Editor’s Note: This is the third article in a series on pelvic health from a five-element perspective. Part 1 (“The Spirit of the Points and the Pelvis”) ran in the April 2025 issue; Part 2 (“The Wood Element and the Pelvis”) ran in the June issue; and Part 3 (“Fire and the Pelvis”) ran in the October issue.
The earth element is represented by the horizon, where the sun meets the sea. When we consider this element in ancient acupuncture tradition, it is situated as the center pole, with water to the north, fire to the south, metal to the west, and wood to the east.
Teachings on this element remind us that the earth is the source from which the other elements rise. Earth often represents home, harmony, balance, and equilibrium. Seasons of the earth element include equinoxes, solstices and of course, late summer.
One of my mentors likened the season of the earth element to any time when we cannot tell what season it is, such as an uncharacteristically warm day in December or snowfall in early May. Elements of balance are present in these moments of transition, like both sides of a coin.
Earth in Balance
Earth within us is our center. When balanced, it keeps us grounded and satisfied. Earth anchors us to the present moment. The organs of earth, spleen and stomach help us to digest; as well as to process and transport nutrients, thoughts and emotions. When out of balance, the earth element can jolt the whole system from its axis. This can lead to one being ungrounded, anxious, worried, and constantly seeking something outside of oneself.
Earth, when chronically out of balance, can yield a martyr – one who suffers and sacrifices for unattainable ideals. When considering treatment of the pelvic floor with acupuncture, the earth element can serve as a beacon light upon the balance point between the tangible-physical and spiritual-emotional.
The earth element has a strong connection with fertility, as Earth is the container for vibrant soil. Earth requires the perfect amount of hydration, so it does not dry and crack or become oversaturated. Earth in different climates facilitates the growth of different crops; it also supports the other elements with its own good health, regardless of the environment.
When dense in nutrients, properly hydrated, and packed to perfection, sprouts grow (wood), mature (fire), provide harvest (earth), compost (metal), and return to essence (water) to carry out the cycle once again. In the human body, the earth element supports each season of fertility. Its fertile nature shows in the flesh of the face, which, if a woman is fertile, would be slightly rosy with a glow. This presentation upon the face is a holograph of the health of the womb in perfect harmony.
The Pelvic Floor
Conversations about menstrual health, sexual health and bodily processes, while more common today than in previous generations, very rarely include education about the pelvic floor. The pelvic floor is often ignored, even in modern medical models. Acupuncture used in the treatment of the pelvic floor teaches our clients about the body. It awakens the systems, energies and sensations that one may not have names for, but can feel. Once this occurs and the pelvis becomes accessible, treatment outcomes improve.
It is quite common to encounter clients who can identify pain or discomfort within their back, hips or pelvis, but much less common for clients to be able to identify deeper patterns/causations beyond the pain or symptom. As acupuncturists, when we activate the subtle energy of the body, we help our clients to observe, witness, and become present and conscious of their body processes.
This presence and awareness within the patient’s body is their experience of the earth element. When body awareness is improved in the patient, there are opportunities for exponential results in clients with any type of pelvic floor pain or dysfunction.
Furthermore, when emotions overtake the body and injure the spleen qi or cause disruption in the ascending and descending of the stomach and spleen qi , heaviness and dampness can settle into the lower jiao or pelvic bowl. This heaviness can cause disruptions in digestion, elimination, bladder function, reproduction, and sexual health. In order to shift these patterns of dysfunction, we can target both the systems of the body and emotions.
Addressing the emotions of sympathy, worry, apathy, and anxiety while harmonizing the flow of the Ren, Du, Chong, Dai, spleen, and stomach will catapult any stagnation into action and transform heaviness into spaciousness.
Treating the Pelvis
Stomach and spleen points of the lower abdomen are points that I find widely beneficial in the treatment of pelvic health as viewed through the lens of the earth element. The transformation and transportation of qi, blood and emotions that the stomach and spleen provide are essential to optimal pelvic health. The following points have proved clinically relevant and effective in the treatment of the pelvis in my practice:
Spleen 13 (Fu She) – Bowel Abode/Official Residence: Located 0.7 cun laterosuperior to SP 12 and 4 cun lateral to the anterior midline (between CV 2 and CV 3), this point has a resonance of home or coming home. It provides a nurturing welcome to the spirit returning back into the body.
I think of this point as a sacred space where the spirit is seen, heard, held, loved, and accepted. This point is grounding and helps one find peace within themselves by remembering who they are. It is often needled for abdominal pain, abdominal masses, hernia or diastases recti, and anterior hip crease pain.
Spleen 14 (Fu Jie) – Abdomen Knot/Bind: Fu Jie is located 1.3 cun below SP 15 and 4 cun lateral to the anterior midline on the lateral side of the rectus abdominus. As its name suggests, this point helps one to unwind the discomfort of a knot in the stomach or an accumulation of unprocessed emotions.
Abdomen Knot softens the bind and allows a smooth flow of qi and nourishment. It frees one from the confines of their emotions. This point is extremely useful when someone is uncomfortable in their own skin. It regulates the flow of qi, and warms the abdomen and genitals.
Spleen 15 (Da Heng) – Great Horizontal/Human’s Horizontal: Da Heng, located 4 cun lateral to the center of the umbilicus (CV 8) and lateral to the rectus abdominus, brings one to the horizon, the center point of the world, to create stability and balance. This is a great point for someone who is ruminating or spinning with thoughts out of control.
I think of this point to be like a sunrise or sunset. When the sun ascends or descends, everything else quiets, which creates a sense of perfect harmony. SP 15 is very useful for imbalances of the intestines including constipation and diarrhea.
Stomach 28 (Shui Dao) – Water Way/Path: Located 2 cun lateral to the midline level with CV 4, Water Path transports the element of water to earth. It rectifies movement in the lower jiao, and elicits fluidity and grace.
This point can be extremely helpful for earth that is stuck or unmovable, as it is gently stimulating. It harmonizes fluids, which make it extremely useful for conception, menstruation and conditions that involve an imbalance of the bladder or bowels.
Stomach 29 (Gui Lai) – Return: ST 29, 2 cun lateral to the midline level with CV 3, can be considered as the essence of earth. It represents the return to one’s true nature. It can help bring one back to the truth, which is held in the deep spaces of the pelvic bowl.
This point reminds one of the harvest within and the great harvests of the past and the future. It grounds one into the energy of forward movement from the essence. In the TCM application ST 29 is used for the treatment of blood stasis, amenorrhea and uterine prolapse. It is commonly indicated for genital pain.
The points of the Stomach and Spleen meridians are centering, grounding and restorative. They provide the distressed earth element with the nourishment and support it craves.
