Gynecological disorders (endometriosis, infertility) Flashcards
endometriosis
Complex, chronic, benign, inflammatory and estrogen-dependent gynecological disease affecting every 10th of reproductive age women worldwide, it is characterized by the growth of the endometrial-like tissue outside the uterine cavity
Distressed endometriosis patients have…?
An overall negative sense of female identity, with lower self-esteem and worse body image relative to non-distressed patients.
Characteristics that contribute to explain the variability in women’s subjective experiences of endometriosis?
Self-esteem: may shape the illness experience with individuals
Self-efficacy: ones belief about ones capacity to manage emotions and feelings, either pos. or neg.
Good Self- est and self-eff might enhance the ability to cope with chronic disease and therefor lead to greater healt with lower anxiety and depression.
Berg and Wilson
Psychogenic model of infertility
The menstrual cycle (socio-biological aspects)
Positive - signs of the fertility
The menstrual cycle (cultural)
Beliefs, restrictions or taboos
Characteristics of abnormal menstrual cycle
- bleeding lasts longer than a week
- less than 3 or more than 5 weeks between two bleedings
- lack of menstrual bleeding (not due to pregnancy)
- blood in urine or in stool
- more than five tampons /day
- problem in daily taskins
- chronic pelvic pain between two menstruations
Menorrhagia
Menstrual disorder
- extremely heavy menstrual bleeding
Amenorrhea
Menstrual disorder
- absence of bleeding lasting more than 6months
Dysmenorrhea
Menstrual disorder
- painful menstruation
Oligomenorrhoea
Menstrual disorder
- less than 9 menses/year
- cycles are longer than 35 days
- lack of menstrual bleeding less than 3months
Symptoms of endometriosis
- painful menstruation
- chronic pelvic/abdominopelvic pain
- painful sexual intercourses
- painful ovulation
- cyclic pain or pain between two menstruations
- pain with bowel movement
- pain with urination
- blood in stool
- menorrhagia
- INFERTILTY
- chronic fatigue
Endometriosis + age
- endometriosis start mainly (95%) in woman in their fertil reproductive ages
- first symptom can appear after the 1st mensturation, even at the age 10.5
Diagnosis + endometrisois
- tests: detailed medical history and symptoms, lab, ultrasound
- Accurate diagnosis after laparoscopic surgical procedures
- diagnostic difficulties and delayed diagnosis
Treatment + endometriosis
- surgical or pharmacological
- suppression of menstrual cycle (pregnancy?)
- pregnancy
purpose: to alleviate pain and promote pregnancy
cause of endometrisosi
unknown
The unknown cause correlates with increased depression symptoms
Experienced subjective pain + endometrisosi
the intensity of pain correlates with impairment of QoL.
Important!! the intensity of pain does NOT correlate with the severity
Coexistence: sexual dysfunction, decreased ability to work
Mental health + endometriosis
mood symptoms are positively associated with the decrease of HRQoL
higher level of mood symptoms are measured in endometriosis, than in any healthy population
woman without pain have lower depression symptoms
Endometrisois + stress
- higher level of perceived stress
Work + endometriosis
85% reduciton in work quality
20% unable to work
Dyspareunia
painful sex
highest pain values during and after sexual intercourse
- decrease of number of sexual intercourses and sexual satisfaction
- the quality of the relationship changes
Dyspareunia + solution
Surgical solution hormonal treatment (side effects?)
Psychological intervention + endometrisois
- progressive muscle relaxation
- mindfulness-based psychological intervention (improving pain threshold and immune response) > goal: cope with chronic pain.
Psychological help + endometriosis
individual treat. + self help groups
- its important to understand the changes in their bodies
- goal: to experience their own felinity and their body positively.
