Modern Causes and TCM Treatment of TCM 'Yinting' (Uterine Prolapse)

"Yinting" (prolapse of the vagina/uterus) is a gynecological disease that mostly occurs in middle-aged and elderly women who have given birth many times. It is a condition in which something bulges out of the woman's vagina, also called yintuo or yindu. It is often accompanied by accompanying symptoms such as weakness of the limbs, increased vaginal discharge, a bearing-down sensation in the lower abdomen, abnormal urination, and aching, cold lower back and knees. Some patients develop it during childbirth; its clinical symptoms correspond to uterine prolapse or vaginal-wall prolapse in modern medicine.

TCM holds that this disease belongs to a deficiency pattern, mostly caused by improper postpartum recuperation leading to insufficiency of central qi or insecurity of kidney qi, further triggered by other factors such as chronic cough or constipation. The true cause of the disease is relaxation of the cardinal ligament of the uterus. The cardinal ligament is formed by connective tissue and smooth muscle between the two layers of the lower broad ligament, extending from the uterine cervix to the lateral pelvic wall; its function is to maintain the normal position of the uterus and prevent it from prolapsing downward.

Women are prone to birth injury during pregnancy and childbirth, so they need at least 42 days of postpartum recuperation to recover. If a new mother (especially one who has given birth many times) takes up physical labor shortly after delivery, she can easily damage the cardinal ligament. Once the cardinal ligament is injured, it easily becomes loose and can no longer fulfill its role of fixing the uterus in its normal position.

Although TCM's understanding of the cause of this disease is not scientific enough, broadly speaking it also classifies it as a deficiency disease, treated mainly with Buzhong Yiqi Decoction, Da Bu Yuan Jian, and Renshen Yangrong Pill. This treatment has a certain effect. Patients unwilling to undergo surgery may first try this method; if it works, surgery can be avoided.