Patient's question:
Regarding endometriosis, what medication should be takenDoctor's answer:
Hormonal Therapy: Since pregnancy and menopause can prevent the occurrence of dysmenorrhea and retrograde menstruation, and can lead to the atrophy and regression of ectopic endometrium, sex hormones have become the main non-surgical treatment for endometriosis in clinical practice. However, hormonal therapy is contraindicated for larger ovarian endometriotic cysts, especially those with uncertain diagnosis or abnormal liver function. Currently, the following hormonal therapies are used in clinical practice:1) Pseudopregnancy Therapy: Kister (1956) first proposed this method. It involves long-term oral administration of high-dose hormones, supplemented with a small amount of estrogen to prevent breakthrough bleeding, thereby creating artificial menopause similar to pregnancy, hence the name pseudopregnancy therapy. Pseudopregnancy therapy can cause decidual changes in ectopic endometrial tissue, interstitial edema, and ultimately endometrial necrosis.
Due to the initially high hormone dosage in pseudopregnancy therapy, many patients found it difficult to tolerate. It has now been modified to daily oral administration of 18-methyl 0.3 mg and ethinyl estradiol 0.03 mg for 6–12 months. If breakthrough bleeding occurs, 18-methyl can be increased to 0.6–0.9 mg daily, and ethinyl estradiol can be increased to 0.06–0.09 mg daily. The symptom relief rate after medication is approximately 80%, with a pregnancy rate of 20–40%, but side effects such as nausea and vomiting remain relatively significant.
2) High-Efficacy Progestogen Therapy: Daily oral administration of 20–30 mg of medroxyprogesterone acetate for 6 months, or intramuscular injection of 250 mg of hydroxyprogesterone caproate every 2 weeks for 3 months, followed by monthly intramuscular injections of 250 mg for 3–6 months. Single progestogen therapy