Endometriosis

Question 1

Clinical features of endometriosis?

Answer 1

chronic pelvic pain

secondary dysmenorrhoea
-pain often starts days before bleeding

deep dyspareunia

subfertility

non-gynaecological: urinary symptoms e.g. dysuria, urgency, haematuria. Dyschezia (painful bowel movements)

on pelvic examination reduced organ mobility, tender nodularity in the posterior vaginal fornix and visible vaginal endometriotic lesions may be seen

Question 2

What is Endometriosis?

Answer 2

growth of ectopic endometrial tissue outside of the uterine cavity

Question 3

Gold standard investigation of endometriosis?

Answer 3

laparoscopy is the gold-standard investigation

Question 4

Management for pain relief of endometriosis

Answer 4

NSAIDs and/or paracetamol are the recommended first-line treatments for symptomatic relief

Question 5

If the pain management of endometriosis does not work..

Answer 5

hormonal treatments such as the combined oral contraceptive pill or progestogens e.g. medroxyprogesterone acetate should be tried