Endometriosis

Question 1

What are the clinical features of endometriosis?

Answer 1

• chronic pelvic pain
• pain starting days before period starts
• deep dyspareunia
• dysmenorrhoea

Question 2

What is the gold standard investigation for endometriosis?

Answer 2

Laparoscopy

Question 3

What is the step-wise management of Endometriosis (for symptomatic relief)?

Answer 3

1. NSAIDs and paracetamol
2. COCP, POP or medroxyprogesterone acetate

Question 4

If analgesia/hormonal treatment does not improve symptoms, or if fertility is a priority - what is the management plan?

Answer 4

GnRH analogues - they induce low oestrogen levels
Surgery - laparoscopic excision or ovarian cystectomy for endometriomas

Question 5

What is endometriosis defined as?

Answer 5

the growth of ectopic endometrial tissue outside of the uterine cavity

Question 6

What does a ruptured endometrioma usually present like?

Answer 6

Acute abdomen (pain)
Pelvis is fluid filled on Ultrasound