Step 1: Tell Us Your Chief Complaints!
Before starting any interventions, we need to know if you plan to become pregnant in the next 3–6 months. Then, we will set your treatment in three different dimensions based on the objectives:
To relieve cramps (menstrual pain)
To sleep well|To be happy at work |To have a happy family life
| |
|---|
| Medicine |
| Timeliness |
| Potency |
| Side Effects |
| Administration |
| Cost |
| Preference |
| Symptom-Controlling Drugs | 4th Generation Progesterone | Birth-control Pills | IUD | GnRH Agonists | Androgen (Androgen-like) | Conservative Surgery | Radical Surgery |
|---|
| Naproxen | Dienogest | Diane | Mirena | Leuprolide | Gestrinone | Adenomyomectomy, Nerve Block, etc. | Hysterectomy |
| Fast-acting | Fast-acting | Several days | Several days | 3 weeks | 2 weeks | Fast-acting | Fast-acting |
| Potent | Extremely Potent | Extremely Potent | Extremely Potent | Extremely Potent | Extremely Potent | Potent | Extremely Potent |
| Minor | Moderate | Moderate | Moderate | Moderate | Moderate to Severe | Moderate to Severe | Moderate to Severe |
| Oral Intake, Daily, During Period | Oral Intake, Daily | Oral Intake, Daily | One device for 5 years | Injection/month, total of3-6 injections | Oral Intake, Daily | Minimally invasive surgery or conventional surgery | Minimally invasive surgery or conventional surgery |
| Covered by Health Insurance | Covered by Health Insurance | Covered by Health Insurance | NT$6,000 and more per injection | NT$6,000 and more per injection | Covered by Health Insurance | Usually NT$10K and more | Usually NT$10K and more |
| 1 | 2 | 2 | 2 | 3 | 3 | 3 | 3 |
To stop abnormal bleeding
To have a quality life|To increase comfort level|To move freely
| |
|---|
| Medicine |
| Timeliness |
| Potency |
| Side Effects |
| Administration |
| Cost |
| Preference |
| Symptom-Controlling Drugs | 4th Generation Progesterone | Birth-control Pills | IUD | GnRH Agonists | Androgen (Androgen-like) | Conservative Surgery | Radical Surgery |
|---|
| Transamine | Dienogest | Diane | Mirena | Leuprolide | Gestrinone | Adenomyomectomy | Hysterectomy |
| Fast-acting | 6-9 months and longer | Several days | 6-9 months and longer | 3 weeks | 2 weeks | Fast-acting | Fast-acting |
| Potent | Potent | Extremely Potent | Extremely Potent | Extremely Potent | Potent | Potent | Extremely Potent |
| Minor | Moderate | Moderate | Moderate | Moderate | Moderate to Severe | Moderate to Severe | Moderate to Severe |
| Oral Intake, Daily, During Period | Oral Intake, Daily | Oral Intake, Daily | One device for 5 years | Injection/month, total of3-6 injections | Oral Intake, Daily | Minimally invasive surgery or conventional surgery | Minimally invasive surgery or conventional surgery |
| Covered by Health Insurance | Covered by Health Insurance | Covered by Health Insurance | Covered by Health Insurance if Hb<10 | NT$6,000 and more per injection | Covered by Health Insurance | Usually NT$10K and more | Usually NT$10K and more |
| 1 | 2 | 2 | 2 | 3 | 3 | 3 | 3 |
To remove chocolate cysts
To prevent recurrence|To reduce possibility of surgery|To lower cancer risks
| |
|---|
| Medicine |
| Timeliness |
| Potency |
| Side Effects |
| Administration |
| Cost |
| Preference |
| Symptom-Controlling Drugs | 4th Generation Progesterone | Birth-control Pills | IUD | GnRH Agonists | Androgen (Androgen-like) | Conservative Surgery | Radical Surgery |
|---|
| - | Dienogest | Diane | - | Leuprolide | Gestrinone | Cystectomy | Oophorectomy and Salpingectomy |
| - | Fast-acting | Fast-acting | - | 3 weeks | 2 weeks | Fast-acting | Fast-acting |
| - | Extremely Potent | Potent | - | Extremely Potent | Extremely Potent | Extremely Potent | Extremely Potent |
| - | Moderate | Moderate | - | Moderate | Moderate to Severe | Moderate to Severe | Moderate to Severe |
| - | Oral Intake, Daily | Oral Intake, Daily | - | Injection/month, total of3-6 injections | Oral Intake, Daily | Minimally invasive surgery or conventional surgery | Minimally invasive surgery or conventional surgery |
| - | Covered by Health Insurance | Covered by Health Insurance | - | NT$6,000 and more per injection | Covered by Health Insurance | Usually NT$10K and more | Usually NT$10K and more |
| - | 1 | 1 | - | 1 | 2 | 2 | 2 |
To prepare for pregnancy
To improve ovary function|To increase fertility|To set a personal pregnancy plan
For Those Who Plan to Become Pregnant in the Next 3–6 Months
Compared with the general population, the success rate of natural conception in females with endometriosis decreases based on the severity of endometriosis. Those with concurrent infertility causes (e.g. bilateral tubal occlusion) may have an even lower success rate of natural conception. However, as the development of in vitro fertilization (IVF) is quite advanced in modern days, those who plan to become pregnant could consult with doctors from the Reproductive Department to schedule a pre-pregnancy physical exam (e.g. hysterosalpingogram (HSG), semen analysis) and establish the most optimal intervention strategy. Below are some brief self-assessment items:
- For clients with at least one non-occlusive tube, and whose male partners are without severe infertility issues, they may consider ovulation induction and intrauterine insemination.
- For clients with bilateral tubal occlusion or combined with male infertility, or having failed intrauterine insemination several times previously, they may consider ovulation induction and IVF.
- For clients who have severe pelvic pain or a large chocolate cyst (which already interferes with ovum pick-up), it is recommended to remove the endometriosis or the ovarian chocolate cyst before starting the reproductive and endocrinological interventions.
By the way, for those who do not plan to become pregnant soon
As endometriosis itself and oophorectomy may reduce the amount of oocyte depository, after the diagnosis of endometriosis but prior to oophorectomy, if the clients do not plan to become pregnant in the near future, they can discuss with the doctors from the Reproductive Department about fertility preservation or oocyte cryopreservation.
