Women suffering from dysmenorrhea are widespread. Angela, 28, has had a history of dysmenorrhea for five years. She can't escape the pain no matter how careful she is before menstruation. On the worst days, she was used to relying on willpower, warm water, and painkillers to survive. She has been married for more than a year but can't conceive. She goes to the hospital for examination, and the doctor says she has endometriosis, and treatment is complex.

Long-term dysmenorrhea, especially severe dysmenorrhea or infertility, is likely caused by endometriosis. Endometriosis is a common gynecologic disease. The incidence rate of women of childbearing age reaches 3%-5%, and 1/3 of patients will develop infertility.
Women have menstrual reflux, and the endometrium is in the wrong position.

Under normal circumstances, the endometrium should grow in the uterine cavity. The endometrium is stripped and discharged from the vagina with each month's menstruation. As the name suggests, endometriosis is when the endometrium is not in the uterine cavity and runs in the wrong position. Removing the ovary, abdominal cavity, intestinal wall, and even bronchus and nasal cavity is common.

Why does the endometrium run to these places? At present, the etiology is not very clear, but clinical studies have found that it is related to menstrual blood reflux in women, which is called planting theory in medicine. Some experts explained, "menstrual blood contains active cells of the endometrium. The cells flow back to the abdominal cavity or ovarian surface with menstrual blood and plant, grow, infiltrate and repeatedly bleed there. Over time, form the focus."

What? Will menstrual blood flow back? Is there something like a magnet in the body that lets it stream back?

90% of ordinary women have experienced menstrual reflux, but less than 5% will develop endometriosis. Some studies believe it may have a great relationship with strenuous exercise during menstruation and personal physique, and the more specific reasons are unclear.

To prevent endometriosis, doctors emphasize that women should not only pay attention to the hygiene and cleanliness of their private places during menstruation but also avoid violent activities, avoid menstrual sex life and reduce the occurrence of accidental pregnancy.

20% are accidental findings, a typical symptom that is often overlooked

There are many types of endometriosis. There are no apparent symptoms in the early stage, so it isn't easy to find without examination. 20% of patients were accidentally found during surgery (because of surgery for other diseases) and laparoscopy.

The typical symptom of the disease is dysmenorrhea, which is progressive, but females often ignore it. When endometriosis develops to a more severe stage, pelvic mass, infertility, and menstrual disorders are usually found by examination.

Cysts are formed on one or both sides of the uterus for endometriosis running to the ovary. If the patient is complicated with dysmenorrhea and infertility, doctors often highly suspect an endometriosis cyst, commonly known as an ovarian chocolate cyst.

Dysmenorrhea needs attention. Don't judge by yourself that it is a physiological reaction. Women should go to the hospital in time to determine the causes of dysmenorrhea. Ultrasound is the first choice for endometriosis; Laparoscopy should be considered only when the symptoms are severe and complicated with infertility.

The recurrence rate of surgery is 10-30%, which must be managed as a chronic disease for a long time.

Endometriosis is a complex gynecological disease. Although early detection and early diagnosis are difficult, treatment methods have advantages and disadvantages. Customize personalized treatment schemes according to the actual situation of patients.

1. When the symptoms are mild and have little effect on physiological function, women can observe it first.

2. Oral contraceptives are often used if there is no infertility or the preferred drug treatment is less than 4cm. Endometriosis also depends on hormones. The disease will also be alleviated and controlled when taking contraceptives to reduce estrogen levels.

However, this method will inhibit hormones and ovulation, affect pregnancy, and are unsuitable for patients with fertility requirements. If patients have reproductive needs, they can choose the Fuyan Pill to eliminate pain and other symptoms.

3. When the diameter of accessory mass is greater than 4cm, or infertility occurs, and the effect of drug treatment is not good, women can consider surgical treatment. Young patients with fertility requirements generally prefer laparoscopic surgery to remove the lesions as much as possible while preserving the uterus and ovaries.

Older patients with no reproductive needs, severe symptoms, and even tend to malignant transformation can undergo radical surgery to remove all the uterus, ovaries, and lesions.

In this reminder, surgery does not mean once and for all. Endometriosis is easy to relapse. The recurrence rate of conservative surgery is as high as 30%. Even if radical surgery is performed, the recurrence rate is 10%. Therefore, women must continue to use drugs to control recurrence after the operation, follow up regularly, and manage it as a chronic disease for a long time.

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