How to treat endometriosis in the pelvic cavity?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 22, 2024
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When women suffer from pelvic endometriosis and the symptoms are not too severe—for instance, if the pain is relatively mild—they can be clinically observed during menstruation. If dysmenorrhea occurs, oral administration of non-steroidal anti-inflammatory drugs such as indomethacin can help alleviate the symptoms. However, some women may experience more severe symptoms and may require pseudopregnancy treatment with drugs, such as oral contraceptives or progestin-based medications. Another approach involves using GnRH analogues, a method known as 'medical oophorectomy.' If symptoms are severe and treatments are ineffective, surgical intervention might be considered. Surgical options include electrocoagulation of endometriotic lesions in the pelvis, sharp or blunt dissection of adhesions, which can also improve the pelvic environment and potentially enhance fertility in women. (Note: Medication should be taken under the guidance of a doctor.)

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Endometriosis Clinical Manifestations

Endometriosis is clinically most evident in dysmenorrhea, which tends to worsen progressively. The clinical presentation varies depending on where the endometrial tissue is located. If the tissue is located on the ovaries, it can form ovarian chocolate cysts. Generally, chocolate cysts can affect fertility, leading to anovulation and the appearance of ovarian chocolate-like cysts. Treatment typically involves surgical intervention, which is characterized by a high risk of recurrence after surgery. If there is no immediate plan for pregnancy, there is also a possibility of recurrence. Additionally, if endometriosis involves the uterus, it can lead to a uniformly enlarged uterus and uneven uterine wall echoes, resulting in adenomyosis. Therefore, the most typical clinical manifestation of endometriosis is progressively worsening dysmenorrhea.

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Written by Zhang Lu
Obstetrics
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Is it easy to get pregnant with endometriosis?

Endometriosis, which has a relatively high incidence among women, refers to the condition where the endometrial tissue is located outside the uterine cavity. This condition can easily lead to infertility. Although endometriosis is a benign disease, it exhibits characteristics similar to those of malignant diseases, primarily manifesting as local infiltration that causes adhesions and can disrupt the function of the fallopian tubes and ovaries. First, it can lead to the presence of chocolate cysts on the ovaries, which can affect the ovulation function of the ovaries. Second, it can sometimes cause adhesions in the fallopian tubes or pelvic adhesions, affecting the egg-pickup function of the fallopian tubes. This prevents sperm and eggs from fertilizing within the fallopian tubes. Even if fertilization occurs, the impaired function of the fallopian tubes may also lead to an increased risk of ectopic pregnancy.

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Written by Yue Hua
Obstetrics and Gynecology
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Can endometriosis lead to pregnancy?

Endometriosis can lead to pregnancy, but about 50% of those affected may not conceive. This is because the disease can cause abnormal anatomical structures in the female pelvic, leading to extensive adhesions around the fallopian tubes, thus affecting the movement of the tubes. This, in turn, impairs their function in transporting the fertilized egg. Therefore, for patients wishing to conceive, it is advisable to monitor follicular development with an ultrasound and have intercourse during the ovulation period, which could increase the chances of pregnancy.

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Written by Li Shun Hua
Obstetrics and Gynecology
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How is endometriosis treated?

The treatment methods for endometriosis depend on the patient's age, the severity of symptoms, and whether they have childbearing requirements. For younger patients who wish to have children, conservative treatment methods are preferable, followed by ovulation induction therapy. For older patients with more severe symptoms, surgical treatment may be considered. If the patient does not have immediate childbearing requirements, a hormonal intrauterine device (IUD) can be placed in the uterus. This device releases progesterone and provides excellent treatment results for endometriosis. If the symptoms of endometriosis are severe, manifesting in pronounced dysmenorrhea, excessive menstrual bleeding, or ovarian cysts, then surgical treatment should be considered.

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Written by Zhang Lu
Obstetrics
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Causes of Infertility in Endometriosis

Endometriosis is a common gynecological disease that severely troubles women's daily lives. Besides causing painful menstruation, endometriosis is also a common cause of infertility. The reasons for infertility caused by endometriosis include the following aspects: First, endometriosis often leads to the formation of chocolate cysts on the ovaries, which can affect ovarian function and cause impaired ovarian function. Second, endometriosis can sometimes affect the function of the fallopian tubes, causing adhesions in the fallopian tubes. This may result in difficulties in egg pickup, preventing the sperm and egg from meeting and forming a fertilized egg in the fallopian tubes, leading to infertility.