Uterus
The Uterus (Zi Gong) is an Extraordinary Fu organ in TCM that governs menstruation, stores Blood and Essence, and nurtures the fetus during pregnancy. It possesses dual Yin-Yang characteristics—storing like a Zang organ while discharging like a Fu organ—and maintains vital connections to the Heart via the Bao Mai and to the Kidneys via the Bao Luo.
Five Element Correspondences
Season
None
Climate
Sensitive to Cold - The Uterus is particularly vulnerable to Cold pathogenic factors
Emotion
Joy and Sadness (via Heart connection) - Emotional states directly affect the Uterus through the Bao Mai
Color
N/A
Taste
N/A
Sound
N/A
Direction
None
Sense Organ
N/A - The Uterus as an Extraordinary Fu does not have a traditional sense organ correspondence
Body Tissue
N/A - The Uterus as an Extraordinary Fu does not govern a specific body tissue
Body Fluid
Menstrual Blood (Yue Jing)
Peak Hours
N/A - As an Extraordinary Fu, the Uterus does not have designated peak hours in the Chinese clock
Meridian
Penetrating Vessel
Educational content · Consult qualified TCM practitioners for diagnosis and treatment
Overview
The Uterus (Zi Gong, 子宫), also known as the "Baby Palace" (Bao Gong), holds a unique position in Traditional Chinese Medicine as one of the six Extraordinary Fu organs (Qi Heng Zhi Fu). Unlike the regular Zang-Fu organs, the Uterus possesses characteristics of both Yin and Yang organs—it stores Blood and Essence like a Zang organ, yet it also discharges menstrual blood and delivers babies like a Fu organ.
In TCM, the Uterus encompasses more than just the anatomical womb—it includes the entire reproductive system: ovaries, fallopian tubes, and cervix. This organ is considered the center of female reproductive health and is intimately connected to a woman's overall vitality and longevity. The proper functioning of the Uterus depends on three key factors: adequate Kidney Qi and Essence, the presence of Tian Kui (the reproductive substance that emerges at puberty), and the healthy flow of the Chong and Ren meridians.
The Uterus maintains special connections with the Heart via the Bao Mai (Uterus Vessel) and with the Kidneys via the Bao Luo (Uterus Channel). This Heart-Uterus connection explains why emotional states profoundly affect menstruation, fertility, and pregnancy in TCM theory.
Historical Context
The understanding of the Uterus in Chinese medicine dates back to ancient times, with the earliest records appearing during the Shang Dynasty (1500-1000 BCE). The foundational text Huang Di Nei Jing (Yellow Emperor's Classic, compiled around 100 BCE) established the Uterus as one of the six Extraordinary Fu organs and described its unique dual nature—storing like a Zang organ yet discharging like a Fu organ.
The Nei Jing's first chapter provided the classical description of female reproductive development in seven-year cycles, linking menstruation to the maturation of Kidney Essence and the emergence of Tian Kui. It also established the critical relationship between the Uterus and the Chong and Ren extraordinary vessels. Later texts, including the Yi Zong Jin Jian (Golden Mirror of Medicine, 1742), further clarified that the term 'Bao' refers to a structure found in both sexes—the Uterus in women and the 'Room of Sperm' in men—both housed in the lower Dan Tian (elixir field).
Throughout Chinese medical history, gynecology developed as a distinct specialty recognizing that women's physiology required specialized understanding and treatment. Classical physicians emphasized the importance of maintaining warmth in the Uterus, proper Blood flow through the Chong and Ren vessels, and emotional harmony via the Heart-Uterus connection.
Physiological Functions
Governing Menstruation
主月经 (Zhǔ Yuè Jīng)The Uterus is the organ responsible for producing and regulating menstruation. When Kidney Essence develops to maturity around age 14, Tian Kui (the reproductive substance) emerges, triggering the Uterus to begin its monthly cycle. Blood accumulates in the Uterus throughout the cycle; if pregnancy does not occur, this blood is discharged as menstruation—called 'monthly tide' (Yue Shui) in Chinese medicine because it follows lunar rhythms. This function continues until menopause around age 49 when Kidney Essence naturally declines.
Storing Essence and Blood
藏精血 (Cáng Jīng Xuè)The Uterus stores not only menstrual Blood but also Kidney Essence (Jing). This storage function is characteristic of Yin/Zang organs. The stored Essence and Blood provide the fundamental material basis for reproduction—nourishing eggs, building the endometrial lining, and creating an optimal environment for conception. This storing capacity makes the Uterus unique among hollow organs.
Conception and Gestation
孕育胎儿 (Yùn Yù Tāi Ér)When conception occurs, the Uterus transforms from a cyclically discharging organ into a nurturing container. It receives the fertilized egg, provides implantation, and houses the developing fetus throughout pregnancy. During gestation, menstruation ceases as Blood is redirected entirely to nourish the baby. The Uterus expands to accommodate fetal growth, supported by the Dai Mai (Girdle Vessel) which helps secure the pregnancy.
Delivering the Baby
分娩 (Fēn Miǎn)The Uterus performs the Yang/Fu-like function of discharging during childbirth. This transformation from Yin storing to Yang expelling demonstrates the organ's dual nature. After delivery, Blood is transported upward and transformed into breast milk for lactation. Once weaning occurs, Blood returns downward to the Uterus and menstruation resumes.
Relationships with Other Organs
Other
The Kidneys are the root of the Uterus's function. Kidney Essence (Jing) is the origin of menstrual Blood and Tian Kui—the reproductive substance that triggers puberty and enables fertility. The Uterus connects to the Kidneys via the Bao Luo (Uterus Channel). Kidney Yang provides warmth to the Uterus essential for conception and holding pregnancy, while Kidney Yin nourishes the Blood and eggs. Kidney deficiency is a primary cause of infertility, irregular periods, and menopausal symptoms.
Other
The Heart connects directly to the Uterus via the Bao Mai (Uterus Vessel). The Heart governs Blood and houses the Shen (spirit/mind), so emotional states profoundly affect menstruation and fertility. When Heart-Qi descends properly, menstruation is regular; when Heart-Qi is blocked by emotional distress, amenorrhea or irregular periods may result. This connection explains premenstrual emotional symptoms and why stress affects reproductive health.
Other
The Liver stores Blood and governs the smooth flow of Qi. During the premenstrual phase, Liver Qi stimulates Blood movement to initiate menstruation. The Liver meridian passes through the genitals and lower abdomen. Liver Qi stagnation commonly causes menstrual pain, breast distension, and emotional irritability before periods. Liver Blood deficiency leads to scanty periods.
Other
The Spleen is the source of Blood production through its transformation of food essence. Spleen Qi holds Blood within the vessels, preventing excessive menstrual bleeding. The Spleen also controls Dampness metabolism—when weak, Dampness and Phlegm can accumulate in the Uterus causing discharge, irregular periods, or infertility. The Spleen supports the Uterus indirectly through adequate Blood supply.
Other
The Pericardium, as the 'Envelope of the Heart,' connects to the Uterus through the Bao Mai. Pericardium conditions directly affect menstruation: Pericardium Blood deficiency causes scanty periods, Pericardium Fire causes heavy bleeding, and Pericardium Blood stasis causes painful periods. The Pericardium mediates the emotional-menstrual connection.
Common Pathological Patterns
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Tongue Manifestations
Tongue diagnosis provides important clues about Uterus conditions:
- Pale tongue: Indicates Blood deficiency affecting the Uterus, often seen with scanty, light-colored periods
- Purple or bluish tongue: Suggests Blood stasis in the Uterus, associated with painful periods and dark clots
- Pale-purple tongue: Indicates Cold in the Uterus with Blood stagnation
- Red tongue: Points to Heat in the Blood, causing heavy or early periods
- Swollen tongue with teeth marks: Reflects Spleen Qi deficiency with Dampness, potentially affecting the Uterus
- Thick greasy coating: Indicates Dampness or Phlegm accumulation that may obstruct the Uterus
Pulse Manifestations
Various pulse qualities reflect Uterus conditions:
- Choppy (Se) pulse: Indicates Blood stasis or Blood deficiency in the Uterus
- Deep (Chen) and Tight (Jin) pulse: Suggests Cold constricting the Uterus
- Slippery (Hua) pulse: May indicate Dampness or Phlegm in the Uterus, or pregnancy
- Thin (Xi) and Weak (Ruo) pulse: Points to Blood and Qi deficiency affecting reproductive function
- Wiry (Xian) pulse: Suggests Liver Qi stagnation affecting the Uterus
- Rapid (Shuo) pulse: Indicates Heat in the Blood affecting the Uterus
The Chi (cubit) position, particularly on the left side in women, is especially relevant for assessing Uterus and Kidney conditions affecting reproduction.
Clinical Relevance
The Uterus is central to treating all gynecological conditions in TCM, including menstrual disorders, infertility, pregnancy complications, and menopausal symptoms. Treatment approaches focus on warming the Uterus when Cold is present, moving Blood when stagnation exists, clearing Dampness when it accumulates, and nourishing Blood and Kidney Essence when deficient.
The Heart-Uterus connection via the Bao Mai has important clinical implications: emotional therapy, stress reduction, and treating the Heart are often essential components of gynecological treatment. Points that calm the Shen (spirit) are frequently combined with reproductive points. Understanding the Chong and Ren vessels is crucial, as these extraordinary meridians originate from the Uterus and directly regulate menstruation and fertility.
Modern clinical applications include treating dysmenorrhea, amenorrhea, PCOS, endometriosis, uterine fibroids, infertility, threatened miscarriage, and menopausal syndrome. Acupuncture protocols typically combine local points (Ren-3, Ren-4, Zi Gong), distal points on the Kidney and Spleen meridians, and points that regulate the Chong and Ren vessels.
Classical Sources
Huang Di Nei Jing Su Wen (Yellow Emperor's Classic)
Chapter 1 - Shang Gu Tian Zhen Lun女子七岁，肾气盛，齿更发长；二七而天癸至，任脉通，太冲脉盛，月事以时下
At seven years, a girl's Kidney Qi becomes abundant, her teeth change and hair grows longer; at fourteen (two times seven), Tian Kui arrives, the Ren Mai opens, the Chong Mai flourishes, and menstruation comes at regular intervals.
Huang Di Nei Jing Su Wen
Chapter 5 - Wu Zang Bie Lun脑、髓、骨、脉、胆、女子胞，此六者，地气之所生也，皆藏于阴而象于地，故藏而不泻，名曰奇恒之府
The brain, marrow, bones, vessels, gallbladder, and uterus—these six are born of Earth Qi, all stored in Yin and imaging the Earth, thus they store but do not discharge, and are called the Extraordinary Fu organs.
Huang Di Nei Jing Su Wen
Chapter 44 - Ping Re Bing Lun月事不来者，胞脉闭也...气上迫肺，心气不得下通，故月事不来也
When menstruation does not come, it means the Uterus Vessel is closed... Qi rises to harass the Lungs, Heart-Qi cannot descend, therefore menstruation does not come.
Huang Di Nei Jing Su Wen
Chapter 47胞络者系于肾
The Uterus Channel extends to (connects with) the Kidneys.
Modern References
Obstetrics and Gynecology in Chinese Medicine
Comprehensive text covering TCM gynecology including detailed discussion of the Uterus, Bao Mai, Bao Luo, and their clinical applications.
The Foundations of Chinese Medicine
Third edition includes thorough coverage of the Extraordinary Fu organs and the Uterus's relationship with the Zang-Fu organs.
Chinese Medical Gynaecology: A Self-Study Course
Practical guide to gynecological patterns and treatments with extensive coverage of Uterus pathology.