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Endometriosis

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

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Endometriosis

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  1. Endometriosis Christina Hodder Leanne Jesso

  2. 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

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

  4. 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

  5. Some Theoretical Causes • Genetic, “runs in the family” • Retrograde menstruation • Problems in the immune system • Estrogen (natural and synthetic)

  6. Effects on the Body • Linked to infertility • Miscarriages • Loss of reproductive organs (hysterectomy) • Psychologically damaging • Chronic pain

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

  8. 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

  9. Stages

  10. Treatment Options- Surgical • Laparoscopy- method of choice • Conservative surgery • Hysterectomy

  11. Patient Satisfaction

  12. 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)

  13. Patient Satisfaction

  14. 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

  15. 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

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

  17. Photos • Endometriosis growing on the ovary and fallopian tube

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

  19. Conclusion • No cure • Disease of ‘coping’ • Combination therapy involving surgery, hormones, and (if needed) assisted reproduction

  20. 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

  21. Websites • http://ladytobaby.com/show.php?cat=38&item=164 • http://www.endo.org.uk/painsurveytoplinepreliminaryresults05.doc

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