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, 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: drug therapy and surgical therapy. For unmarried, premenopausal young patients with mild conditions, drug therapy should be the first choice. For severe conditions, surgical therapy can be considered, but a cautious approach should be taken regarding the preservation of the ovaries.I. Drug Therapy:
1. Western Medicine: Danazol, norethisterone, tamoxifen, and progesterone can be used.
2. Traditional Chinese Medicine: The treatment principle focuses on invigorating blood circulation, removing blood stasis, softening and resolving masses, and using herbs based on syndrome differentiation. The combination of Western and Chinese medicine yields better results.
II. Surgical Therapy:
1. Conservative Surgery: Excise lesions, detach adhesions, repair the ovaries, correct the uterine position, and preserve fertility.
2. Semi-radical Surgery: Total hysterectomy with at least one ovary preserved to maintain endocrine function.
3. Radical Surgery: Total hysterectomy and bilateral adnexectomy (including ovaries and fallopian tubes) to prevent recurrence, but postoperative menopausal syndrome is likely to occur, so appropriate estrogen replacement therapy should be supplemented.