Endometriosis

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Endometriosis

• Christina Hodder
• Leanne Jesso

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Introduction

• Uterine lining implants itself to other organs in
  the pelvic region. Ex.. Ovaries, bladder,
  fallopian tubes
• Appears as cysts and adhesions
• Causes a great deal of menstrual pain
• Affects women of the reproductive age
• Remains a hidden disease until other problems
  arise

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Brief History

• Thought to be a disease of the upper class, white
  woman
• The first report in 1860 by a Dr. Rokitansky

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Symptoms

• Pelvic Pain (acute or chronic)
• Dyspareunia (painful intercourse)
• Painful bowel movements
• Premenstrual staining and abnormal bleeding
• Difficult urination and/or blood present in the
  urine
• Infertility

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Some Theoretical Causes

• Genetic, runs in the family
• Retrograde menstruation
• Problems in the immune system
• Estrogen (natural and synthetic)

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Effects on the Body

• Linked to infertility
• Miscarriages
• Loss of reproductive organs (hysterectomy)
• Psychologically damaging
• Chronic pain

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Methods of Diagnosis

• Most cases diagnosed because of other
  complication(s)
• Laparoscopy is best detector and treatment option

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Some Classifications

• Mild- Rare, scattered lesions, no scarring
• Moderate- Minimal adhesions and superficial
  implants
• Severe- Reproductive organs are bound down by
  growths, bladder and/or bowel may also become
  affected

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Stages
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Treatment Options- Surgical

• Laparoscopy- method of choice
• Conservative surgery
• Hysterectomy

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Patient Satisfaction
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Treatment Options- Non surgical

• Gonadotropin-releasing hormone agonists, Danazol,
  Norethindrone, Gestrinone
• All acyclic, some high androgen, others high
  progesterone, all low estrogen
• Negative side effects such as accelerated bone
  loss, weight gain, nausea, breakthrough bleeding
• Pain killers (aspirin, morphine, and codeine)

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Patient Satisfaction
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Statistics

• 6-58 of infertile women have endometriosis
• 30-50 of women with endometriosis are infertile
  (twice the rate of the general population)
• Up to 22 of women have no symptoms
• 30-50 of women with this disease have had
  miscarriages
• Between 1965-1984 2 million US women between
  ages 25-54 diagnosed received a hysterectomy
• Painful disease 66 of women experience chronic
  pain
• 1 out of 10 women from menarche to menopause can
  be expected to have some degree of endometriosis
  EXCEPT women with a sister, mother, or daughter
  already diagnosed, then incidences double to 1
  out of 5

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Interesting Facts

• Men can also develop endometriosis after
  prolonged treatments involving synthetic estrogen
• Reported cases in primates such as baboons,
  African Green Monkeys, and Rhesus Monkeys
• Pharmaceutical companies cashing in on womens
  pain 3 month Endometriosis Kit 525.95 USD
• Endometriosis has been removed from areas other
  than the abdomen such as the thigh, thumb, and
  knee

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Photos

• A small adhesion on an ovary about to be removed
  surgically

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Photos

• Endometriosis growing on the ovary and fallopian
  tube

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Photos

• Severe endometriosis on the back of the uterus
  causing adhesions of the bowel and pelvic organs

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Conclusion

• No cure
• Disease of coping
• Combination therapy involving surgery, hormones,
  and (if needed) assisted reproduction

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Works Cited

• Buttram, Veasy C. Jr. et al. Endometriosis
  Advanced Management and Surgical Techniques. New
  York Springer-Verlag, 1995.
• OConnor, Daniel T. Endometriosis. London
  Churchill Livingstone, 1987.
• Shaw, Robert W. Endometriosis Current
  Understanding and Management. London Blackwell
  Science Ltd., 1995.
• Wilson, Emery A. Endometriosis. New York Alan R.
  Liss, 1987.
• http//www.endometriosis.org/
• http//ladytobaby.com/show.php?cat38item164
• www.dictionary.com

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Websites

• http//ladytobaby.com/show.php?cat38item164
• http//www.endo.org.uk/painsurveytoplinepreliminar
  yresults05.doc