Endometriosis

Question 1

Chemical reasons for endometriosis?

Answer 1

Overproduction of prostaglandins because increase COX-2 activity and overproduction of estrogen from increased aromatase activity; progesterone resistance

Question 2

Risk factors for endometriosis

Answer 2

Early menarche (before 11yo)
Shorter cycles (

Question 3

Reduces endometriosis risk?

Answer 3

1. regular exercise >4 hrs/wk
2. Multiparous
3. Breastfeeding

Question 4

Typical sx endometriosis

Answer 4

1. Dyspareunia
2. Dysmenorrhea
3. Menorrhagia
4. Abdomino/pelvic pain

Question 5

Perform cystoscopy if suspect…

Answer 5

bladder endometriosis

Question 6

Should you always do a biopsy to dx endometriosis?

Answer 6

Only if you are uncertain of lesion origin

Question 7

Endometriosis staging

Answer 7

Stage I minimal
II = mild
III = moderate
IV = severe 
(peritoneum, ovaries, tubes, depth of invasion/filmy vs dense adhesive disease)

Question 8

How do you treat infertility from endometriosis?

Answer 8

OCPs and medicine do not improve fertility
Surgery can improve, but not certain how much
Repeated surgery can reduce fertility, ovarian reserve