional Chinese medicine framework, Cold can constrict the vessels and impede the movement of Qi and Blood.
We may consider this pattern when menstrual pain is severe, cramping or gripping, and noticeably improves with a hot-water bottle, warm bath or firm pressure. The feet and lower abdomen may feel cold, and the menstrual blood may be dark and clotted.
Acupuncture, moxibustion and carefully chosen herbs may be used to warm the lower abdomen and encourage movement.
This does not mean that every woman with endometriosis has Cold. Some women show far more Heat and inflammation. Others have a combination of Cold, stagnation and deficiency. Treatment needs to reflect the individual landscape.
The trapped current: Liver Qi Stagnation
In Chinese medicine, the Liver is responsible for maintaining the smooth movement of Qi throughout the body and has a particularly close relationship with the menstrual cycle.
When this movement becomes constrained, we call it Liver Qi Stagnation.
A woman may experience bloating, breast tenderness, irritability, frustration, mood changes, headaches or pain that builds before the period.
Stress does not mean she caused her endometriosis, and endometriosis should never be reduced to “being too stressed.” Chronic pain itself places an enormous strain on the nervous system.
The Chinese medicine observation is simply that emotional and physical tension can affect the movement of the whole system. Pain creates tension, tension restricts movement, and restricted movement may make pain harder to manage. It can become a circle rather than having one simple cause.
Acupuncture may be used to encourage smoother circulation, settle the nervous system and reduce muscular guarding around the abdomen and pelvis.
Contemporary research suggests that acupuncture may help reduce endometriosis-related menstrual and pelvic pain and improve quality of life. However, the quality of the available research varies and stronger trials are still needed.
The depleted soil: Qi, Blood and Kidney Deficiency
Endometriosis can be profoundly exhausting.
Years of heavy bleeding, pain, inflammation, disrupted sleep, digestive disturbance, repeated procedures and the emotional burden of not being believed can deplete a woman’s reserves.
In Chinese medicine, this may appear as Qi Deficiency, Blood Deficiency or Kidney Deficiency. The garden has not only become congested. The soil itself has become depleted.
Signs might include:
- Persistent fatigue or brain fog
- Feeling weak during or after the period
- Dizziness or paleness
- Poor sleep
- Lower back weakness
- Digestive symptoms
- Reduced libido
- Difficulty recovering from pain, illness or surgery
This creates a difficult cycle. The body needs energy and nourishment to maintain healthy movement, but chronic pain and bleeding continue to drain those same resources.
Treatment therefore cannot focus only on “moving Blood.” Strongly moving treatment may be too much for someone who is already depleted. We may also need to nourish Blood, support digestion, restore warmth, improve sleep and rebuild the person’s strength.
This is one of the things I value most about Chinese medicine. Two women may arrive with the same biomedical diagnosis of endometriosis and receive very different treatments because their bodies are telling two completely different stories.
Changing the underlying terrain
The new visibility surrounding endometriosis is doing vital work. Women speaking openly, from Hollywood celebrities to the person sitting beside you at work, are dismantling the idea that severe menstrual pain should be silently endured.
Modern diagnosis and treatment matter. Appropriate medical investigation matters. Skilled surgery can matter enormously. Surgery can remove the end result quickly. It can excise lesions, release adhesions and create physical change where it is badly needed. Hormonal medications may also suppress the hormonal stimulation that drives symptoms. Chinese medicine should not be used to delay specialist care but once the immediate problem has been treated, there is still another important question to ask:
What was happening within this woman’s underlying terrain, and how can we begin changing that terrain now?
In Chinese medicine, we might call this changing the body’s underlying template.
If there is still Cold, poor circulation, Blood Stasis, digestive weakness, nervous system strain or deep depletion, then the broader pattern has not changed just because the visible end result has been removed.
It is a little like clearing a garden without changing the conditions that allowed it to become overgrown. Removing the weeds may be essential, but we also need to nourish the soil, improve the circulation of water, bring in warmth and sunlight, and create an environment that supports healthier growth.
This is where Chinese medicine comes in.
Acupuncture and Chinese herbal medicine allow us to work on both the symptoms a woman is experiencing now and the deeper pattern underneath them. Treatment may focus on warming what is cold, moving what has become stuck, calming what is overstrained and nourishing what has been depleted.
The aim is not simply to chase pain each month. It is to gradually shift the template from which the pain, stagnation and depletion are arising.
Chinese herbal medicine is always individually prescribed and should be managed by a qualified practitioner, particularly when someone is taking medication, preparing for surgery, undergoing fertility treatment or trying to conceive. Research into Chinese herbal medicine for endometriosis has shown some promising findings, but the evidence remains limited by small and lower-quality studies.
After more than 20 years in practice…
I do not see endometriosis as just a problematic period or a pelvic condition occurring in isolation. I see the pain, fatigue, digestive changes, interrupted sleep, fertility concerns, fear and years a woman may have spent questioning her own experience.
Surgery may remove what has developed. Medication may suppress the symptoms. These interventions can be necessary, valuable and sometimes completely life-changing.
Chinese medicine asks us to look underneath all of that.
It asks what needs to move, what needs to be warmed, what needs to be nourished and what needs to be restored. It helps us work on the inner terrain so that we are not only responding to the end result, but actively changing the template beneath it.
The silence around endometriosis is finally breaking.
Women deserve care that listens to the whole story and care that nourishes the whole person.
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