Notes in OG7.3 Dysmenorrhoea and Endometriosis

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Published	10/04/2024	Primary dysmenorrhea occurs within 2 years of {{c1::menarche}} due to {{c1::unknown}} cause
Published	10/04/2024	Primary dysmenorrhea is usually most severe on {{c1::1st and 2nd days of menstruation}}
Published	10/04/2024	NSAIDs treat dysmenorrhea by {{c1::↓ uterine production of PGF2α}}
Published	10/04/2024	Causes of secondary dysmenorrhea:- uterine = {{c1::fibroids, adenomyosis, copper coil}}- cervical = {{c1::cervical stenosis, lesions}}- congenital = {…
Published	10/04/2024	Fixed retroverted uterus, dysmenorrhea, pelvic tenderness, enlarged ovaries and palpable nodules in pouch of douglas or utero-sacral ligaments →&…
Published	10/04/2024	Decapeptyl given as monthly, 3 monthly, or 6 monthly {{c1::IM injection::administration}}Can be given pre-operatively to deactivate {{c1::endometriosi…
Published	10/04/2024	How does decapeptyl work to treat endometriosis?{{c1::Binds to GnRH receptors suppressing LH and FSH release, therefore ↓ estrogen}}
Published	10/04/2024	Definitive treatment for endometriosis → {{c1::Total abdominal hysterectomy and bilateral salpingoopherectomy}}
Published	10/04/2024	Prevalence of endometriosis = {{c1::5-15::range}}% of women of reproductive age
Published	10/04/2024	Symptoms of endometriosis{{c1::30}}% asymptomatic87% {{c1::chronic pelvic pain (cyclical - premenstrual/menstrual)}}{{c1::deep dyspareunia}}{{c1::subf…
Published	10/04/2024	Examination of endometriosis{{c1::fixed}}, {{c1::retroverted}} uteruspelvic, uterosacral ligament {{c1::tenderness}}enlarged {{c1::ovaries, adnexal ma…
Published	10/04/2024	{{c1::"kissing ovaries"::""}} = ovaries close together/adherent in pouch of Douglas, usually due to pelvic adhesions caused by endometriosis
Published	10/04/2024	Diagnosis of endometriosisprevious gold standard was {{c1::laparoscopy/laparotomy + histology}}now -> based on {{c1::clinical picture}} and respons…
Published	10/04/2024	side effects of decapeptyl{{c1::menopause-like}} symptomscannot be used long-term due to {{c1::decreased bone density}}
Published	10/04/2024	Medical treatment of endometriosis{{c1::suppress ovulation: COCP, GnRH analogues (decapeptyl), progestogens}}{{c1::analgesia: mefenamic acid, paraceta…
Published	10/04/2024	Surgical treatment of endometriosisconservative = {{c1::laparascopic resection of lesions via excision or ablation}}definitive = {{c1::hysterectomy + …
Published	10/04/2024	Staging of endometriosisStages 1-2 (minimal-mild disease): {{c1::superficial peritoneal}} endometriosis, possible presence of {{c1::small deep lesions…
Published	10/04/2024	adenomyosis incidence = {{c1::10}}% of womenmore common if > {{c1::40}} yearscommonly seen with {{c1::endometriosis}} and {{c1::fibroids}}
Published	10/04/2024	presentation of adenomyosis{{c1::heavy menstrual bleeding, dysmenorrhea, intermenstrual bleeding}}{{c1::leg, lower back, chronic pelvic pain}}{{c1::bl…
Published	10/04/2024	adenomyosis on US or MRIloss of {{c1::clear border between junctional zone}} (between endometrium and myometrium)focal vs diffuse
Published	10/04/2024	treatment of adenomyosisnon-hormonal treatment: if trying to {{c1::conceive}} or cannot take hormonal treatment, RXs = {{c1::TXA}}, {{c1::mefenamic ac…
Published	10/04/2024	Secondary dysmenorrhea = {{c1::recurrent menstrual pain resulting from clinically identifiable cause or abnormality}}, {{c1::worsens}} over time
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