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Endometriosis: Treatments
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Endometriosis is a complex hormonal and immune disease affecting millions of women during their reproductive years. Before alternative treatment for endometriosis is discussed, here is a definition. Endometriosis can be defined as growth of endometrial cells that is not normal that spreads to areas in the body where those kinds of cells are not supposed to be.
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Endometriosis is the presence of endometrial glands or stroma in sites other than the uterine cavity. It is variable in both its surgical appearance and clinical manifestation often with poor correlation between the two. Surgical treatment of endometriosis aims to remove visible areas of endometriosis and restore anatomy by division of adhesions.
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GnRH analogs comprise the newest class of hormones used for endometriosis treatment. After a few weeks of treatment, analog use leads to depletion of the pituitary hormones which direct the ovary to release estrogen. Estrogen levels fall to menopausal levels, ovulation does not occur, the endometrium does not grow, and menstruation does not occur. This results in a state called reversible menopause. Side effects of these drugs are associated with a lack of estrogen and include hot flashes, vaginal dryness, and loss of bone calcium. The medications are usually given for six months and can be administered as a daily or monthly injection or as a nasal spray.
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In 1989 a lengthy review of endometriosis was published in English, again in the Journal of the American College of Traditional Chinese Medicine (12). The report was compiled by He Xianlin, a physician at the Guangzhou Municipal Hospital. More than two dozen formulas are presented in the review, including some of those already mentioned above, and there are suggestions for acupuncture therapy as well. A comment about treatment worth noting is this: "Although there are many ways to achieve the same goal, one thing is agreed upon by all sources with regard to endometriosis. The major pathology is that of qi and blood stagnation. Both problems will need to be addressed but at the root of it all is the kidney qi deficiency syndrome.
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Analogues of GnRH, the gonadotropin releasing hormone, are the newest class of hormones used for endometriosis treatment. Brand names include Lupron and Synarel. These analogues switch off production of FSH and LH from the pituitary... inducing a menopausal state. These analogs can be given in the form of special injections called depot preparations, which release small quantities of the drug daily, allowing administration at monthly intervals.
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Before reviewing the traditional herbal treatments, the intensive investigation into a new herbal drug, gossypol, will be reviewed because the Chinese literature on endometriosis is dominated by reference to this herbal drug. Research into its use for endometriosis began in 1979. A review of gossypol research was published in Recent Advances in Chinese Herbal Drugs (2) and information here comes from that review plus several abstracts of recent studies published in Abstracts of Chinese Medicine (3).
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