TCM Treatment of Endometriosis: Pathogenesis, Mechanism and Clinical Practice

Endometriosis (EMs) is a chronic neuroinflammatory disorder prevalent in women of reproductive age characterized by heterogeneous clinical manifestations, while conventional Western therapies are limited by obvious adverse reactions and unsatisfactory long-term efficacy. In traditional Chinese medicine (TCM), endometriosis is categorized as "abdominal mass" and "dysmenorrhea", and qi stagnation and blood stasis is recognized as the core pathogenic basis. TCM exerts therapeutic effects on endometriosis mainly by suppressing NF-κB-mediated inflammatory cascades, modulating immune homeostasis, balancing sex hormone secretion and abnormal angiogenesis. Clinically, herbal compound prescriptions, acupuncture and combined TCM interventions can alleviate pelvic pain, shrink ectopic lesions and cut postoperative recurrence risks. Nevertheless, the clinical application of TCM is hindered by non-unified syndrome differentiation criteria and insufficient high-level mechanistic verification. This review concludes that TCM serves as a valuable adjunctive regimen for endometriosis management; however, standardized multi-omics mechanistic exploration, large-sample randomized controlled trials and integrated Chinese-Western therapeutic protocol optimization are urgently required to facilitate the standardized formulation and international recognition of TCM for endometriosis treatment.