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Endometriosis ...what is the best way forward?

In this article by Lucia Osborne-Crowley, endometriosis is outlined succinctly as;

a chronic, estrogen-dependent condition that causes dysmenorrhea and pelvic pain.

It has long been believed that the best way to treat endometriosis, a chronic inflammatory condition that affects one in 10 women globally, is by performing laparoscopic surgery to remove damaged tissue from the body.**

woman curled up on bed

The nature of the beast is the chronic inflammatory nature of it which can result in short term gains from surgical intervention;

“We find that patients don’t always get better with surgery, and those who do often feel better for a very short time,” Andrew Horne, a professor of gynaecology and reproductive sciences at Edinburgh University’s MRC Centre for Reproductive Health, tells the Guardian.

"A targeted approach to screening would also allow for a more patient-specific treatment plan. That could include surgery in cases where it is likely to improve symptoms, or otherwise a combination of the other available treatments for the disease".

Chinese herbal medicine (CHM) has been used for endometriosis for many years in Asian populations and is used in clinics like mine here in Australia to help address some of the debilitating symptoms of endometriosis.

Could CHM have a role as "one of the other available treatments" in an integrated health care model?

Efficacy and Safety of Chinese Herbal Medicine for Endometriosis Associated Pain.

This retrospective study in a territory teaching hospital of the China Academy of Chinese Medical Sciences in Beijing, China compared the short- and long-term effectiveness and safety of CHM for endometriosis associated pain (EAP) before and after CHM treatment.

A total of 338 out of 1143 women confirmed with endometriosis by ultrasonogram or surgery within three months received a CHM decoction twice a day for at least 3 and up to 24 months.

All data were collected by a Structured Medical Records of Endometriosis (SMRE) in every clinic visit covering the whole treatment period. Pain score, evaluated by Numeric Rating Scale, was significantly decreased from 3rd to 12th month in women with moderate or severe pain.

Frequency and severity rating of menstrual symptoms, evaluated by Cox Menstrual Symptom Scale, were significantly decreased in women with any pain level. Psychological changes rated by Self-rating Anxiety Scale (SAS) were significantly lower in 3, 6, 12, and 24 months of treatment, but those by Self-rating Depression Scale (SDS) was significantly decreased in six months of treatment.

There was no severe adverse event but only minor side-effects.

In conclusion,

This study showed that CHM relieved EAP and related symptoms with minimal side-effects after treatment.

This is one study and research is ongoing . A large-scale randomised and placebo-controlled trial could be designed to confirm the efficacy and safety and in so doing, lead to:

Integrated Health Care

Keywords: Chinese Herbal Medicine; Clinical Study; Emotional Function; Endometriosis; Pain, Integrated Health Care

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