Uterine Fibroids and Adenomyosis — Combined Korean Medicine Management Based on Blood Stasis
Table of Contents
How uterine fibroids and adenomyosis differ
Uterine fibroids are benign tumors arising in the muscular layer of the uterus, found in 20–40% of women of reproductive age. Adenomyosis is a condition in which endometrial tissue grows into the uterine muscular layer, causing the uterus to enlarge as a whole. Both conditions present with heavy menstrual bleeding, menstrual cramps, and a feeling of pelvic pressure, and as they grow, they can become a cause of infertility.
Blood stasis (瘀血) — the shared pathological mechanism
Korean medicine views both uterine fibroids and adenomyosis as masses (jingga, 癥瘕) formed by the accumulation of blood stasis (eohyeol, 瘀血) in the uterus. Whether through qi stagnation (giche, 氣滯) blocking blood flow, cold pathogens (hansa, 寒邪) causing blood to congeal, or damp-heat (seupyeol, 濕熱) entangling with qi and blood, palpable masses gradually form over time. The basic principle of treatment is therefore activating blood and dispelling stasis (hwalhyeolhwaeo, 活血化瘀) — restoring circulation by dissolving stagnant blood.
Gyeji-bokryeong-hwan (桂枝茯苓丸)
Gyeji-bokryeong-hwan, recorded in the Jingui Yaolue, is a representative formula for removing uterine blood stasis. It consists of five herbs: cinnamon twig (gyeji), poria (bokryeong), tree peony bark (mokdanpi), peach kernel (doin), and white peony (jakyak). Cinnamon twig warms and circulates qi and blood, peach kernel and tree peony bark directly attack blood stasis, poria drains dampness, and white peony relieves pain.
- Heavy bleeding: Add cattail pollen (pohwang) and notoginseng (samchilgeun) to combine hemostasis with stasis-clearing
- Severe pain: Add corydalis (yeonhosaek) and lindera (oyak) to move qi and stop pain (haenggijitong, 行氣止痛)
- Mass over 5 cm: Add sparganium (samreung) and zedoary (bongchul) to strengthen the action of breaking masses and dispersing accumulations (pajingsojeok, 破癥消積)
Size monitoring and Korean medicine support before and after surgery
Fibroid size is tracked with ultrasound every 6 months. If the mass shrinks or stops growing after herbal treatment, management without surgery becomes feasible. When surgery is unavoidable, 2–4 weeks of preoperative herbal medicine reduces bleeding and stabilizes the uterus, leading to a smoother surgical course. After surgery, formulas that tonify deficiency and activate blood (boheohwalhyeol, 補虛活血) are used to support stasis discharge and uterine recovery.