Endometriosis

Christina Hodder

Leanne Jesso

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

Brief History

Thought to be a disease of the upper class, white woman

The first report in 1860 by a Dr. Rokitansky

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

Some Theoretical Causes

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

Effects on the Body

Linked to infertility Miscarriages Loss of reproductive organs

(hysterectomy) Psychologically damaging Chronic pain

Methods of Diagnosis

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

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

Stages

Treatment Options- Surgical

Laparoscopy- method of choice Conservative surgery Hysterectomy

Patient Satisfaction

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)

Patient Satisfaction

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

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 women’s 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

Photos

A small adhesion on an ovary about to be removed surgically

Photos

Endometriosis growing on the ovary and fallopian tube

Photos

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

Conclusion

No cure Disease of ‘coping’ Combination therapy involving surgery,

hormones, and (if needed) assisted reproduction

Works Cited

Buttram, Veasy C. Jr. et al. Endometriosis: Advanced Management and Surgical Techniques. New York: Springer-Verlag, 1995.

O’Connor, 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?cat=38&item=164 www.dictionary.com

Websites

http://ladytobaby.com/show.php?cat=38&item=164

http://www.endo.org.uk/painsurveytoplinepreliminaryresults05.doc