Shao Fu Zhu Yu Tang
Specifically for Endometriosis
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Why it works for Endometriosis:
Pathophysiologic fit (TCM → biomed bridge): In TCM, Shao Fu Zhu Yu Tang (SFZYT) “warms the channels,” invigorates blood, and relieves lower-abdominal pain—a pattern often seen in endometriosis (cold + blood stasis). Ingredient lists and traditional actions are consistent across standard formularies. tcmwiki.com
Modern mechanisms (preclinical): In rodent endometriosis models, SFZYT reduced lesion size, microvessel density, and hypoxia markers; other studies report effects on angiogenesis (VEGF/PI3K/Akt/eNOS), inflammation (e.g., TNF-α), fibrosis, and gut microbiota, all processes implicated in endometriosis pain and recurrence. castoragev2.blob.core.windows.net
How to use for Endometriosis:
Core composition (10 herbs):
Xiao Hui Xiang (Foeniculi), Gan Jiang (Zingiberis), Yan Hu Suo (Corydalis), Mo Yao (Myrrh), Dang Gui (Angelica sinensis), Chuan Xiong (Ligusticum chuanxiong), Rou Gui (Cinnamomi cortex), Chi Shao (Radix Paeoniae rubra), Pu Huang (Typha pollen), Wu Ling Zhi (Trogopterorum faeces). tcmwiki.com
Typical preparation: Decoction of the above herbs (often ~6–10 g each for the main items; smaller for aromatics/warmers), taken once or twice daily. Patent granules/pills are also used. (Exact grams vary by patient; the classic prescription lists small unit amounts that are scaled in practice.) tcmwiki.com
Course & timing: In clinical studies, courses commonly last 1–3 months or several menstrual cycles, often as an adjunct to conventional therapy (e.g., with GnRH analogs, progestins, NSAIDs). The latest meta-analysis pooled 11 RCTs where SZD + conventional medicine outperformed conventional medicine alone on pain and biomarkers (details below). MDPI
Who’s a good candidate (TCM): Lower-abdominal cold/stasis pattern (e.g., fixed stabbing pain, clots, pain improved with warmth). Practitioners add/subtract herbs based on symptoms (e.g., damp/cold, qi deficiency, fertility goals). yibian.hopto.org
Scientific Evidence for Endometriosis:
Systematic review & meta-analysis (2025):
11 randomized trials (n = 1,186). Shao Fu Zhu Yu Tang + conventional meds vs conventional meds alone:
– Higher overall clinical response (TER) (OR 1.15, 95% CI 1.09–1.22)
– Lower CA-125 and pain (VAS) scores
– Similar rates of (mostly mild) adverse events; some trials reported lower recurrence with the combo.
Authors note methodological heterogeneity and geographic concentration; better trials still needed. MDPI
Preclinical confirmations:
– Rat model: SFZYT regressed lesions, reduced microvessel density and HIF-1α. rcastoragev2.blob.core.windows.net
– Mouse model (2024, Heliyon): SFZYT reduced ectopic lesion weight, modulated intestinal flora, and attenuated fibrosis. Cell
– Additional mechanistic/lab work supports anti-angiogenic, anti-inflammatory, and anti-fibrotic effects. pdf.hanspub.org
Specific Warnings for Endometriosis:
Because SFZYT “moves blood,” several safety points apply—especially in people seeking pregnancy or taking blood-affecting drugs.
- Pregnancy: Avoid/contraindicated. Classic sources caution use in pregnancy or in patients without blood stasis; myrrh (Mo Yao) in particular is likely unsafe in pregnancy due to uterine-stimulating effects. Wu Ling Zhi is also traditionally avoided in pregnancy. yibian.hopto.org
- Anticoagulants/antiplatelets & bleeding risk:
- Herbs that invigorate blood (Dang Gui/Angelica sinensis, Corydalis, Typha pollen/Pu Huang, Chuan Xiong) may potentiate bleeding with drugs like warfarin, DOACs, aspirin, clopidogrel. Documented cautions exist for dong quai (Angelica) and corydalis/berberine-containing herbs. Discuss with your doctor and pharmacist. WebMD
- Drug–herb interactions (selected):
- Corydalis (berberine) can interact with CYP-metabolized drugs, antidiabetics, antihypertensives, and others; separate from critical meds and monitor. WebMD
- Liver considerations: Cinnamon bark (Rou Gui) contains coumarin (potential hepatotoxicity in excess); berberine-containing herbs can affect liver enzymes—use supervised dosing, especially with liver disease. (See general herb–drug interaction resources.) SPS - Specialist Pharmacy Service
- Allergies & GI: Myrrh and Angelica can cause GI upset or allergic reactions in sensitive individuals. Memorial Sloan Kettering Cancer Center
- Quality & authenticity: As with many TCM formulas, adulteration and mislabeling occur; independent testing shows quality-control challenges even for related gynecologic formulas. Buy from reputable dispensaries that provide batch testing/COAs. Frontiers
- Diet/ethical notes: Wu Ling Zhi is an animal-derived ingredient (flying squirrel feces), which some patients may wish to avoid; plant-only modifications are sometimes used—discuss with your practitioner. tcmwiki.com
General Information (All Ailments)
What It Is
Shao Fu Zhu Yu Tang, translated as “Drive Out Blood Stasis in the Lower Abdomen Decoction,” is a classical Traditional Chinese Medicine (TCM) formula developed by Wang Qingren during the Qing Dynasty. It appears in his influential text “Yi Lin Gai Cuo” (Correction of Errors in Medical Classics). The formula is designed to invigorate blood circulation, dispel blood stasis, warm the womb, and relieve pain.
It is typically prescribed for conditions involving blood stasis in the lower abdomen, often associated with gynecological disorders such as dysmenorrhea (menstrual cramps), irregular menstruation, infertility, or pelvic pain. However, it can also apply to certain urological and lower abdominal disorders in men when there is evidence of cold-induced stagnation.
The formula usually contains herbs such as:
- Dang Gui (Angelica sinensis) – nourishes and invigorates the blood
- Chuan Xiong (Ligusticum chuanxiong) – promotes the movement of qi and blood
- Chi Shao (Red peony root) – cools and invigorates the blood
- Yan Hu Suo (Corydalis) – alleviates pain and moves qi and blood
- Mo Yao (Myrrh) and Wu Ling Zhi (Flying squirrel feces) – break up blood stasis and relieve pain
- Pu Huang (Cattail pollen) and Xiao Hui Xiang (Fennel fruit) – move blood and warm the lower abdomen
- Rou Gui (Cinnamon bark) and Gan Jiang (Dried ginger) – warm the meridians and dispel cold
How It Works
In TCM theory, pain and dysfunction in the lower abdomen often result from blood stasis combined with cold accumulation. Shao Fu Zhu Yu Tang works by targeting both of these pathogenic factors.
- Invigorates and moves the blood: Several herbs (Dang Gui, Chuan Xiong, Chi Shao, Mo Yao, Wu Ling Zhi) stimulate circulation and remove stagnant blood. This helps relieve pain and restore normal flow through the lower abdomen.
- Warms the channels and dispels cold: Herbs like Rou Gui, Gan Jiang, and Xiao Hui Xiang warm the uterus and lower jiao (lower body region), counteracting the constricting and stagnating effects of cold.
- Relieves pain and regulates qi: Yan Hu Suo and Pu Huang both move qi and blood, reducing pain associated with stagnation. The synergy of these ingredients provides analgesic and anti-inflammatory effects.
- Restores proper physiological balance: By promoting warmth and circulation, the formula enhances uterine health, improves menstrual flow, and supports fertility where cold and stasis are contributing factors.
Why It’s Important
Shao Fu Zhu Yu Tang holds significance because it addresses a common pathological pattern in women’s health: cold-induced blood stasis. Such conditions often underlie menstrual irregularities, chronic pelvic pain, or infertility that do not respond well to symptomatic Western treatments.
The formula’s importance lies in:
- Holistic action: It treats both the root (cold and stagnation) and the branch (pain and obstruction).
- Gynecological relevance: It’s especially beneficial for conditions like endometriosis, amenorrhea, dysmenorrhea, uterine fibroids, or chronic pelvic inflammation, when the presentation fits the TCM diagnosis of “cold stasis in the lower abdomen.”
- Complementary use: It can be integrated with modern medicine to enhance circulation, reduce inflammation, and manage chronic pelvic pain naturally.
By promoting smooth blood flow, it aligns with TCM’s core idea that “when there is free flow, there is no pain.”
Considerations
Although Shao Fu Zhu Yu Tang is potent and widely used, it requires careful consideration:
Pattern differentiation: It is suitable only for cases with blood stasis and cold. It should not be used for conditions involving heat, yin deficiency, or bleeding due to deficiency. Misuse may worsen symptoms.
Symptoms suggesting appropriateness: Lower abdominal pain that improves with warmth, dark or clotted menstrual blood, cold limbs, and a pale or purplish tongue with a choppy pulse indicate the correct pattern.
Contraindications:
- Not suitable during pregnancy due to strong blood-moving properties.
- Avoid in patients with heavy menstrual bleeding or signs of internal heat.
- Should not be used in cases of acute infection or inflammation with fever.
Modern medical caution:
- May interact with anticoagulant or antiplatelet medications, potentially increasing bleeding risk.
- Should be used under guidance of a qualified TCM practitioner or integrative physician to ensure proper diagnosis and dosage.
Duration and monitoring: Typically taken during the luteal or premenstrual phase (or as directed), but long-term use should be monitored to avoid overactivation of blood flow or depletion of qi and blood.
Helps with these conditions
Shao Fu Zhu Yu Tang is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Endometriosis
Pathophysiologic fit (TCM → biomed bridge): In TCM, Shao Fu Zhu Yu Tang (SFZYT) “warms the channels,” invigorates blood, and relieves lower-abdominal...
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