How is endometriosis treated?

Written by Li Shun Hua
Obstetrics and Gynecology
Updated on September 22, 2024
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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 Xiu Rong
Obstetrics and Gynecology
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What tests are done for endometriosis?

Endometriosis is generally diagnosed through color ultrasound and CA-125 blood tests. If the endometrial tissue is located within the uterine muscle, it forms adenomyosis, at which point the ultrasound will show an enlarged uterus and uneven muscle wall echogenicity. Blood tests for the tumor marker CA-125, if elevated above the normal level of 35, generally indicate adenomyosis. If the endometrial tissue is located in the ovaries, it can form ovarian chocolate cysts, which are visible on the ultrasound as ovarian sections and echoes, with typical ultrasound reports indicating ovarian chocolate cysts. Therefore, routine examinations for endometriosis typically include color ultrasound and blood tests, which can confirm the diagnosis.

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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 Zhang Lu
Obstetrics
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Does endometriosis cause infertility?

Endometriosis is a common cause of infertility, primarily due to the ectopic implantation of endometrial tissue in the pelvic cavity or other locations. Endometriosis leads to infertility mainly because it affects ovarian function, such as causing ovulatory disorders. Additionally, endometriosis can cause pelvic adhesions, affecting the function of the fallopian tubes, such as their ability to pick up eggs. Women with infertility should be checked for endometriosis, and if confirmed, surgical or medicinal treatments can be considered to improve the condition and potentially increase the chances of conception. Therefore, endometriosis is a cause of infertility, and careful examination for endometriosis should be conducted in patients with infertility.

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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 Hou Jie
Obstetrics and Gynecology
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Does endometriosis require the removal of the uterus?

Endometrial displacement, depending on the specific location of the displacement, calls for different treatments. When the endometrial glands and stroma invade the myometrium, it is called adenomyosis. Treatment is based on the patient's symptoms, age, and fertility requirements. If there are fertility requirements, or the patient is near menopause, medicinal treatment can be tried to alleviate symptoms. For younger patients with adenomyosis who have reproductive needs, focal excision surgery can be considered. For patients with severe symptoms, who either have no reproductive needs or for whom medicinal treatment is ineffective, a total hysterectomy may be considered.