Endometriosis symptoms

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 03, 2024
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When women suffer from endometriosis, the typical symptom is progressively worsening dysmenorrhea. What is progressively worsening dysmenorrhea? It is mainly because the ectopic endometrial tissue also becomes congested, swollen, and sheds each month during menstruation, causing the ectopic lesions to gradually enlarge, thus making the dysmenorrhea increasingly painful. Some women may have ovarian endometriomas or ectopic endometrial lesions in the posterior cul-de-sac of the vagina, which can also cause severe pain during intercourse. Ovarian endometriomas can also affect the normal ovulation of the ovaries, leading to menstrual cycle disorders, such as irregular menstruation or increased menstrual flow, among other phenomena. Endometriosis can also alter the pelvic environment, leading to difficulties in conception for women.

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Written by Yue Hua
Obstetrics and Gynecology
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Does endometriosis need treatment?

Whether or not endometriosis requires treatment entirely depends on the patient's symptoms. If it is a mild case of endometriosis without severe symptoms, the patient can undergo regular follow-up visits. However, if the patient experiences severe abdominal pain during menstruation, it depends on whether the patient has reproductive demands. If there are reproductive demands, medication can be administered; clinically, high-dose progestogens are commonly used to prevent the ectopic endometrial tissue from continuing to grow. If the patient has no desire for childbirth and suffers from severe pain, a hysterectomy and bilateral adnexectomy may be performed.

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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.

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Written by Zhang Lu
Obstetrics
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What to do about dysmenorrhea caused by endometriosis?

There are two types of dysmenorrhea, primary dysmenorrhea and secondary dysmenorrhea. An important cause of secondary dysmenorrhea is endometriosis. The dysmenorrhea caused by endometriosis comes from specific diseases, and the interventions include the following aspects: First, symptomatic treatment should be conducted first, which means using pain relief medication to alleviate the pain. In clinical practice, various pain relief medications can be used for dysmenorrhea caused by endometriosis. Second, treatment should be aimed at the cause of the dysmenorrhea. Treatment for endometriosis currently includes both medicinal and surgical approaches. If surgical treatment is chosen, it can involve the removal of ectopic cysts or pelvic ectopic cysts, among other conditions; if medicinal treatment is chosen, methods such as pseudopregnancy or artificial menopause can be used.

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Written by Yue Hua
Obstetrics and Gynecology
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How is endometriosis diagnosed?

Endometriosis is a condition where the uterine lining grows outside of the uterine cavity, commonly seen in the pelvic region, particularly above the ovaries. Therefore, ultrasound (B-ultrasound) examinations are primarily used for accuracy. The ultrasound may reveal a large mass on one side of the fallopian tubes or ovaries, with uneven content inside. During the ultrasound, it can also be observed that the capsule of the mass is intact. Additionally, during a gynecological examination, the doctor may also feel a mass in the adnexa.

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Written by Zhang Lu
Obstetrics
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How is endometriosis diagnosed?

Endometriosis refers to the occurrence of endometrial tissue outside the uterine cavity, a common gynecological condition that often leads to painful menstruation, pain during intercourse, and infertility. Diagnosing endometriosis involves several approaches. First, inquire about the patient's clinical symptoms, including any painful menstruation and pain during intercourse. Second, a pelvic ultrasound should be performed to observe the situation inside the pelvis, assessing for any ovarian endometriotic cysts or pelvic endometriotic lesions. Third, a blood test for CA-125 can be conducted, as the levels of CA-125 tend to increase with endometriosis. Fourth, laparoscopy can be used to collect local tissue for pathological examination, which is the gold standard in diagnosing endometriosis.