Menstrual Hell? Understanding Adenomyosis Through 'Accumulation and Gathering', an SOS From the Uterus

Let us explore how the concept of accumulation and gathering from the Donguibogam is understood in modern medicine. Adenomyosis, which leads to severe dysmenorrhea, menorrhagia, and uterine hypertrophy, is a condition where endometrial tissue penetrates into the myometrium and undergoes proliferation. Endometrial tissue, which normally belongs only inside the uterine lining, establishes itself in the muscular wall and causes multiple complications. What the Donguibogam describes as qi and blood stagnation or the buildup of blood stasis corresponds closely with this displaced tissue, along with the resulting inflammation and circulatory disorder. While the exact cause of adenomyosis remains unclear, multiple contributing factors are recognized. First, the displaced tissue tends to undergo proliferation in response to the female hormone estrogen, meaning it often worsens during phases of higher estrogen levels. When endometrial tissue infiltrates the muscularis, it thickens and bleeds along with each menstrual cycle. Because this hemorrhage occurs directly within the myometrium, dysmenorrhea becomes significantly worse and leads to menorrhagia. This process triggers a chronic inflammatory response within the uterus, prompting the excessive release of pain-inducing prostaglandin and causing intense pain. Furthermore, an abnormal increase in nerve fibers has been observed in the uterine tissue of patients with adenomyosis, heightening pain sensitivity so that even mild stimulation causes marked pain. It is comparable to a small skin wound becoming hypersensitive and aching at the lightest touch. As the uterus undergoes hypertrophy and the muscularis thickens, tissue elasticity declines, leaving many patients with dull pain or pelvic discomfort even between periods. Impaired blood supply to the uterus can also cause muscle cells to suffer damage and undergo fibrosis. These mechanisms provide modern support for the classical concepts of qi and blood circulation disorder and stagnant waste products described in the Donguibogam. Diagnosis is typically made using ultrasound or magnetic resonance imaging, and treatment approaches range from medication for pain control and hormonal therapy to surgery in severe cases. If you are experiencing this pain, consulting a specialist can help you find an approach suited to your condition.