Exploring the Perturbation of Uterine Storage-Discharge Function by Mirena Based on the “Thoroughfare and Conception Vessel Impairment” Theory

Abstract

The levonorgestrel-releasing intrauterine system (Mirena) is widely used in gynecological practice. However, its adverse effects, such as irregular uterine bleeding and reduced menstrual flow, can be profoundly explained through the Traditional Chinese Medicine (TCM) theory of “Thoroughfare and Conception Vessel Impairment.” Based on the TCM theoretical system, this article proposes that Mirena, categorized as an “injury by metal blade,” directly affects the uterus, damaging the collaterals of the Thoroughfare and Conception Vessels, leading to “internal retention of static blood.” Its local warm and dry nature can also consume and damage Yin blood, and over time affect the Kidneys, forming the core pathogenesis of “Kidney Deficiency and Blood Stasis, Disorder of the Thoroughfare and Conception Vessels.” This ultimately disrupts the uterine storage-discharge function: inadequate storage manifests as scanty menstruation or amenorrhea, while excessive discharge manifests as profuse or prolonged uterine bleeding. Targeting this pathogenesis, TCM adopts the basic principle of “tonifying the Kidney, activating blood, and regulating the Thoroughfare and Conception Vessels.” Through staged pattern differentiation and dynamic intervention strategies, TCM can effectively regulate the storage-discharge function and reduce adverse effects, demonstrating the unique advantage of synergistic “toxicity reduction and efficacy enhancement” in integrated Chinese and Western medicine. This study provides a theoretical basis and practical pathway for TCM’s participation in the clinical management of Mirena therapy.