Endometriosis

Group F

By: Kelly Conrad, Sara Dietrich, Justin Fordham, Patricia

Duenas, Elle Pavelonis, Javi Perez, Lauren Real, Macie
Stutz, Raquel Trotter
Endometriosis
Painful disorder
Tissue that normally lines the
endometrium grows outside the
uterus
Involves ovaries, fallopian tubes,
& the tissue lining the pelvis
More painful when
menstruating
Diagnosis
Pelvic exam
Feeling for abnormalities, such as cysts
on reproductive organs or scars behind
uterus
Ultrasound
Transducer or transvaginal
Can help identify cysts
Laparoscopy
Medical management is usually tried
first
How does it affect the health of the
women who develop the disorder?
Problems with fertility may develop
- of women with endometriosis have
difficulty getting pregnant
A full term pregnancy is possible
for some women
Ovarian Cancer
Endometriosis-associated
adenocarcinoma
Signs and Symptoms
Variety of different kinds of pain
Menstrual cramps, chronic lower back pain, during
intercourse, intestinal pain, and pain during voiding
Bleeding/Spotting during menstrual
periods
Infertility
Digestive problems
Diarrhea, constipation, bloating, or nausea.
Pathophysiology/Etiology
Normal menstrual cycle
Ovaries release hormones and endometrial tissue builds up in
The endometrial lining sheds if fertilization does not occur
Bleeding occurs through the vagina.

In Endometriosis this process is altered.

Pathophysiology/Etiology
In Endometriosis the lining type tissue is located in locations besides the uterine
cavity.

Common sites of implantation are

Ovaries,
Uterine Ligaments,
Rectovaginal Septum
Pelvic Peritoneum.

The cause of endometriosis is unknown; however, there are risk factors. Misplaced
tissue responds to hormones as normal and bleeding occurs, the blood however,
does not have a way out like in normal menstrual cycle. The bleeding irritates
surrounding areas causing inflammation and pain.
Risk Factors
Never giving birth
Starting period at an early
age
Going through menopause
at an older age
Short menstrual cycles
High levels of estrogen in
your body
Low BMI
Alcohol consumption
Medical condition that prevents
the normal passage of menstrual
flow out of the body
Examples:
Uterine abnormalities
Treatment Options
Medical Management
NSAIDs
Hormonal therapy
Surgical Treatment
Removal of lesions via
laparoscopy procedure and
laser treatment
Hysterectomy with bilateral salpingo-
oophorectomy
Therapeutic Management
Heat therapy
Relaxation techniques
Emotional support
Chocolate Cysts and Treatment
Known as Ovarian Endometriomas
Cyst is filled with old blood that appears brown
Three theories to the cause
1. invagination of ovarian cortex secondary to bleeding of a superficial implant
2. invagination of ovarian cortex secondary to metaplasia of coelmic
epithelium in cortical inclusion cysts
3. endometriotic transformation of functional cyst
Diagnosis
Gold Standard: laparoscopy
Vaginal ultrasound
Treatment
Medications: Danzol or GnRH
Surgical removal
Endometriosis and Cancer
Ovarian cancer
Studies suggest that endometriosis increases the risk of ovarian cancer
Women who had endometriosis present on the ovary had the highest risk
of ovarian cancer
The overall lifetime risk is low to begin with
Endometriosis-associated adenocarcinoma
Another rare form of cancer that can develop later in life in women who
have had endometriosis
The most common type of adenocarcinoma
Made up of cells that look much like the normal uterine lining
(endometrium)
Resources for Support
- SHARE Cancer Support
- Support network of breast and ovarian cancer
survivors
- Community of women who have been affected
- Helpline: 844-ASK-SHARE
- Teals the Deal Foundation
- Raise awareness about Gynecological Cancers
- Provide education about symptoms and
treatment options
- Support those fighting against cancer
- Contact: 801-923-TEAL
Endometriosis Staging
Staged based on location,
amount, size, and depth of
endometrial implants
Classified into one of four
stages:
Stage I: Minimal
Stage II: Mild
Stage III: Moderate
Stage IV: Severe
Successful treatments in reducing pain from
endometriosis
- Pharmacological - Surgical treatment
- NSAIDS (short-term)
- Opioids
- Laporoscopy
- Birth control methods
- Non-pharmacological - Laparotomy
- Heating pads
- Hysterectomy
- Exercise
- Rest
Practice Question #1
Risk Factors for Endometriosis

Four women presented to a clinic with severe abdominal pain. Based on your
knowledge of the disease, which woman is most at risk for developing
endometriosis?

A. A 25-year-old Caucasian woman with 3 children and a history of chlamydia

B. A 39-year-old obese woman currently experiencing menopause
C. A 28-year-old African American woman with no previous pregnancies who
has been taking estrogen pills for 10 years
D. A 16-year-old Hispanic girl who has not experienced menarche
Practice Question #2
Nursing Considerations for Endometriosis

You are a nurse taking care of a 31-year-old woman who was just diagnosed
with stage III endometriosis. She is recently married and is actively attempting
to become pregnant. Which topics would be important to include in your
teaching plan for this patient? Select all the apply.

A. Proper use, dosage, and side effects of NSAIDs

B. Methods of contraception and protection from STIs
C. Possible fertility issues and resources for emotional support
D. Information about a hysterectomy procedure
 References
About Us: Breast and Ovarian Cancer Survivors - SHARE. (2016). Retrieved from
https://www.sharecancersupport.org/about-us/

Carnahan, M., Fedor, J., Agarwal., A., & Gupta, S. (2013). Ovarian endometrioma. Retrieved from:
http://www.medscape.com/viewarticle/777490_2

Durham, R., & Chapman, L. (2014). Maternal-newborn nursing: The critical components of nursing
care (2nd ed.). Philadelphia, PA: F.A. Davis Company.

Endometriosis: Risk factor for ovarian cancer? (2016). Retrieved from

http://www.mayoclinic.org/diseases-conditions/endometriosis/expert-answers/endometriosis/faq-20057966

Mayo Clinic Staff. (2016). Endometriosis. Mayo Foundation. Retrieved from

http://www.mayoclinic.org/diseases-conditions/endometriosis/home/ovc-20236421

Teal's the Deal Foundation. (2016). Retrieved from https://www.tealsthedeal.org/

U.S. Department of Health and Human Services (2014). Endometriosis. Office on Womens Health. Retrieved from
https://www.womenshealth.gov/files/assets/docs/fact-sheets/endometriosis.pdf