Endometriosis RANZCOG clinical guideline

Question 1

what is adenomyosis?

Answer 1

the glands and support structure of the endometrium are found in the muscle layer of the uterus
This displaced tissue can break down and bleed during each menstrual cycle and heavy painful periods result

Question 2

What is the incidence of adenomyosis

Answer 2

25-30%

Question 3

Medical management of endometriosis comprises of which medications?

Answer 3

• 3 month trial of NSAIDs
• COCP - improves pain and long term won’t delay fertility although obviously while using impacts fertility
• as an adjunct to surgery for the treatment of DIE consider use of GnRH agonist for 3 months pre-operatively

Question 4

Give 3 examples of hormonal therapies for the treatment of endometriosis and why they work

Answer 4

• COCP - slows or stops the growth of endometriosis by regulating oestrogen levels
• progesterone (oral, depot or IUD) - stopping bleeding including the menstrual cycle
• GnRH agonist and antagonist - as above