Treatment for Endometriosis
1. Medication
Drugs are used to counteract or inhibit the periodic endocrine stimulation of ovary. At first, testosterone was used, which had more side effects and less efficacy, so it was gradually abandoned. Later, it gradually developed into pseudo pregnancy therapy and pseudo menopause therapy.
1.1 Pseudo pregnancy therapy
It is to use powerful progesterone contraceptive, take it continuously in a larger dose for a long time, so that menstruation stops. Endometrium and ectopic endometrium react like pregnancy under the action of drugs, so it is also called pseudopregnancy therapy.
1.2 Pseudo menopause therapy
Since the 1980s, a drug called Goserellin has been widely used. It can strongly inhibit the function of the ovary, make it almost lose its function, so as to achieve the purpose of treatment. Moreover, because this drug is a long-term sustained-release preparation, it only needs to be injected subcutaneously once a month, which is very convenient. This kind of medicine can cause endometrium atrophy, so it is called pseudo menopause therapy.
2. Surgical treatment
It is generally believed that the chocolate cyst on the ovary is usually large in volume, or the endometriosis nodule in other parts, whose volume is more than 2cm in diameter, which is not suitable for drug control but needs surgical treatment.
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If the use of drugs for six months or even a year can not produce an obvious effect, surgery should be considered.
If the patient is young and has no children, the endometriosis lesions are usually removed during the operation, while the uterus and normal ovarian tissue are preserved. It's called conservative surgery. The operation retains the possibility of fertility but has a greater chance of recurrence. If there are children and the patient is older than 35, the endometriosis can be removed at the same time, but the normal ovarian tissue can be preserved.
In the long run, the effect of this method is better than conservative operation, but it can not absolutely prevent recurrences. If the patient is near menopause, or endometriosis is too extensive to be eradicated completely, the uterus and ovary should be removed together during the operation.
In recent years, the wide application of laparoscopy has made the treatment of endometriosis have a new choice, especially in foreign countries, the combination of laparoscopic surgery and Goserelin has become a more and more extensive treatment program.
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3. Radiotherapy
Although radiotherapy has been used for endometriosis for many years, it has achieved a significant curative effect by using many kinds of drugs and operations and generally does not damage the ovarian function. The function of radiotherapy for endometriosis is to destroy the ovarian tissue, so as to eliminate the influence of ovarian hormones, make the endometrium atrophic, and achieve the purpose of treatment.
Radiation has no obvious effect on the destruction of ectopic endometrium, but it can not tolerate hormone treatment and because the focus is located in the intestine, urinary tract, and extensive pelvic adhesion, especially with serious diseases such as heart, lung or kidney.
Even if some patients receive radiotherapy, they must be diagnosed clearly first, especially the malignant ovarian tumor can not be misdiagnosed as an endometrial cyst in case of the wrong treatment.
4. Promoting pregnancy
Pregnancy is not only the main treatment goal for young patients but also the best treatment for endometriosis. Hormone inhibition could not increase the pregnancy rate. In order to change the environment of the pelvic cavity, we should check the tubal fluid under the laparoscope as early as possible, or resect or electrocoagulation the slight lesions under the microscope, so as to get pregnant as soon as possible.
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Once patients get pregnant, ectopic endometrial lesions necrosis atrophy, and may even be cured. For severe patients, the first operation, and take positive measures to help pregnancy. IVF-ET should be considered if the pregnancy is not successful, the patient is older, or there are obvious lesions and obstruction in the fallopian tubes.
5. TCM Treatment
According to traditional Chinese medicine, endometriosis belongs to the category of abdominal mass, and blood stasis is the main pathogenesis of endometriosis. In the formula of herbal medicine Fuyan Pill invented by Dr. Lee Xiaoping, there are more than 50 kinds of herbs, such as radix bupleuri, Poria cocos, Scutellaria, rhizoma atractylodis, yam, safflower, peach kernel, honeysuckle and so on.
These ingredients can not only effectively kill all kinds of bacteria, viruses, and pathogens, turn mycoplasma, chlamydia, and gonorrhea to negative, eliminate inflammation, but also activate blood circulation, effectively relieve the symptoms of local pain and irregular menstruation in patients with endometriosis. In addition, it can also help patients improve immunity so as to prevent a recurrence.
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