Ovarian cysts are one of the common gynecological diseases in women, especially prevalent among women of childbearing age. Many women feel anxious and confused when they learn they have ovarian cysts because their understanding of the disease is limited, and they have many questions about treatment options. This article will explore the causes, symptoms, treatment methods, and preventive measures of ovarian cysts from the perspective of integrated Chinese and Western medicine, and use real cases to help everyone better understand and cope with this disease.

1. Differences in Understanding Ovarian Cysts from Chinese and Western Medical Perspectives
Western Medical Understanding:

Western medicine categorizes ovarian cysts into functional and pathological types. Western medicine believes that ovarian cysts are largely related to hormones, which can stimulate cyst growth. However, Western medicine does not have many particularly effective treatments for ovarian cysts. If the patient is asymptomatic, Western medicine generally recommends observation until surgical criteria are met before proceeding with treatment.

• ​Classification: Functional cysts (such as follicular cysts), pathological cysts (dermoid cysts, endometriomas, etc.), diagnosed through ultrasound, laparoscopy, MRI, etc.
• ​Treatment Limitations: Asymptomatic observation, surgery recommended for cysts >4cm, but with a recurrence rate as high as 60%. Endometriomas can lead to infertility, and curettage can cause significant trauma.

Chinese Medical Diagnosis:

• ​Disease Name: Belongs to “Zheng Jia,” referred to as “Chang Tan” in the “Jin Gui Yao Lue,” essentially caused by the obstruction of the uterus by qi, blood, phlegm, and dampness.
• ​Core Pathogenesis:
  1. ​Deficiency of Vital Energy: Spleen and kidney yang deficiency leading to internal phlegm and dampness, as stated in the “Huang Di Nei Jing,” “Where evil gathers, the vital energy must be deficient.”
  2. ​Qi Stagnation and Blood Stasis: Emotional distress leading to liver depression, obstructing blood flow and forming masses.
  3. ​Phlegm and Dampness Stagnation: Polycystic patients with heavy phlegm and dampness, like “breeding in a swamp,” making conception difficult.

Here, let me tell you about the more common endometrioma. Have you heard of this term? Endometriomas can affect pregnancy, making it difficult to conceive. They form cysts within the uterus. Normally, menstruation should be completely discharged at the end of the period, but in patients with endometriomas, either there is persistent spotting after menstruation, or blood streaks appear a few days after menstruation ends. This is because endometriomas form structures similar to small holes or pits, and the blood that flows out is not bright red but brown. Due to the affected uterine environment, it naturally hinders pregnancy. Western medicine’s treatment for endometriomas mostly involves surgical removal or curettage, which can be quite harmful to the body.

However, if the cyst, fibroid, or tumor is large, I suggest surgical removal first, followed by Chinese medicine conditioning, which might yield better results. Because once a tangible evil has formed, relying solely on Chinese medicine to eliminate it may take a long time, possibly three months, six months, or even a year or two. With integrated Chinese and Western medicine, the advantage of Chinese medicine lies in enhancing the body’s immunity, boosting vital energy, and preventing disease recurrence.

I have treated many patients with cysts and fibroids, and they share a common characteristic: the symptoms keep recurring. Just as one area is removed, another area develops within half a year or a year, making it difficult to cure fundamentally. This is the limitation of Western medicine treatment in this aspect.

Next, let’s see how Chinese medicine views ovarian cysts.

In Chinese medicine, ovarian cysts belong to “Zheng Jia,” a term ancient people used to describe the accumulation of tangible blood, meaning the accumulation of tangible evil within the female reproductive system, including the uterus and ovaries. Chinese medicine believes that the core cause and pathogenesis of ovarian cysts, first, is “deficiency attracts evil,” where evil easily invades where vital energy is deficient. Therefore, the site where tangible evil forms is often where vital energy is weak, meaning, from a Chinese medicine perspective, the constitution of patients with ovarian cysts is declining. As we often say, when someone is down on their luck, even drinking cold water can get stuck in their teeth. When the body is weak, various diseases are more likely to occur. The healthier the body, the less likely it is to get sick, while those with weaker bodies are more easily troubled by diseases. Therefore, in treating ovarian cysts, one should not start with aggressive methods; even while expelling evil, one must also protect vital energy.

Secondly, qi stagnation and blood stasis, phlegm and dampness stagnation are common causes and pathogenesis of ovarian cysts. Different causes and pathogenesis manifest differently. Women with qi stagnation and blood stasis often have heavy menstrual flow and experience significant bloating and pain during menstruation. Patients with heavy phlegm and dampness have a typical characteristic of being overweight.

Many women trying to conceive may have heard of polycystic ovary syndrome. Generally, slimmer women with polycystic ovaries are more likely to get pregnant, while heavier women find it more difficult, because patients with heavy phlegm and dampness have more difficulty eliminating tangible evil within their bodies, like planting seeds in a swamp. The environment is poor, and the seeds may rot before they can sprout, making it relatively difficult for women with a phlegm and dampness constitution to conceive. In fact, in cases of qi stagnation and blood stasis, phlegm and dampness stagnation, there are often accompanying symptoms of kidney deficiency and essence depletion, and qi and blood deficiency. When treating such patients, one must focus on strengthening the body’s vital energy while using medications to resolve phlegm and dampness, qi stagnation, and blood stasis.

Moreover, these conditions may coexist in one person, with varying proportions of different factors. Some may have more deficiency symptoms, some more qi stagnation and blood stasis, and some more phlegm and dampness. Generally, those with more qi stagnation and blood stasis have less smooth qi flow; those with heavy phlegm and dampness tend to crave sweets and fruits because they have more internal dampness.

Symptom Comparison Table:

​Type	​Typical Manifestations	​Chinese Medicine Syndrome	Chinese Medicine Treatment
Endometrioma	Post-menstrual spotting, brown discharge	Cold congealing blood stasis	Invigorate blood and resolve stasis
Dermoid Cyst	Asymptomatic or lower abdominal mass	Phlegm and stasis intertwined	Resolve phlegm and disperse masses
Physiological Cyst	Resolves within 3 months	Primarily qi stagnation	Warm yang and promote diuresis

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​2. Chinese Medicine Differentiation and Treatment with Classic Formulas

1. ​Qi Stagnation and Blood Stasis Type
   • ​Manifestations: Pre-menstrual bloating and pain, clotted menstrual blood, dark tongue with stasis spots.
   • ​Main Formula: Gui Zhi Fu Ling Wan (Cinnamon Twig and Poria Pill) (Cinnamon Twig + Peach Kernel + Red Peony Root), invigorates blood and resolves stasis, safe for pregnant women.
   • ​Combined Medications: Paired with Tiao Jing Wan (Regulate Menstruation Pill) (containing Evodia Fruit, Angelica Sinensis), improves scanty menstruation.
2. ​Phlegm and Dampness Stasis Type
   • ​Manifestations: Obesity, excessive vaginal discharge, thick and greasy tongue coating.
   • ​Main Formula: Cang Fu Dao Tan Wan with Rhizoma Sparganii and Curcuma Zedoaria, resolves phlegm and disperses masses.
   • ​External Application: Angelica Dahurica + Gleditsia Spine Powder mixed with vinegar, applied for transdermal absorption to dispel dampness.
3. ​Spleen and Kidney Yang Deficiency Type
   • ​Manifestations: Fear of cold, cold limbs, frequent nocturnal urination.
   • ​Main Formula: Zhen Wu Tang combined with Dang Gui Shao Yao San, warms yang and promotes diuresis.

Before conditioning, let’s emphasize “treating the disease before it occurs.” The best scenario is that everyone does not develop ovarian cysts. To achieve “treating the disease before it occurs,” one must first maintain a happy mood, as an unhappy mood can easily lead to qi stagnation. Secondly, one should eat less sweets in their diet. The current society is different from ancient times, and such diseases were relatively rare in ancient medical texts.

I remember reading the medical cases of the famous doctor Wu Nanjing from Jiangsu and Zhejiang, which mentioned a local doctor who was very effective in treating infertility. He had a preventive recipe that involved stewing chicken with Angelica Sinensis, which was very effective in a time when resources were not abundant. But now, most families, mothers, and women trying to conceive are not lacking in nutrition. However, there are now many people with a phlegm and dampness constitution, which is also related to some modern societal concepts, such as the belief that eating fruits is good for supplementing trace elements and vitamins, but is that really the case?

Everyone can think about it. Therefore, one should eat less sweets and cold foods. If one cannot avoid these and does not exercise, the treatment effect may not be good.

A few days ago, I treated a patient in their early 20s who said they sweat a lot from their hands and feet and asked if it could be treated. After taking their pulse, I found it to be very weak and said it could be conditioned. When I asked about their sleep, they said it was okay, but when I asked what time they sleep, they said they go to bed at five or six in the morning. Upon hearing this, I directly told their parents that I couldn’t treat this condition unless they changed their sleep schedule. So, I think many people should realize that prevention is more important than treatment.

For ovarian cysts of the qi stagnation and blood stasis type, there is a very effective Chinese patent medicine that people who do not want to take Chinese herbs can try, called Gui Zhi Fu Ling Wan. It is very effective for uterine fibroids, uterine cysts, and other uterine diseases. There is another medicine that pairs well with it, called Tiao Jing Wan from Tong Ren Tang, suitable for those with scanty menstruation. The ingredients of Tiao Jing Wan are similar to the Wen Jing Tang mentioned in the “Jin Gui Yao Lue.” When treating tangible diseases of the ovaries and uterus, I most commonly use Gui Zhi Fu Ling Wan and Dang Gui Shao Yao San, which are quite effective. Gui Zhi Fu Ling Wan is convenient and can be taken by pregnant women, suitable for those with cysts, fibroids, or phlegm and dampness, qi stagnation and blood stasis. If the constitution is more deficient, taking it with Tiao Jing Wan will yield better results, which is a relatively universal method for conditioning cysts and fibroids.

Earlier, we discussed ovarian cysts of the qi stagnation and blood stasis type, phlegm and dampness stasis type, and spleen and kidney yang deficiency type, which might have been quite professional. I’m not sure if everyone could understand. If you have any questions or related concerns, feel free to raise them. You can also bring up viewpoints from health articles you’ve seen for discussion.

I suddenly remembered that today I treated a very interesting patient. He has a very weak constitution. Yesterday, he and his son each ate half an orange, and while his son was fine, he had diarrhea five or six times that day. Today, he came for treatment, and I told him that his constitution is not suitable for eating oranges, and I couldn’t treat this condition. I think when encountering unsuitable patients, one can choose not to treat them, because a person’s choices have a significant impact on their health and destiny. Some people are not ready to be cured yet.

Typical Cases:

• Case 1: Qi Stagnation and Blood Stasis Type Ovarian Cyst
• Patient, female, 32 years old, with ovarian cysts accompanied by dysmenorrhea and irregular menstruation. Through detailed questioning and pulse diagnosis, diagnosed as qi stagnation and blood stasis type. Treated with Gui Zhi Fu Ling Wan and Dang Gui Shao Yao San with modifications. Three months later, a follow-up ultrasound showed significant cyst shrinkage, and symptoms of dysmenorrhea and irregular menstruation improved.
• Case 2: Phlegm and Dampness Stagnation Type Ovarian Cyst
• Patient, female, 40 years old, with ovarian cysts, overweight, accompanied by scanty menstruation and fatigue. Diagnosed as phlegm and dampness stagnation type. Treated with Er Chen Tang and Cang Fu Dao Tan Wan with modifications, and advised to control diet and increase exercise. Six months later, a follow-up ultrasound showed cyst shrinkage and weight loss.
• Case 3: Integrated Chinese and Western Medicine Treatment
• Patient, female, 45 years old, with a large ovarian cyst accompanied by abdominal pain. The doctor recommended surgical removal first, followed by Chinese medicine conditioning. After surgery, treated with Chinese herbs and acupuncture. Three months later, a follow-up ultrasound showed no signs of recurrence, and abdominal pain symptoms were relieved.

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​3. 4 Essential Conditioning Points to Know

1. ​Dietary Restrictions
   • ❌ Sweets, cold foods (worsen phlegm and dampness)
   • ✅ Job’s Tears and Red Bean Porridge, Angelica Sinensis Stewed Chicken (strengthens spleen and promotes diuresis)
2. ​Sleep Management
   • Go to bed before 11 PM to avoid staying up late and damaging liver blood.
   • Case: 20-year-old patient with excessive hand and foot sweating due to staying up late, symptoms relieved after adjusting sleep schedule.
3. ​Exercise Recommendations
   • Perform the “Raise Single Arm to Regulate Spleen and Stomach” movement from Eight Brocades for 10 minutes every morning.
   • Avoid intense exercise that worsens qi stagnation.
4. ​Emotional Regulation
   • Mindfulness meditation + Rose Tea to soothe the liver and relieve depression.

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​4. Integrated Chinese and Western Medicine Treatment Strategies

​Stage	​Western Medicine Methods	​Timing for Chinese Medicine Intervention	​Advantages
Cyst >4cm	Laparoscopic surgery removal	Start Chinese medicine conditioning 1 week post-surgery	Reduces recurrence rate to 20%
Endometrioma	Pre-surgery GnRH-a medication to shrink cyst	Combined with acupuncture at Sanyinjiao and Guanyuan points	Shortens post-surgery recovery period
Post-surgery recurrence	Observation and waiting	Gui Zhi Fu Ling Wan + Moxibustion at Qihai point	Controls growth rate

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​5. Advanced Guide for Chinese Medicine Enthusiasts

1. ​Tongue Diagnosis Techniques
   • Initial diagnosis of dark red tongue with stasis spots → qi stagnation and blood stasis
   • Three weeks later, tongue coating turns white and greasy → increased phlegm and dampness, need to adjust formula.
2. ​Combination of External Therapies
   • ​Ear Acupressure: Use endocrine, ovary, and subcortex ear points, change weekly.
   • ​Herbal Foot Soak: Boil 15g of Mugwort and 5 slices of Ginger in water, soak feet for 20 minutes before bed to warm meridians and dispel cold.
3. ​Handling Structural Abnormalities
   • Uterine diverticulum causing prolonged menstruation: Diagnosed by ultrasound, treated with Chinese herbs and acupuncture at Guanyuan and Uterus points.

Core Quotes from the “Huang Di Nei Jing”

1. ​Idea of Treating Before Disease Occurs
   • ​Original Text:
     “Superior physicians treat disease before it occurs, not after it has occurred.” (“Su Wen · Four Seasons Adjusting the Spirit”)
     “Sages treat disease before it occurs, not after it has occurred; they treat chaos before it occurs, not after it has occurred.” (“Su Wen · Theory of Acupuncture”)
   • ​Interpretation: Emphasizes prevention as the primary approach, maintaining health through regulating diet, sleep, and emotions.
2. ​Theory of Yin and Yang and the Five Elements
   • ​Original Text:
     “Yin and Yang are the ways of heaven and earth, the root of all things, the parents of change, the beginning of life and death, the residence of the spirit.” (“Su Wen · Yin and Yang Corresponding to Phenomena”)
   • ​Interpretation: Yin and Yang balance is the foundation of health, and disease arises from their imbalance.
3. ​Functions of the Viscera and Nourishment
   • ​Original Text:
     “The five viscera all receive qi from the stomach, the stomach being the root of the five viscera.” (“Su Wen · True Viscera Theory”)
     “The heart is the official of the monarch, from which the spirit emerges.” (“Su Wen · Secret Canon of the Spiritual Orchid”)
   • ​Interpretation: The spleen and stomach are the foundation of acquired constitution, the heart governs the spirit, and nourishment requires regulating the functions of the viscera.
4. ​Theory of Emotions Causing Disease
   • ​Original Text:
     “Anger causes qi to rise, joy causes qi to relax, sorrow causes qi to dissipate, fear causes qi to descend, shock causes qi to become chaotic, and overthinking causes qi to stagnate.” (“Su Wen · Theory of Pain”)
   • ​Interpretation: Excessive emotions lead to qi disorder, which is the root of all diseases.

“Huang Di Nei Jing” Nourishment Aphorisms

• “Follow the laws of Yin and Yang, harmonize with techniques, regulate diet and drink, maintain regular daily routines, and avoid excessive labor.” (“Su Wen · On Ancient Heavenly Truth”)
• “Nourish Yang in spring and summer, nourish Yin in autumn and winter.” (“Su Wen · Four Seasons Adjusting the Spirit”)

Classic Quotes from the “Jin Gui Yao Lue”

1. ​Principles of Treating Miscellaneous Diseases
   • ​Original Text:
     “Superior physicians treat disease before it occurs, seeing liver disease, knowing it will transmit to the spleen, and thus first strengthen the spleen.” (“Viscera and Meridians, Diseases and Pulses”)
   • ​Interpretation: Emphasizes the laws of disease transmission and the importance of holistic conditioning.
2. ​Application of Classic Formulas
   • ​Gui Zhi Fu Ling Wan (“Treatment of Women’s Pregnancy Diseases and Pulses”):
     “Women with chronic masses, menstruation stopped for less than three months, with continuous bleeding… treated with Gui Zhi Fu Ling Wan.”
     ​Effects: Invigorates blood and resolves stasis, used for uterine fibroids, ovarian cysts, etc.
   • ​Wu Tou Tang (“Treatment of Wind and Joint Diseases and Pulses”):
     “Disease of joint stiffness, unable to bend or stretch, with pain, treated with Wu Tou Tang.”
     ​Effects: Warms meridians and dispels cold, treats cold and dampness causing joint pain.
3. ​Dampness Causing Disease and Treatment
   • ​Original Text:
     “Dampness injures from below, fog injures from above… clear evil resides above, turbid evil resides below.” (“Viscera and Meridians, Diseases and Pulses”)
   • ​Interpretation: Dampness can be cold or hot, requiring differential diagnosis and treatment, such as using warming and dampness-resolving methods for cold dampness.
4. ​Conditioning for Chronic Fatigue
   • ​Original Text:
     “Chronic fatigue with abdominal urgency, palpitations, nosebleeds, abdominal pain, nocturnal emissions, limb soreness, hand and foot heat, dry throat and mouth, treated with Xiao Jian Zhong Tang.”
   • ​Interpretation: Harmonizes Yin and Yang, nourishes qi and blood, improves symptoms of chronic fatigue.

“Jin Gui Yao Lue” Dietary Recipes

• Angelica, Ginger, and Mutton Soup: Warms and nourishes qi and blood, improves cold-deficient constitution.
• Lily and Rehmannia Decoction: Nourishes the heart and moistens the lungs, treats lily disease (anxiety and insomnia).