Patient's question:
Painful menstruation for several years, currently worsening. Wondering about the best treatment method? Can it be cured without surgery? How much does it cost? Duration and onset of this episode: This month during menstruation Current general condition: Menstrual cycle shortened (less than 20 days), cold all over the body during pain, sweating profusely, feeling unwell but not life-threatening. Medical history: Had an abortion two years ago, and the condition worsened after the surgery. Previous diagnoses, treatments, and outcomes: Occasionally taken Chinese medicine (Fuyixiao Granules, Fuyitong Granules, produced by Tianjin University of Traditional Chinese Medicine Affiliated Hospital). Other: Can it be cured without surgery?Doctor's answer:
Hello: Endometriosis treatment should be comprehensively analyzed and developed based on factors such as the patient's age, the severity of symptoms, the extent of the disease, the size of the tumors, and whether there are fertility requirements. Treatment methods can be divided into two categories: medical treatment and surgical treatment. For unmarried, premenopausal young patients with mild conditions, medical treatment should be the first choice. For severe conditions, surgical treatment can be considered, but a cautious attitude should be taken regarding the preservation of the ovaries.I. Medical Treatment:
1. Western Medicine: Danazol, norethisterone, tamoxifen, and progesterone can be selected.
2. Traditional Chinese Medicine: The treatment principle focuses on invigorating blood circulation, removing blood stasis, softening and resolving nodules, and using herbs based on syndrome differentiation. The combination of Western and Chinese medicine is often more effective.
II. Surgical Treatment:
1. Conservative Surgery: Resection of lesions, separation of adhesions, restoration of ovarian function, correction of uterine position, and preservation of fertility.
2. Hemi (Semi-radical Surgery): Total hysterectomy with preservation of at least one ovary to maintain its endocrine function.
3. Radical Surgery: Total hysterectomy and bilateral adnexectomy (including ovaries and fallopian tubes) to prevent recurrence, but postoperative menopausal syndrome is common, and appropriate estrogen replacement therapy should be administered.