What are the clinical manifestations of endometriosis?

In our daily life, having a disease is not terrible. If it can be treated in time, the disease can be recovered well. Especially gynecological diseases have a great impact on women's physical and mental health. Among them, endometriosis is a relatively common disease. If it can be treated in time, it can greatly help women recover their health as soon as possible. However, if we want to detect the disease in time, we must know more about its clinical manifestations. Let’s take a look at the clinical manifestations of endometriosis.

What are the clinical manifestations of endometriosis?

1. Dysmenorrhea

Dysmenorrhea is the most typical symptom of endometriosis. It can occur before, during, or after your period. In severe stages, the pain is unbearable and increasing the dosage of analgesics may not even be effective. The pain is caused by internal bleeding from endometriosis stimulating local tissue inflammatory response. Endometriosis lesions secrete more prostaglandins, which causes uterine muscle contractions and makes dysmenorrhea more pronounced. After menstruation, bleeding stops and pain is relieved.

2. Abnormal menstruation

It may present as heavy menstruation or irregular menstrual cycles. Most of the menstrual abnormalities are related to the impact of endometriosis on ovarian function. Patients with endometriosis may experience ovarian dysfunction, such as abnormal ovulation.

3. Infertility

Infertility is common in women with endometriosis. Cause: Endometriosis can often cause adhesions around the fallopian tubes, affecting the pickup of oocytes; or ovarian lesions can affect ovulation.

4. Pain during sexual intercourse

Endometriosis in the rectouterine fossa and vaginal rectal septum may cause dyspareunia (deep tenderness) and frequent, painful bowel movements (tenesmus) during menstruation.

5. Others

Bladder irritation symptoms: When endometriosis spreads to the bladder, there will be periodic frequent urination, painful urination, and hematuria. Endometriosis in abdominal wall scars and umbilicus causes periodic local lumps and pain.

treat

1. Medication

Drugs are used to counteract or suppress cyclical endocrine stimulation of the ovaries. Initially, testosterone-type male hormones were used, but they had serious side effects and were not strong enough, so they were gradually abandoned. Later, it gradually developed into pseudo-pregnancy therapy and pseudo-menopause therapy.

(1) Pseudo-pregnancy therapy is the use of powerful progestin contraceptive drugs, which are taken continuously for a long time in larger doses to stop menstruation. The endometrium and ectopic endometrium undergo a pregnancy-like reaction under the action of the drugs, so it is also called pseudo-pregnancy therapy. There are many drugs used for this therapy, and they are still being developed. The main ones for oral administration include progesterone acetate, provira, and nemethicone, while the ones for intramuscular injection include progesterone caproate. This treatment must be continued for at least six months before the ectopic endometrium can stop moving and eventually shrink, thus producing therapeutic effects.

(2) Pseudomenopause therapy In the 1970s and 1980s, foreign countries mainly used a drug called danazol, which is a derivative of androgen and has a good effect. It is also being used in my country, but it has relatively large side effects. Since the 1980s, a drug called goserelin has been widely used abroad. It can strongly suppress the function of the ovaries, making them almost completely ineffective, thereby achieving the purpose of treatment. Moreover, since this drug is a long-acting sustained-release preparation, it only needs to be injected subcutaneously once a month, which is very convenient. This type of drug can cause the endometrium to atrophy similar to that of menopausal women, so it is called pseudomenopause therapy.

2. Surgical treatment

It is generally believed that chocolate cysts occurring on the ovaries are often larger in size, or endometriotic nodules occurring in other parts of the body with a diameter of more than 2 cm are difficult to control with drugs and require surgical treatment; or if the condition does not improve after six months or even a year of drug treatment, surgical removal should also be considered. If the patient is young and has no children, surgery usually only removes the endometriosis, while preserving the uterus and normal ovarian tissue. It's called conservative surgery. This surgery preserves the possibility of fertility, but the chance of recurrence is greater. If the patient already has children and is older (35), the uterus can be removed at the same time as the endometriotic lesions are removed, while preserving the normal ovarian tissue. In the long run, this method is better than conservative surgery, but it cannot absolutely prevent recurrence. If the patient is near menopause, or the endometriosis is too extensive to be completely eradicated, the uterus and ovaries should be removed during surgery.

The above is an understanding of the clinical manifestations of endometriosis. By understanding these contents, we can also discover the disease more urgently and actively treat it. In fact, in life, there are many gynecological diseases in the early stages of the disease will have some abdominal pain or abnormal leucorrhea and irregular menstruation and other different symptoms. Therefore, we must observe our body changes more often and seek medical attention in time if we find any abnormalities.