The best treatment for endometriosis

Among gynecological diseases, endometriosis is also a common one, which is more common in women of childbearing age. This disease causes great harm to women, affecting menstruation and causing female infertility. Good treatment methods are needed for endometriosis. What are the best treatment methods for endometriosis?

The best treatment for endometriosis

1. Medication

Endometriosis treatment uses drugs to resist or inhibit the regular endocrine stimulation of the uterus and ovaries. Initially, testosterone-type androgens were used, but due to their severe side effects and insufficient effectiveness, they have gradually been phased out. Later, it gradually developed into a pseudo-pregnancy treatment and a pseudo-menopause treatment.

(1) Pseudo-pregnancy therapy uses estrogen drugs, which are taken continuously for a long time in larger dosages to stop menstruation. The uterine wall and disordered uterine wall produce a reaction similar to pregnancy under the effect of the drug. Therefore, it is also called pseudo-pregnancy therapy. There are many drugs used for this type of treatment, and the trend is still developing. The main ones for oral administration include progesterone acetate, provira, and nemetone, while the ones for intramuscular injection include progesterone acetate. This type of treatment must last at least six months before the disordered endometrium can cease activity and eventually shrink, thus producing results.

(2) Pseudomenopause treatment Danazol is a male hormone compound that actually works well, but has relatively large side effects. At present, gonadotropin-releasing hormone inhibitors (GnRHa) are widely used. The most common one is goserelin. It can significantly inhibit the function of the ovaries, making them almost completely ineffective, thereby achieving the therapeutic purpose. Moreover, because this type of drug is a highly effective slow-acting herbal preparation, it only needs to be injected subcutaneously once a month, which is very convenient. This type of drug can cause the uterine wall to produce a condition similar to the endometrial atrophy of menopausal women, so it is called pseudomenopause treatment.

2. Surgical treatment

It is generally believed that chocolate cysts occurring on the ovaries are usually very large in size, or endometriosis masses occurring in other parts of the body with a diameter of more than 2 cm are not easy to control with medication and require surgical treatment; or if the condition does not improve after six months or even a year of medication, surgical removal should also be considered. If the patient is young and has no children, surgery usually involves removing only the endometriotic lesions, while preserving the uterus and normal ovarian tissue. This is called traditional surgery. This type of surgery preserves the possibility of pregnancy, but the chance of recurrence is high. If there are children and the patient is very old (over 35 years old), the uterus can be removed while removing the endometriosis, but the normal uterine and ovarian tissue can be preserved. This is called semi-traditional surgery. This method keeps pace with the times and is better than traditional surgical treatment, but it cannot guarantee the prevention of recurrence. If the patient is near menopause, or if the endometriosis is too extensive to be completely eliminated, the ovaries may be removed during surgery, a procedure called radical resection.

Symptoms of endometriosis

(1) Dysmenorrhea Dysmenorrhea is the most typical symptom of endometriosis. It is secondary and exacerbated idiopathically. It usually starts 1 to 2 days before the menarche, is most severe on the first day of the menstrual period, and then gradually eases and disappears when the menstrual period is over. In severe cases, the pain is unbearable, and even increased doses of analgesics are ineffective. The pain is caused by the internal bleeding of endometriosis irritating the local tissue inflammation. In addition, endometriosis increases the secretion of prostaglandins, causing uterine muscle atrophy, and menstrual pain will inevitably become more obvious.

(2) Irregular menstruation can be manifested as excessive menstruation or irregular menstrual cycles. Most of the causes of irregular menstruation are related to endometriosis affecting the ovaries. Patients with endometriosis may experience ovarian imbalance, such as abnormal ovulation.

(3) Infertility: Patients with endometriosis often suffer from infertility. The infertility rate among patients with endometriosis is 40% to 50%. The key is that endometriosis can often cause adhesions around the bilateral fallopian tubes, affecting the retrieval of oocytes; or uterine and ovarian changes can affect the ovulation period.

(4) Pain during sexual intercourse Endometriosis of the uterine duodenal pouch and the duodenal septum in the vagina can cause pain during sexual intercourse (shallow dull pain), increased frequency of bowel movements during menstruation, and pain (rectal prolapse).

(5) Other cases of endometriosis extending to the bladder may cause regular urination, urgency, pain, and hematuria. Endometriosis in abdominal scars and navel will cause regular local lumps and pain. Patients with gastrointestinal endometriosis may experience abdominal pain, diarrhea or constipation, and even regular small amounts of blood in the stool. When the disordered endometrium invades and compresses the urethra, unilateral low back pain and hematuria may occur, but this is extremely rare.