Gynecological disorders (endometriosis, infertility)

Question 1

endometriosis

Answer 1

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

Question 2

Distressed endometriosis patients have…?

Answer 2

An overall negative sense of female identity, with lower self-esteem and worse body image relative to non-distressed patients.

Question 3

Characteristics that contribute to explain the variability in women’s subjective experiences of endometriosis?

Answer 3

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.

Question 4

Berg and Wilson

Answer 4

Psychogenic model of infertility

Question 5

The menstrual cycle (socio-biological aspects)

Answer 5

Positive - signs of the fertility

Question 6

The menstrual cycle (cultural)

Answer 6

Beliefs, restrictions or taboos

Question 7

Characteristics of abnormal menstrual cycle

Answer 7

• 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

Question 8

Menorrhagia

Answer 8

Menstrual disorder

- extremely heavy menstrual bleeding

Question 9

Amenorrhea

Answer 9

Menstrual disorder

- absence of bleeding lasting more than 6months

Question 10

Dysmenorrhea

Answer 10

Menstrual disorder

- painful menstruation

Question 11

Oligomenorrhoea

Answer 11

Menstrual disorder

• less than 9 menses/year
• cycles are longer than 35 days
• lack of menstrual bleeding less than 3months

Question 12

Symptoms of endometriosis

Answer 12

• 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

Question 13

Endometriosis + age

Answer 13

• 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

Question 14

Diagnosis + endometrisois

Answer 14

• tests: detailed medical history and symptoms, lab, ultrasound
• Accurate diagnosis after laparoscopic surgical procedures
• diagnostic difficulties and delayed diagnosis

Question 15

Treatment + endometriosis

Answer 15

• surgical or pharmacological
• suppression of menstrual cycle (pregnancy?)
• pregnancy

purpose: to alleviate pain and promote pregnancy

Question 16

cause of endometrisosi

Answer 16

unknown

The unknown cause correlates with increased depression symptoms

Question 17

Experienced subjective pain + endometrisosi

Answer 17

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

Question 18

Mental health + endometriosis

Answer 18

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

Question 19

Endometrisois + stress

Answer 19

• higher level of perceived stress

Question 20

Work + endometriosis

Answer 20

85% reduciton in work quality

20% unable to work

Question 21

Dyspareunia

Answer 21

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

Question 22

Dyspareunia + solution

Answer 22

Surgical solution
hormonal treatment (side effects?)

Question 23

Psychological intervention + endometrisois

Answer 23

• progressive muscle relaxation
• mindfulness-based psychological intervention (improving pain threshold and immune response) > goal: cope with chronic pain.

Question 24

Psychological help + endometriosis

Answer 24

individual treat. + self help groups

• its important to understand the changes in their bodies
• goal: to experience their own felinity and their body positively.

Question 25

Symbols and rituals related to fertility (belief)

Answer 25

contryside: lying down after sex, not shoer,

Question 26

reproductive health rights

Answer 26

1. the right to the integrity and security of the body
   2- the right of intimate sexuality
2. the right to the knowledge from scientific progress
3. the right to informed decisions
4. The right to education
5. The right to gender equality in marriage and in divorce

Question 27

Infertility

Answer 27

typically defined as the inability to achieve pregnancy after one year of unprotected intercourse

after 35 years: half year is enough to speak about infertility.

Question 28

problem with the “infertility” defintion

Answer 28

• we can only see the doctors dimension
• what about the psychosocial factors?
• a complex view of infertility

Question 29

Nikolett Papay

Answer 29

Alternative definition of infertility

“infertility is a common dysfunction of the couple being in reproductive age, who have explicit intention to have a child, despite regular sexual life for at least one year. this period of prolonged dysfunction has an impact on interpersonal and interpersonal issues”

Question 30

Infertility, caused by men or woman?

Answer 30

30% woman
30% men
15 caused by couple
15 unknown cause

Question 31

Unexplained infertility

Answer 31

Biomedical aspects that the medical cause has not yet been found

Question 32

Functional infertility

Answer 32

is listed to the somatization disorders

Question 33

How was infertility described before?

Answer 33

woman has always been blamed for the problems because the main task of women life was the childbirth

infertility caused by men has less social and moral implications, since its the woman who is getting pregnant.

Question 34

Psychogenic hypothesis to infertility

Answer 34

the freudian psychoanalytic school

• unexplained infertility problems are caused by serious psychopathological events
• affected women have unsolved personal conflicts
• Repressed feelings and anxiety from female role (being a mother)

Question 35

Setan et al (new psychoanalytic model of unexplained infertility)

Answer 35

Unexplained infertility is a unconscious defense

The unsolved oedipal conflict (with the ideal self)

trauma of early childhood, symbolic relationship between couple

Question 36

Fisher

Answer 36

Two personality of women with infertility

• emotionally immature, submissive type: negative or irrational fear in connection with sexuality, pregnancy and maternity

Question 37

Cannabis + infertility

Answer 37

Directly linked to the increased primary infertility

Can affect the reproductive processes of both sexes.

Question 38

Personality + fertility

Answer 38

Open, optimistic attitudes towards (in)fertility

Infertility: neuroticism, introversion and guilt, low scores in cooperation

Question 39

Assisted Reproductive technology (ART)

Answer 39

• Negative psychological consequences -> 75% has no child!