1. Endometriosis Christina Hodder Leanne Jesso

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. Brief History Thought to be a disease of the upper class, white woman The first report in 1860 by a Dr. Rokitansky

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 (natural and synthetic)

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

11. Patient Satisfaction

12. Treatment Options- Non surgical Gonadotropin-releasing hormone agonists, Danazol, Norethindrone, 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)

13. Patient Satisfaction

14. 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

15. Interesting Facts Men can also develop endometriosis after prolonged treatments involving synthetic estrogen Reported cases in primates such as baboons, African Green Monkeys, and Rhesus Monkeys Pharmaceutical companies cashing in on women’s pain= 3 month “Endometriosis Kit” $525.95 USD Endometriosis has been removed from areas other than the abdomen such as the thigh, thumb, and knee

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

17. Photos Endometriosis growing on the ovary and fallopian tube

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

19. Conclusion No cure Disease of ‘coping’ Combination therapy involving surgery, hormones, and (if needed) assisted reproduction

20. Works Cited Buttram, Veasy C. Jr. et al. Endometriosis: Advanced Management and Surgical Techniques. New York: Springer-Verlag, 1995. O’Connor, Daniel T. Endometriosis. London: Churchill Livingstone, 1987. Shaw, Robert W. Endometriosis: Current Understanding and Management. London: Blackwell Science Ltd., 1995. Wilson, Emery A. Endometriosis. New York: Alan R. Liss, 1987. http://www.endometriosis.org/ http://ladytobaby.com/show.php?cat=38&item=164 www.dictionary.com

21. Websites http://ladytobaby.com/show.php?cat=38&item=164 http://www.endo.org.uk/painsurveytoplinepreliminaryresu lts05.doc