Endometriosis

IntroductionUterine lining implants

itself to other organs in the pelvic region. Ex.. Ovaries, bladder, fallopian tubes

Appears as cysts and adhesions

Causes a great deal of menstrual pain

Affects women of the reproductive age

Remains a “hidden” disease until other problems arise

possible locations of endometriosis

SymptomsPelvic Pain (acute or chronic)Dyspareunia (painful intercourse)Painful bowel movementsPremenstrual staining and abnormal

bleedingDifficult urination and/or blood present in

the urineInfertility

Some Theoretical CausesGenetic, “runs in the family” Retrograde menstruationProblems in the immune systemEstrogen

Effects on the BodyLinked to infertilityMiscarriages Loss of reproductive organs (hysterectomy)Psychologically damagingChronic pain

Methods of DiagnosisMost cases diagnosed because of other

complication(s)Laparoscopy is best detector and treatment

option

Some ClassificationsMild- Rare, scattered lesions, no scarringModerate- Minimal adhesions and superficial

implantsSevere- Reproductive organs are bound down

by growths, bladder and/or bowel may also become affected

Stages

PhotosA small adhesion

on an ovary about to be removed surgically

PhotosEndometriosis

growing on the ovary and fallopian tube

PhotosSevere

endometriosis on the back of the uterus causing adhesions of the bowel and pelvic organs

Treatment Options- Surgical

Laparoscopy- method of choiceConservative surgeryHysterectomy

Treatment Options- Non surgicalGonadotropin-releasing hormone agonists,

Danazol, GestrinoneAll acyclic, some high androgen, others

high progesterone, all low estrogen Negative side effects such as accelerated

bone loss, weight gain, nausea, breakthrough bleeding

Pain killers (aspirin, morphine, and codeine)

Statistics6-58% of infertile women have endometriosis30-50% of women with endometriosis are infertile

(twice the rate of the general population)Up to 22% of women have no symptoms30-50% of women with this disease have had

miscarriages Between 1965-1984 ~2 million US women

between ages 25-54 diagnosed received a hysterectomy

Painful disease: 66% of women experience chronic pain

1 out of 10 women from menarche to menopause can be expected to have some degree of endometriosis EXCEPT women with a sister, mother, or daughter already diagnosed, then incidences double to 1 out of 5

ConclusionNo cureCombination therapy involving surgery,

hormones, and (if needed) assisted reproduction