Endometriosis & Adenomyosis Flashcards
RFs for endometriosis:
having a first-degree relative
autoimmune disorders
CP of endometriosis:
cyclic pelvic pain that starts 1-2w before menses, peaks 1-2d before onset, subsides at onset of flow.
dyspareunia of deep penetration
infertility
when should a physical exam be performed to eval for endometriosis
beginning of menses when implants are likely to be largest & most tender
what is a chocolate cyst?
endometrioma (collection of endometriosis in ovary)
what kind of tx for endometriosis in women attempting to conceive?
no medical management will help. Just use NSAIDs.
Would normally use OCPs, progestins, Lupron, or danazol
SE’s of OCPs?
irritability
depression
breakthrough bleeding
bloating
SEs of danazol (androgen derivative)
acne oily skin weight gain edema hirsutism deepening of voice
what is adenomyosis
extension of endometrial tissue into myometrium.
High ES levels stimulate hyperplasia of basalis layer of endometrium
adenomyosis is most often seen in what age group and why?
parous women.
Endomyometritis is the first insult to the endometrial-myometrial barrier => invasion of cells
in what part of uterus is adenomyosis most extensive?
fundus & posterior uterine wall
does adenomyosis respond to OCPs?
no
what is an adenomyoma?
a welll-circumscribed isolated region of adenomyosis
CP of adenomyosis
secondary dysmenorrhea
menorrhagia
diffusely enlarged, globular uterus
how to dx adenomyosis
u/s. If suggestive, then f/u w/MRI
what must be obtained before treating adenomyosis?
if over age 35, get TSH and endometrial bx
