Endometriosis, Breast Pain and Menorrhagia Flashcards
What is endometriosis?
The growth of endometrial-like tissue outside the uterus
Oestrogen-dependent condition associated with menstruation
Symptoms of endometriosis
Pelvic pain, painful periods, subfertility, and tiredness
Aims of endometriosis drug treatment and surgical
Drugs - suppress ovarian function, contraception
Surgical - remove or destroy endometriotic lesions
Endometriosis drug treatment
3 month trial of paracetamol or NSAID alone or in combination
Suspected, confirmed, recurrent: Hormonal treatment with combined oral contraceptive or progestogen
Which Gonadotrophin-affecting drug is licensed for the treatment endometriosis?
Danazol
Treatment of infertility and mechanism of action
Cetrorelix and Gainrelix
Luteinising hormone and follicle stimulating hormone antagonists which inhibit the release of gonadotrophins
Management of non-serious breast pain
Reduction in dietary fat
Withdrawal of an oral contraceptive or of hormone replacement therapy
Treatment of non-serious breast pain
Mild, non-cyclical pain: Simple analgesics
Moderate to severe, cyclic pain or symptoms lasting >6 months: Danazol
Adjunct: Tamoxifen (unlicensed)
What is considered as heavy menstrual bleeding?
Excessive blood loos
Duration >7 days
Need to change menstrual products every 1-2 hours
Treatment of menorrhagia with fibroids <3cm with suspected or diagnosed adenomyosis
1st: Levonorgestrel-releasing intrauterine system
2nd: Tranexamic acid or an NSAID
3rd: Combined hormonal contraceptive or cyclical oral progestogen or progestogen-only contraceptives
Treatment of menorrhagia with fibroids of >3cm
Any of the following:
Tranexamic acid and NSAID
Levonorgestrel-releasing intrauterine system
Combined hormonal
Cyclical oral progestogen
Ulipristal acetate
Uterine artery embolisation
Surgery
Treatment for moderate to severe symptoms of uterine fibroids in premenopausal women where surgery and uterine artery embolisation are unsuitable
Intermittent ulipristal acetate
