Week 3: Endometriosis

Question 1

Define endometriosis

Answer 1

• presence of endometrial glands and storm outside the endometrial cavity
• usually accompanied by blood or hemosiderin laden macrophages
• associated with relentless ovulation or outflow obstruction
• presents as primary amenorrhea, pain, infertility, or adnexal mass

Question 2

Adenomyosis

Answer 2

-direct extension -endometriosis grows into myometrium

Question 3

Clinical manifestations of endometriosis

Answer 3

• dysmenorrhea
• chronic pelvic pain
• dysparenunia - pain during deep penetration
• infertility
• abnormal pelvic exam: adnexal mass, uterosacral nodularity

Question 4

Risk factors for endometriosis

Answer 4

• early menarche
• late childbearing
• low parity
• shortened breastfeeding
• menopause

Question 5

Diagnosis of endometriosis

Answer 5

• symptoms or findings leading to surgical exploration of biopsy
• presence of 2 or more of following: endometrial gland,s endometrial storm, hemosiderin laden macrophages

Question 6

Management of endometriosis

Answer 6

1. medical: no one drug was found to be better than another
   - OCPs
   - oral, IM, SQ progestins
   - progestin containing IUD
   - GnRH agonist
2. Surgery
   - resection of deep disease