Benign conditions of the uterus

Question 1

what is a fibroid (or leiomyoma)

Answer 1

smooth muscle tumour of myometrium

caused by oestrogen

Question 2

are fibroids common or rare?

Answer 2

30% women over 30 have them

Question 3

fibroid symptoms

Answer 3

heavy periods
pain (organ squeezes to try to get rid of it)

anaemia
infertility
miscarriage

Question 4

treatment of fibroids

Answer 4

myomectomy - to keep fertility

hysterectomy - if fertility not required

Question 5

endometrial polyp - overview

Answer 5

benign localised growth of endometrium
disordered cycle of apoptosis/regrowth

lumps in cavity
infertility
pain
bleeding

Question 6

adenomyosis

Answer 6

ectopic endometrial tissue in myometrium

constant pain
post menopausal
(opposite symptoms to endometriosis)

Rx - hysterectomy

Question 7

menorrhagia - investigations

Answer 7

FBC
TVS
endometrial biopsy if over 45 - intermenstrual bleeds

Question 8

treatment for menorrhagia

Answer 8

transexamic acid (anti-fibrinolytic)
mefenamic acid (NSAID - pain)
progestagens (from day 5-25 of cycle)
Danazol - inhibits sex steroids

COCP, mirena, endometrial ablation, myomectomy, hysterectomy

Question 9

danazol - what is it + SEs

Answer 9

inhibits sex steroid production and receptors

has masculin side effects - acne, hair, deep voice