Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Female, 33 years old, has had dysmenorrhea since her period at age 14. had two medical abortions at age 28 and 31. Now the dysmenorrhea is very, very severe, heavy menstrual flow, many, many clots, hard like meat, dark red, on the five days of the period all such clots. I’ve had many ultrasounds (about 5 times a year) and occasionally have a small amount of fluid, but the rest of the ultrasound report came back good for everything, no masses, inflammation or anything like that. Recently, I had 3 consecutive gynecological ultrasound, and the results of the 3 times are as follows: Note: Menstrual period: April 10-13, 2011, large amount of menstrual period, many blood clots and pain. Small abdominal pain a few days before the menstrual period. The third menstrual period: May 9-12, 2011, with heavy menstrual flow, clots and pain. Small abdominal pain a few days before menstruation. 13, 14 small amount of menstruation, small amount of hard clots, no dysmenorrhea. The ultrasound result on May 13, 2011 is as follows: Uterus: clear outline, bright edges, anterior position. The echogenicity of the uterine body is uniform, the anterior and posterior cervical diameters are 38 mm, and the thickness of the endometrium is 2 mm. CDFI:No abnormal blood flow signal was seen. No free fluid was detected in the rectal fossa of the uterus. Conclusion: No abnormalities in the uterus and bilateral adnexa. It is this period May 9-12, 2011 with heavy menstrual flow, clots and pain. I had pain in my abdomen for a few days before my period. 13, 14 a small amount of menstruation, a small amount of hard clots, no menstrual pain, but until now it has not stopped, about two hours a clot flows down, some menstrual blood. The duration of the period is significantly longer than before. There is also pain in my abdomen and a small amount of brown menstrual blood every time I ovulate. Dear Dr. Zhang, in your busy schedule, please analyze my situation carefully and see what is wrong with me! I’ve been to many doctors and taken many herbal medicines, but they didn’t work for long, and every time I had a period the pain was unbearable. Now I have been divorced for more than 2 years, no sex life and no children. Please, you must take a good look at me! If necessary I can go to your place and let you check it out personally. Thank you very much! I will be grateful to you for the rest of my life if I am cured! Jian Zhang, Department of Gynecology, International Peace Maternal and Child Health Hospital: Hello! After reading your medical history, I wonder if you have myometriosis or endometriosis? Because you are too far from Shanghai, you don’t need to come to Shanghai for a while, you can ask the local doctor to do an internal gynecological examination, if you really have endometriosis, usually the gynecological examination can be detected by the general doctor. Also, have you had your blood drawn for CA125 and CA199? Patient: Thank you very much, Dr. Zhang, for responding to my question during your precious time off. I’m going to the second hospital in Qinghai province on Wednesday to have a very famous doctor do a gynecological internal examination. I haven’t checked CA125, and CA199, so I’ll check them out by the way. I will let you know the results as soon as possible so that you can judge my condition correctly. Please tell me if the internal gynecological examination is a test where the doctor touches the vagina and cervix with his hand and presses on the abdomen. But after the pressure, my right ovary hurt for half a day. By the way, my period is almost over today and I still have a little blood clot, and it still hurts about the right ovary area. But that’s okay, I will go for the test as soon as possible and present the results to you. Thank you again! Have a good night! Jian Zhang, Department of Gynecology, International Peace Maternal and Child Health Hospital: Hello! I will contact you after the examination. Patient: Hello, Dr. Jian Zhang! I’d like to thank you for sacrificing your precious rest time for us patients who don’t know each other. I went to Qinghai Red Cross Hospital today, registered with a famous doctor, and had a gynecological internal examination as you suggested. The doctor said: smooth cervix, normal uterus size, only a little white discharge, slight pressure pain, typical dysmenorrhea, no abnormalities in the bilateral adnexa. Diagnosis: endometriosis. Prescription: Dysmenorrhea 2# soup 7 pills to be taken seven days before the regular period. Mafron contraceptive pill. I said should we check AC125,AC199, he said we don’t need it first. So I didn’t check it first. Dr. Zhang, after reading the above test results, do you think it is endometriosis? If so, in my case, I am currently single and cannot have a child right away. Is there any better way to deal with endometriosis other than getting pregnant? I’ve actually taken menstrual pain soup before and it didn’t really work. I can’t stand the monthly menstrual cramps and heavy periods! Now I am seriously anemic. With your years of experience in medicine, what should I do? Thank you so much! Jian Zhang, Department of Gynecology, International Peace Maternal and Child Health Hospital: Hello! You should try it for a month to see the effect.