Endometriosis and benign conditions of the uterus Flashcards
what is endometriosis?
painful disorder in which tissue that normally lines the inside of the uterus endometrium grows outside your uterus.
causes of endometriosis?
- Retrograde menstration (Sampson’s theory): menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body.
- Transformation of peritoneal cells: ells that line the inner side of your abdomen — into endometrial cells
- Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
what is Halban’s theory?
distant lesions are established by the hematogenous or lymphogenous spread of viable endometrial cells
What is Meyers’s theory?
that metaplasia of the coelomic epithelium is the origin of endometriosis.
A coelom is a fluid-filled body cavity that is completely lined by tissue created from the mesoderm
Presentations of endometriosis?
cyclic pain
Painful periods (dysmenorrhea). most painful before period starts and eases with period
Painful intercourse (dyspareunia)
Pain with bowel movements (dyschezia) or urination (dysuria)
infertility, carried the pregnancies to a viable gestational age (low parity)
when to refer endometriosis?
a trial of paracetamol or NSAID (alone or in combination) does not provide
adequate pain relief.
initial hormonal treatment for endometriosis is not effective, not tolerated or is
contraindicated.
how to treat emdometriosis?
not trying to become pregnant—>
extended cycle (few periods a year) or continuous cycle (no periods). these can done via the pill
Trying to get pregnent—> GnRH agnoist (lowers oestrogen)
this stops the body from making the hormones responsible for ovulation, the menstrual cycle (oestrogen, and the growth of endometriosis. This treatment causes a temporary menopause, but it also helps control the growth of endometriosis. Once you stop taking the medicine, your menstrual cycle returns
side effect of GnRH agonist?
associated with low levels of oestrogen so much like during menopause:
insomnia decreased libido headaches acne muscle pain depression
Bone thinning
need add back of oesterogen
the effect of progestrone on endometrium?
progesterone makes the endomertrium thin.
how does Depot Provera treat endometrosis?
The progestin in Depo-Provera is thought to help suppress the growth of endometrial tissue and may also reduce endometriosis-induced inflammation.
epo-Provera may also prevent ovulation and lowers the amount of estrogen circulating in your body.
What is Mirena?
levonorgestrel (a synthetic progestogen)-releasing intrauterine system
what is adenomyosis?
Adenomyosis occurs when endometrial cells exist and grow into the walls of the uterus. Like endometriosis, the cells behave as they would normally act, and are affected each month with a woman’s period. The result of these menstrual cycles can be an enlarged uterus, pelvic pain and heavy bleeding.
pariaty in adenomyosis and endometriosis?
Adenomyosis–> older multiparous
endometriosis–> young nulliparous
what is a fibrioid
benign uterine tumours os smooth muscle
oesterogen dependent
sumptons of fibroids?
asymptomatic heavy periods anaemis infertitlity miscariiage
