Endometriosis

Question 1

What is endometriosis?

Answer 1

Endometriosis is the growth of endometrium-like tissue outside the uterus.

Question 2

What symptoms are commonly associated with endometriosis?

Answer 2

Pelvic pain, painful periods (dysmenorrhea), and subfertility.

Question 3

What imaging is used first if endometriosis is suspected?

Answer 3

Transvaginal ultrasound scan.

Question 4

How is a definitive diagnosis of endometriosis made?

Answer 4

By laparoscopic visualization of the pelvis.

Question 5

What is the first-line drug treatment for endometriosis-related pain?

Answer 5

A short trial (e.g. 3 months) of paracetamol or NSAIDs, alone or combined.

Question 6

What hormonal treatments are offered for endometriosis?

Answer 6

Combined oral contraceptives or progestogens.

Hormonal treatment should not be offered to those trying to conceive as it does not improve pregnancy rates.

Question 7

What is the role of surgery in endometriosis management?

Answer 7

To remove or destroy endometriotic lesions, especially in severe or refractory cases.

Question 8

When should GnRH analogues be considered before surgery?

Answer 8

For deep endometriosis involving the bowel, bladder, or ureter.