Patient's question:
Detailed medical condition and consultation purpose: I want to know if I can still have children after not having children now! I also want to know what will happen after not having children!Current general condition: I am currently taking medication, and menstrual pain has become less severe.
Medical history: I have had an ectopic pregnancy in the past.
First follow-up question: I currently have children, but I cannot have more. What problems might arise in the future?
What harm does this condition pose to me?
Second follow-up question: What is my current chance of pregnancy?
Third follow-up question
Doctor's answer:
Under normal circumstances, the endometrium grows inside the uterine cavity. If active endometrial tissue grows outside the uterine cavity in other parts of the body and causes cyclic bleeding, it is called endometriosis.The pathogenesis of endometriosis has not yet been fully elucidated, but there are several theories about its etiology. One theory, the retrograde menstruation theory, suggests that during menstruation, if menstrual blood flows through the fallopian tubes into the pelvic cavity, the endometrial tissue in the blood may implant in the ovaries, peritoneum, and other areas. Under suitable conditions, this tissue survives and develops into endometriosis. Another theory, the coelomic epithelial metaplasia theory, proposes that certain tissues derived from coelomic epithelium, such as the germinal epithelium of the ovaries, peritoneum, and pleura, can differentiate into endometrial tissue when exposed to certain stimuli (e.g., inflammation, hormones, or menstrual blood), leading to endometriosis. A third theory, the benign metastasis theory, suggests that endometrial tissue can enter the uterine blood vessels and lymphatic vessels and subsequently spread to nearby organs, pelvic lymph nodes, and distant sites, causing endometriosis.
During the menstrual cycle, ectopic endometrial tissue, like the endometrium in the uterine cavity, undergoes cyclical changes under the influence of ovarian hormones, resulting in clinical symptoms. Currently, the treatment of endometriosis is primarily divided into drug therapy and surgical therapy. The specific approach should be considered based on the patient's age, the severity of symptoms, fertility requirements, the location and extent of the lesions, and other factors.
Drug therapy is generally suitable for mild to moderate endometriosis. Since the occurrence, development, and regression of endometriosis are regulated by endocrine functions, hormonal treatments are effective, such as the use of progestins, androgen derivatives, and gonadotropin-releasing hormone agonists. Drug therapy has certain side effects and must be conducted under the guidance of a doctor.
Surgical therapy is recommended for patients with more severe conditions or those who do not respond to drug treatment. Depending on the extent of the surgery, it can be classified as conservative surgery, semi-radical surgery, or radical surgery. It is advisable to undergo medical examination and diagnosis at a hospital, and then consult with a doctor to determine the most appropriate treatment based on the specific situation.