Endometriosis

Question 1

Define endometriosis

Answer 1

Endometrial tissue (that normally lies in the womb) is found outside the uterus

• Pelvic area
• Lower abdomen
• Gut
• Rarely in other body parts e.g. lung

Question 2

What is the epidemiology of endometriosis?

Answer 2

Varies from 1-5:10

Question 3

What causes endometriosis?

Answer 3

• Unknown
• Runs in family
• Rare past menopause
• COCP reduces risk

Question 4

What are the clinical features of endometriosis?

Answer 4

Asymptomatic* BUT bigger patches = worse symptoms

• Dysmenorrhoea
• Dyspareunia (deep)
• Lower abdominal and pelvic pain
• Bleeding between periods
• Reduced fertility

Question 5

How is endometriosis diagnosed?

Answer 5

Clinical picture w/ trial medication

Laparoscopic surgery w/ biopsy BUT not donw w/I 3 months of hormonal treatment

Question 6

How is endometriosis managed?

Answer 6

REASSURANCE - patches not cancerous

MEDICAL

• COCP
• Progesterone (Mirena)
• Gonadotrophin releasing hormone
• Levonorgestrel IUD

SURGICAL

• Coagulation
• Ablation
• Excision
• Hysterectomy (last resort)