Endometriosis is a condition I am passionate about treating, in part because the conventional options, while important, sometimes leave women still in pain, exhausted, and searching for more. In over 20 years of working with women with endometriosis, one of the most common things I hear is: “I didn’t know acupuncture could help with this.”
Whether you’ve just been diagnosed, or have been managing this condition for years, if you’re wondering whether acupuncture and Chinese herbal medicine can help with endometriosis, I want you to know that the research has come a long way, and it deserves a fresh perspective.
Pain relief: where the evidence is strongest
A 2024 systematic review published in the Archives of Gynecology and Obstetrics found that acupuncture was associated with reductions in endometriosis-related pain and improvements in quality of life compared to control groups, with effects attributed in part to modulation of prostaglandins, beta-endorphins and inflammatory markers (1).
A 2025 systematic review and meta-analysis of 9 randomised controlled trials found that acupuncture as a standalone therapy was associated with significant reductions in pain intensity and improved clinical response rates in women with endometriosis-related pain (2).
Multiple studies have also found that acupuncture may reduce central sensitisation, the amplified pain response that develops in many women with chronic endometriosis over time (3). This is an important finding, because central sensitisation is one of the reasons endometriosis pain often feels disproportionate to the visible extent of the lesions.
Inflammation and CA-125 markers
Endometriosis is fundamentally an inflammatory condition, and some of the most interesting research looks beyond pain scores to inflammatory biomarkers. Research suggests acupuncture may down-regulate pro-inflammatory cytokines and support anti-inflammatory immune pathways (4). Clinically, this maps onto the reduction in CA-125 (a marker of endometriosis activity) seen in several herbal medicine studies, including the 2024 Gui Zhi Fu Ling Wan meta-analysis (5).
Herbal medicine: a longer research tradition
Chinese herbal medicine has a longer clinical research history in endometriosis than acupuncture. Gui Zhi Fu Ling Wan is the most studied formula: a 2024 meta-analysis of 9 ranomised controlled trials involving 897 participants found it was associated with reductions in pain scores, CA-125 levels, oestradiol and the size of endometriotic cysts when used alongside conventional treatment (5).
A 2025 meta-analysis found that combining acupuncture with Chinese herbal medicine produced better outcomes for endometriosis pain than herbal medicine alone, suggesting the two approaches have a synergistic effect when used together (6).
What we observe in clinical experience
Research averages don’t capture the variation between individuals within a population. Two women with stage 2 endometriosis can have completely different pain profiles, hormonal pictures and responses to treatment. A Chinese medicine diagnosis looks at the pattern behind the Western diagnosis, and the patten-based nuance is what allows treatment to be personalised rather than protocol-driven.
The evidence base for acupuncture in endometriosis is also still developing. Most studies are small, with heterogeneous populations and varying control conditions. This doesn’t necessarily mean the treatment doesn’t work, but perhaps the research hasn’t fully caught up with clinical experience yet!
Endometriosis is a condition I work with every day, and one needing better support. If you would like to understand how acupuncture and Chinese medicine might fit into your treatment picture, I’d love to hear from you. Book a consultation.
As an AHPRA-registered health practitioner, I am required to note that while these findings are promising, individual results vary and the research is still developing. Acupuncture and herbal medicine are complementary support, not a replacement for medical care or surgery where clinically indicated.
Written by Dr Mary-Jo Bevin (TCM) | AHPRA-registered Doctor of Chinese Medicine | 20+ years clinical experience in women’s health | Windsor, Melbourne.
References
1. Chen C, et al. Acupuncture for endometriosis-related pain: systematic review and meta-analysis. Arch Gynecol Obstet. 2024;310(4):2101–2114.
2. Yang F, et al. Acupuncture monotherapy for endometriosis-related pain: systematic review and meta-analysis. Medicine. 2025;104(34):e44005.
3. Lyu Z, et al. Neuroglial crosstalk and central sensitisation in acupuncture analgesia. Evid Based Complement Alternat Med. 2021;2021:8881557.
4. Zhang Q, et al. Mechanisms of acupuncture-electroacupuncture on inflammatory pain. Molecular Pain. 2023;19:17448069231202882.
5. Qin Y, et al. Guizhi Fuling pills combined with dienogest for endometriosis: meta-analysis. Medicine. 2024;103(49):e40528.
6. Xu Z, et al. Acupuncture combined with Chinese herbal medicine vs herbal medicine alone for endometriosis pain. Frontiers in Medicine. 2025.
