Endometriosis

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. possible locations of endometriosis

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

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

11. Photos
 Endometriosis growing
on the ovary and
fallopian tube

12. Photos
 Severe endometriosis
on the back of the
uterus causing
adhesions of the bowel
and pelvic organs

13. Treatment Options- Surgical
 Laparoscopy- method of choice
 Conservative surgery
 Hysterectomy

15. Treatment Options- Non surgical
 Gonadotropin-releasing hormone agonists,
Danazol, 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)

16. 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

17. Conclusion
 No cure
 Combination therapy involving surgery, hormones,
and (if needed) assisted reproduction