In the past few decades, Guixiong Xiaoyi formula has been widely used as a traditional medicine for the treatment of endometriosis. 9 The diversity of chemical components in traditional Chinese medicine (TCM) provides a great advantage for the treatment of multi-factor diseases such as endometriosis by adopting the unique therapeutic principle of “Multi-component and multi-target”. In recent years, traditional medicine, also known as complementary and alternative medicine (CAM), has become a common treatment option for endometrioid-related symptoms. 7, 8 However, these treatments do not produce satisfactory therapeutic effects, and are associated with considerable side effects. 4 Conventional treatment for endometriosis is to lower estrogen levels throughout the body 5, 6 using drugs, including progesterone, androgen, gonadotropin-releasing hormone (GnRH) agonists, and aromatase inhibitors.

2, 3 Many factors, such as retrograde menstruation, estrogen, and inflammation contribute to the etiology of endometriosis. 1 Approximately 20% to 50% of infertile women reportedly suffer from endometriosis, and approximately 30% to 50% of women with endometriosis are sub-fertile or infertile. Endometriosis is a common chronic disease in women of childbearing age, characterized by the presence of functional endometrial tissues outside the uterine cavity, especially in the ovaries, peritoneum, uterine and cervical ligaments, and rectovaginal sac.

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