Endometriosis Flashcards
Women with endometriosis typically have a range of pelvic–abdominal pain symptoms, including:
dysmenorrhoea, dyspareunia, heavy menstrual bleeding, non-menstrual pelvic pain, pain at ovulation, dyschezia and dysuria, as well as chronic fatigue
Endometriosis definition/aetiology
Inflammatory condition characterized by lesions of endometrial-like tissue outside of the uterus and is associated with pelvic pain and infertility.
Lesions arise through retrograde endo- metrial tissue loss during menstruation, coelomic metaplasia and lymphatic spread in immunologically and genetically susceptible indivi- duals. While its underlying cause is uncertain, it is likely to be multifac- torial including genetic factors with possible epigenetic influences, perhaps promoted through environmental exposures.
Endometriosis mechanism of chronic pain
Endometriosis lesions, particularly deep infiltrating lesions, are often innervated. The presence of endometriotic lesions, followed by denervation and re-innervation, may result in ac- companying changes in the central nervous system (central sensitization), creating a chronic pain syndrome
Endometriosis mechanism of infertility
Endometriosis is also associated with infertility, with a strong association between severity of disease and impact on fertility, probably due to impaired tubo-ovarian function, the presence of ovarian endometrioma, subclinical pelvic inflammation, possibly reduced oocyte quality and reduced endometrial receptivity to implantation. Both endometriosis and adenomyosis (lesions occur- ring in the uterine intramural muscular layer) reduce the chance of success of assisted reproductive treatment.
