When we talk about chronic diseases, hypertension, diabetes, cardiovascular diseases, and so on may be the first things that come to mind. In fact, endometriosis, like other chronic diseases, has an insidious onset, complex etiology, and a long course of disease. And it requires long-term management and individualized treatment.

Delayed diagnosis of endometriosis is common.

 Normally, the endometrium only appears inside the uterine cavity. Endometriosis, on the other hand, simply means that the endometrial tissue appears outside the uterine cavity, such as in the ovaries, fallopian tubes, intestines, kidneys, lungs, and even in the brain and extremities.

Since the endothelial tissue can invade many parts of the body, the clinical symptoms of different patients are clinically diverse, commonly including chronic pelvic pain, dysmenorrhea, pain during sexual intercourse, difficulty in conception and even infertility.

According to statistics, the prevalence of the disease in women of childbearing age is about 10 to 15 percent. Nearly 200 million women worldwide are affected by endometriosis and the incidence has been rising significantly in recent years, while delays in diagnosis of such a highly prevalent disease are common.

Dysmenorrhea is the first manifestation of endometriosis, but most women do not consult a doctor immediately after the onset of dysmenorrhea, thinking that "dysmenorrhea is normal" and "it will pass if they tolerate it", which leads to a delay in the diagnosis of endometriosis.

Delayed diagnosis can affect the treatment and prognosis of the disease and increase the risk of recurrence. Therefore, when severe dysmenorrhea occurs, which cannot be relieved by medication, or when there are symptoms such as painful intercourse, irregular menstruation, or infertility, it is important to seek medical diagnosis promptly.

So why does endometriosis require long-term management?

Reason 1: With the biological behavior of a malignant tumor

Although endometriosis is a benign disease, it is like a malignant tumor, capable of planting, invasion, and distant metastasis, often involving the intestines, the urinary system and other important organs, and surgery is difficult to remove completely, so it is also known as the gynecological "benign cancer."

Reason 2: Unknown etiology or difficulty in removing the cause of the disease

Some studies have suggested that the occurrence of endometriosis is closely related to a variety of factors, such as reverse menstrual flow, immune abnormalities, genes, epigenetics, inflammation, etc., but the exact pathogenesis is unclear. As a result, endometriosis is incurable or difficult to eradicate.

Reason 3: Very recurrent

As an estrogen-dependent disease, patients are at risk of recurrence after conservative surgery as long as they are not removed from the estrogenic environment. In particular, recurrent endometriosis is generally difficult to cure with reoperation and has a greater impact on ovarian reserve function.

In short, endometriosis is a chronic disease with unknown pathogenesis, difficult early diagnosis, hard to cure, and prone to recurrence. A long-term management plan for patients can maximize pain relief, control disease progression, and prevent recurrence.

For endometriosis, doctors usually treat it this way:

I. Surgical treatment

Laparoscopy is the preferred surgical treatment, which can improve the fertility of young, mild to moderate endometriosis patients. However, surgical treatment cannot cure endometriosis, and some patients may still experience recurrence after surgery. Postoperative medication can reduce the risk of recurrence and minimize the systemic effects of endometriosis.

II. Drug therapy

Maximizing the therapeutic effect of drugs is the key to achieving long-term management of endometriosis or even lifelong management.

Currently, the main drugs commonly used in clinical practice for the treatment of endometriosis include non-steroidal anti-inflammatory drugs (e.g., ibuprofen) for pain relief, progestogens for endometrial atrophy (e.g., dienogest is the preferred choice for long-term use), oral short-acting contraceptives for inhibiting the hypothalamic-pituitary-ovarian axis, and gonadotropin-releasing hormone agonists.

However, as long-term use of these drugs may lead to some side effects, more and more patients are choosing Chinese herbal remedies. Composed of more than 50 kinds of pure natural herbs, Fuyan Pill has the effect of clearing heat and removing toxins, activating blood circulation and removing blood stasis, which can eliminate patients' menstrual cramps as well as other symptoms, and it will not bring any adverse effects to the body.

Of course, the long-term management of endometriosis requires the participation of the doctor and the patient. As a patient, you should do the following in the long-term battle against endometriosis:

1. Take an active role in learning about endometriosis. The more you know, the better;

2. Follow up regularly and for a long period, and cooperate with the doctor's treatment;

3. Adjust your mindset, increase confidence and be your health management expert.

Lastly, I would like to remind you that you should not have surgery if endometriosis can be controlled by medication. If it can be solved by one operation, you should avoid repeating it several times! In other words, if you have to have surgery, you should strive to have surgery only once in your life.

Recommended Readings:

Is Endometriosis Prone to Recurrence?

Can You Get Endometriosis Without the Uterus?

How Does Moxibustion Treat Endometriosis?