Endometriosis -- Drug Treatment Versus Surgical Treatment
Endometriosis is a condition in which the lining of the uterus grows outside the uterus, causing repeated bleeding, pain, infertility, and lumps.It is a common disease in females. At present, drug treatment and surgical treatment are the main means of handling endometriosis. According to the different clinical manifestations of the disease and the characteristics of the patient, different methods will be adopted.
＃Drug treatment＃
The mechanism of drug treatment for endometriosis is to inhibit endometriosis by controlling the endogenous hormonal environment. Because estrogen stimulation can lead to the occurrence and development of endometriosis, while both estrogen and progesterone receptors are present in ectopic endometrium tissue.
Although the pain and endometriosis development can be controlled, the side effects of medication can also occur. Therefore, medication should be appropriate, and attention should be paid to avoid excessive ovarian inhibition.
Improper selection of drugs and prolonged use of drugs may cause excessive inhibition of the gonad axis, delay the timing of pregnancy, and cause irreversible damage to female fertility.
For unmarried patients, or those temporarily without fertility requirements, or young patients with small lesions, the drug therapy can be used to prevent the development of endometriosis, reduce the activity of endometriosis lesions, and inhibit the formation of adhesions.
GnRH-A combined with reverse additive therapy is recommended for patients of reproductive age. Also, the herbal medicine Fuyan Pill is suitable for patients with endometriosis, that leads to no side effects on female body.
In addition, the current findings suggest that medical treatment for women with different stages of ectopic disease may not improve the natural pregnancy rate and may delay the treatment of infertility. For women who want to have children, the most common treatments are surgery and fertility assistance.
＃Surgical treatment＃
Evidence-based medical evidence indicates that for infertile patients with typeⅠ/Ⅱ endometriosis, laparoscopic surgery can be used to increase pregnancy rate. Disease staging and fertility index are scored during the operation.
The goals of this procedure include optimal treatment of visible and deep diseases, restoration of normal anatomical structures, and prevention of adhesions. The analysis indicated that the improvement rates for mild, moderate, and severe endometriosis caused by laparoscopic surgery are 100%, 70%, and 40%, respectively, and the recurrence rate is 20% at the beginning and 40% at subsequent procedures.
Due to the risks of surgery, repeated surgeries should be avoided whenever possible. Although there is no clear advantage of surgical excision, it seems possible to perform histological examination after excision and can help to avoid further damage. For these reasons, many people advocate removing endometriosis lesions whenever possible.
While many women think menstrual cramps are their fate, at least two-thirds of women diagnosed with endometriosis have significant menstrual cramps by the age of 20. Over such a long period of time, endometriosis can be progressive enough to disrupt many women's fertility. For their own health, female friends need to pay attention to dysmenorrhea and go to the hospital in time for medical treatment.
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