Endometriosis

Question 1

Risk factors for endometriosis

Answer 1

Obstruction of menstrual outflow
Exposure to diethylstilbestrol in utero
Prolonged exposure to endogenous estrogen due to early menses, late menopause, obesity
Short periods
Low birth weight
Exposure to endocrine disrupting chemicals

Question 2

Signs/symptoms of endometriosis

Answer 2

Cyclic pelvic pain, 4 Ds (dysmenorrhea, dyschezia, dyspareunia, dysuria)

Question 3

Complications of endometriosis

Answer 3

Infertility, ovarian failure, ectopic pregnancy

Question 4

Non-pharm treatment of endometriosis

Answer 4

Surgery, artificial insemination, assisted reproductive technology (ART)

Question 5

Pharmacological treatment for endometriosis

Answer 5

NSAIDs for dysmenorrhea +/-:

CHCs, progestins (1st line)
GnRH agonists +/- add-back therapy of norethindrone, estrogens, GnRH antagonists (second-line)
Danazol, aromatase inhibitors (third-line)