Treatment of postpartum endometriosis

In our daily lives, many women suffer from gynecological diseases due to various reasons, such as physiological hygiene problems or some unclean sexual life. Among them, postpartum endometriosis is a relatively common disease. The occurrence of such a disease is very harmful to women's bodies, so we must treat it in time. Let’s take a look at the treatment methods of postpartum endometriosis.

Symptoms of postpartum endometriosis

First, the occurrence of postpartum endometriosis is mainly because the endometrium does not appear in the place where it should appear, but has metastasized. The symptoms of endometriosis will manifest in menstrual disorders in women. In clinical practice, about 30% of patients will experience increasing menstrual flow and longer menstrual periods. Patients experience severe pain and distension before menstruation, and the pain may extend to the anus and thighs. In severe cases, they may experience cold limbs and vomiting. After menstruation, the pain will ease slightly and then disappear. Because some endometrial tissue may implant in the rectal pit, it may cause pain during sexual intercourse. However, 25% of patients with this condition may not have symptoms of dysmenorrhea.

Secondly, rectal irritation is also a common symptom of postpartum endometriosis. This is mainly because the endometrium is scattered in the rectal pit. Patients with endometriosis will feel the urge to defecate during menstruation, and experience swelling and pain in the anus and perineum, which causes pain in the waist and abdomen. The symptoms disappear after menstruation. Because endometrial tissue grows in an abnormal position, it may cause blockage of the fallopian tubes or the ovaries may not ovulate normally, reducing the chance of conception, so infertility is also one of the symptoms.

Treatment of postpartum endometriosis

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.

Women's health issues are issues that we cannot ignore, especially gynecological diseases that are more harmful to women. The above is an introduction to the treatment methods of postpartum endometriosis. Many women do not pay attention to their body care after childbirth, which is particularly prone to the occurrence of gynecological diseases and is also very harmful to the body.