Chronic Pelvic Inflammatory Disease
Overview
Chronic pelvic inflammatory disease is long-standing inflammation of the female upper genital tract (uterus, fallopian tubes, ovaries, and surrounding tissues), often following infection, causing persistent lower abdominal or pelvic pain, lumbosacral ache, abnormal vaginal discharge, pain during intercourse, and irregular menstruation, with a risk of infertility or ectopic pregnancy. Chinese medicine treats it under 'woman's abdominal pain' and 'discharge disease' (dai xia), with patterns of damp-heat and stasis, spleen deficiency with dampness, and qi stagnation with blood stasis.
TCM disease & pathogenesis
In TCM this appears under 'woman's abdominal pain', 'discharge disease' (dai xia), and abdominal masses (zheng jia). The site is the uterus, the chong and ren vessels, and the lower abdomen, involving the liver, spleen, and kidney together with damp-heat and toxic evil. After menstruation or childbirth the uterine vessels are empty, or hygiene is poor, so damp-heat and toxic evil invade and contend with qi and blood in the uterus, obstructing qi and injuring the ren and dai vessels, causing lower-abdominal pain and abnormal discharge. Over time dampness, heat, and stasis bind and pain results from blockage; recurrent episodes consume qi and blood and may lead to spleen-kidney yang deficiency with lingering evil. Treatment clears heat, drains dampness, transforms stasis, and moves qi to stop pain, tonifying where deficient; acute toxic-heat attacks require prompt biomedical treatment.
Pattern differentiation (clinical patterns)
Damp-Heat with Stasis Obstruction
Lower-abdominal distending or fixed stabbing pain, copious yellow discharge, lumbosacral ache, recurrent low fever, red tongue with yellow greasy coating, wiry rapid pulse.
Clear heat and drain dampness; transform stasis and stop pain.
Spleen Deficiency with Excess Dampness
White or pale-yellow copious thin discharge without strong odor, fatigue and poor appetite, loose stools, pale tongue with white greasy coating, moderate weak pulse.
Fortify the spleen and boost qi; raise yang and remove dampness.
Qi Stagnation with Blood Stasis
Distending stabbing lower-abdominal pain worse during menstruation, dark menses with clots, low mood, dark tongue with stasis spots, wiry rough pulse.
Move qi and quicken blood; transform stasis and stop pain.
Connections
Daily care & prevention
Keep the genital area clean and dry and avoid unhygienic practices; complete any prescribed antibiotic course and attend gynecology follow-up; rest during flare-ups, keep the lower abdomen and lower back warm, and avoid cold-raw food. Press Guanyuan (CV4), Zhongji (CV3), Sanyinjiao (SP6), Zusanli (ST36), Yinlingquan (SP9), and Xuehai (SP10). Acute worsening with fever requires urgent care.
When to seek medical care
Seek urgent care for high fever with chills, severe or worsening lower abdominal pain, purulent or foul vaginal discharge, abnormal vaginal bleeding, or pelvic pain with a known or possible pregnancy.