How to treat endometriosis

  Some patients with endometriosis may be asymptomatic, while those with symptoms mainly present with lower abdominal pain, dysmenorrhea, infertility, discomfort during intercourse, and abnormal menstruation. Treatment aims to shrink and remove lesions, reduce and control pain, treat and promote fertility, and prevent and reduce recurrence. Treatment methods are as follows: 1. Expectant treatment: Patients with mild lesions with mild or no symptoms can take expectant treatment, such as regular review and symptomatic treatment of mild dysmenorrhea caused by lesions, by taking non-steroidal anti-inflammatory drugs such as indomethacin, diclofenac, ibuprofen, etc. However, since endometriosis can cause infertility, for patients who wish to have children and are infertile, they should be treated with medication or surgery as early as possible to induce pregnancy. After pregnancy, the ectopic endometrial lesions will shrink and the symptoms will be relieved or even cured after delivery.  2. Drug therapy: It is suitable for patients with chronic pelvic pain, obvious menstrual dysmenorrhea, fertility requirements and no ovarian cyst formation. Because NSAIDs can only relieve the symptoms and cannot stop the progress of the disease, hormonal drugs such as oral contraceptives, progesterone, mifepristone, progesterone, gonadotropin-releasing hormone (LHRH), etc. are needed to control the symptoms and slow down the progress of the disease.  3.Surgical treatment: For patients with ovarian endometriosis cysts whose symptoms are not relieved after drug treatment, whose local lesions are aggravated, whose fertility function is not restored or who are larger, surgical treatment is required. Laparoscopic surgery is currently preferred, and commonly used surgical procedures include surgery to preserve fertility, surgery to preserve ovarian function, and radical surgery.  In summary, patients with endometriosis who are asymptomatic or have mild symptoms can be treated expectantly; patients with fertility requirements can be treated medically or surgically; those who are ineffective with medication can be treated surgically with preoperative and postoperative adjuvant medication.