Endometriosis

Question 1

What is endometriosis

Answer 1

endometriosis where it shouldn’t be

most commonly in the pelvis

Question 2

retrograde menstruation - what’s this?
is it bad?
link to endometriosis?

Answer 2

period going up into pelvis

all women get RM - if genetically predisposed may lead to endometriosis

Question 3

what causes endometriosis

Answer 3

unopposed oestrogen (without progesterone)

so young women who dont ovulate much
dont get it past menopause

Question 4

endometriosis - is it more or less common after menopause?

Answer 4

more common BEFORE menopause

Question 5

symptoms of endometriosis?

Answer 5

CYCLICAL pain (from causing stretching cause oestrogen makes it grow)
dyspareunia
dysmenorrhoea

blood in urine (endometriosis in bladder)
nosebleeds on period (endometriosis in nose)

Question 6

investigation of endometriosis

Answer 6

laparoscopy

CA125 is increased

Question 7

treatment options for endometriosis - stop oestrogen

Answer 7

COCP - triphasing (give for 3 months at a time
continuous GnRH - binds to receptor. doesnt let go - pituitary releases all of its LH/FSH then doesnt make any more -> menopausal symptoms so temporary measure only

progestagens - if oestrogen is contraindicated (mini pill, depo, mirena)

surgery - ablation, excision