Endometriosis Flashcards
what is endometriosis?
a chronic condition characterized by the growth of hormone responsive endometrial tissue outside the uterine cavity
where are ectopic endometriosis implants typically found?
typically found on the peritoneal surface, within the ovary or invading the recto vaginal septum. however, many examples of more widely distributed lesions have been described.
how prevalent is endometriosis and its symptoms?
among reproductive age people, around 10% (190 million)
disease is accompanied by pelvic pain or infertility in up to 90 million people
symptoms are associated with work absenteeism, social isolation and high therapy costs
what is the objective of the “ask me about my uterus” book?
it insists doctors take women’s pain seriously
how does endometriosis affect the experience of menstrual pain?
many people experience cramps, but those with endometriosis describe much worse menstrual pain.
they report the pain increases over time, but severity of pain isn’t necessarily a reliable indicator of the extent of the condition. some people report no pain, some report a lot.
what are some common signs and symptoms of endometriosis
-painful periods (dysmenorrhea): pelvic pain and cramping can begin before a period and extend several days. there can be lower back and abdominal pain.
-pain with intercourse: during or after sex is common
-pain with bowel movements or urination: most likely to experience during a period
-excessive bleeding: occasional heavy periods (menorrhagia) or bleeding between periods (mentometrorrhagia)
-infertility: endometriosis is first diagnosed in some people who are seeking treatment for infertility
-other symptoms: the experience of fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods
where is endometriosis located?
ovaries
fallopian tubes
ligaments that support uterus (uterosacral ligaments)
posterior cul-de-sac, ie the space between the uterus and rectum
outer surface of uterus
lining of the pelvic cavity
and more
where else can endometrial tissue be found?
intestines
rectum
bladder
vagina
cervix
vulva
how is endometriosis diagnosed?
direct visualization of the endometriosis implants is standard for diagnosis.
- superficial lesions on peritoneal or ovarian surfaces
- pigmented lesions appear dark blue or brown due to haemosiderin content, and non pigmented lesions are usually white in colour and may show vesicular or fibrotic appearances
what is haemosidren
when red blood cells break down and start to release iron
what is a vesicle
small fluid filled sac in the body
what does fibrotic mean
the formation of an abnormal amount of fibrous tissue
what is laparoscopy?
a small telescope (laparoscope) is inserted into the abdomen to look directly at the internal tissue
laparoscopies are always carried out under general anesthetic
during a laparoscopy, various procedures can be performed in order to destroy or remove the endometriosis, endometriotic cysts and release scar tissue (adhesions)
how are lesions clinically classified?
classically, it is taught that endometriosis implants are blue-black “powder burns” or “mulberry lesions”
in recent years, several stages of implant development have been appreciated, each with a corresponding appearance.
early, active lesions can appear as popular excrescences (solid mass) or vesicles, and can range in colour from clear to bright red
1/3 of lesions are in phase with eutopic endometrium, and have a tendency to spontaneously grow and regress
this characteristic suggests a fluctuating proliferation in association with hormone production during the menstrual cycle
what are endometriomas?
cysts that form in the ovaries, with the same kind of tissue that grows in the uterus (endometrium)
these cysts fill with blood as they grow, which turns into dark brown fluid.
endometriomas sometimes called “chocolate cysts”
cause pain, discomfort, and scarring + damage to ovaries.
