The normal endometrium: not too thick, not too thin, growing quietly, shedding gently, every month week after week, she can prophesy the future and nurture life. But once out of control, running where she doesn’t belong, the uterine cavity is covered with endometrium and beyond the uterus, setting off an immune storm that grows, infiltrates and bleeds once for each menstrual period, and so on repeatedly leading to secondary pain, infertility and pelvic masses! It can occur anywhere at any time: 1. Endometriosis: leading to dysmenorrhea and adhesions! 2. ovarian endometriosis cysts: destroy ovarian function, affect ovarian ovulation, adhesions wrapping the ovaries and fallopian tubes leading to infertility! 3, adenomyosis: dysmenorrhea, heavy menstrual flow, anemia, enlarged uterus, miscarriage! 4, ureteral endometriosis: leading to ureteral dilatation, hydronephrosis and even renal atrophy! 5.Distant: lung, pleura, chest pain or hemoptysis per menstruation! 6, deep infiltration: rectum, vaginal vault, etc., dysmenorrhea, painful intercourse, chronic pelvic pain! Pain! Pain! Such a powerful disease, with an unknown pathogenesis, no perfect preventive measures and no complete cure, the only thing we know about him is that he needs comrades in arms – sex hormones! Many patients have ultrasound examinations suggesting only endo-ovarian cysts or adenomyosis, but in the minds of our specialists, the lesions are never just that, because small lesions cannot be revealed by ultrasound. Whether it is endometriosis I, II, III or IV can only be clarified by surgical exploration. Dr. Xiao Zhai followed the director to do several stage IV endometriosis, and the feeling is: So we need to start to disassociate and control his comrades – sex hormones before his wings are full: Drug treatment: those without infertility and without adnexal masses. Inhibit ovarian function, lower sex hormone levels, stop the development of endo-anomalies, reduce the activity of endo-anomalous lesions and reduce the formation of adhesions. 1. Non-steroidal anti-inflammatory drug (NSAID) once every 6 hours. Side effects: Gastrointestinal reactions and gastric ulcers. 2.Compound oral short-acting contraceptives Used continuously or in cycles for more than 6 months to inhibit ovulation and reduce sex hormone levels. It is the best treatment drug for adolescent endometriosis. Side effects: less, >40 years old use need to be alert to blood clots. 3.High-efficiency progestin Used continuously for more than 6 months to make ectopic endometrium shrink. Side effects: breakthrough bleeding, breast swelling and pain, weight gain, gastrointestinal discomfort and abnormal liver function. 4.Androgen derivative progesterone Side effects: masculine features, increased hair, thickened voice, liver function damage and weight gain. gnRH-a: the fiercest fighter Injected once a month for 3-6 months, causing temporary menopause, lowering sex hormone level and promoting atrophy of endometriotic lesions. Ovarian function can be restored after stopping the drug, so there is nothing to fear! Side effects: Menopausal symptoms will occur, this is very unpleasant, drink more Mrs. Jingxin oral liquid is useless! Sometimes you can only add some estrogen in reverse! Surgical treatment: combined with infertility, adnexal mass > 4cm, painful menstruation drug treatment is ineffective. Surgery is the gold standard for the diagnosis of endo, and the best treatment option for combined infertility, but this step is not what the patient wants: surgical debridement of ovarian endo cysts, excavation of adenomyosis lesions, separation of adhesions, restoration of normal anatomical position, electrocoagulation of pelvic endo lesions, the further the surgical staging, the more difficult the surgery, the greater the damage and the greater the possibility of recurrence! Because recurrence can still occur after surgery, follow-up medication is still needed. The most important question: What if I have endometriosis before I have had a child? If the lesions are small and you are planning to get married and have children in the near future, it is recommended to prepare for pregnancy as early as possible because the naturally elevated progesterone after pregnancy can also inhibit the growth of endometriosis lesions. Insist on breastfeeding for 2 years after delivery, the sex hormone level during breastfeeding is very low, which can give a heavy blow to the endo lesion that has stopped growing! If the lesion is about 4cm, it is recommended to actively prepare for pregnancy for 6 months, and if you fail to conceive successfully, it is recommended to promptly seek medical consultation and surgical treatment if necessary. If there are no plans to have children in the near future and there is no pelvic mass or it is smaller, you can choose medication for the appeal to control it! Patients with endometriosis, do not give up.