• Triad of symptoms: dysmenorrhea, dyspareunia, infertility. • Physical examination: reveals one or more of the following: tenderness of the pelvic area and/or cul-de-sac, enlarged or tender ovaries, a uterus that tips backward and lacks mobility, fixed pelvic structures, adhesions. • Pelvic ultrasounds: detection and consistency of endome-triomas. • Definitive diagnosis: laparoscopy or laparotomy visualizing pelvic endometrial implants. • Symptoms begin at onset of menstruation or later, worsening with time. Triad of symptoms: dysmenorrhea, dyspareunia, infertility. Features include acute pain before menses, lasting a day or two during menses or throughout the month; vomiting; diarrhea; fainting concurrent with pelvic/abdominal cramping and labor-like pains; chronic bearing down pain; pressure on low back; pains radiating down legs; pain with urination or bowel movements; bleeding from nose, bladder, or bowels; fatigue. • Curious feature: pain and extent of disease correlate poorly. Symptom severity correlates with depth of lesions rather than number of lesions. • Physical examination: one or more of the following: tenderness in pelvic area and/or cul-de-sac; enlarged or tender ovaries; uterus tips backward and lacks mobility; fixed pelvic structure; adhesions. Other findings include endometrial tissue or surgical scar tissue in vagina or on cervix. Examination during the first or second day of menses: tender septum between rectum and vagina. • Pelvic ultrasound: useful assessing pain and tumors but not definitive; detects mass on ovary; determines size, characteristics, consistency of endometriosis. Blood test CA-125 can be positive in endometriosis but cannot distinguish endometriosis, fibroids, malignancies, and even normal tissue. • Definitive diagnosis: biopsy by laparoscopy or laparotomy of visualized tissue. • Estrogens stimulate growth of implants: therapy manipulating endogenous hormones may be effective. • High-fiber foods optimize intestinal transit time and balance friendly gut microflora that displace undesirable strains that deconjugate estrogens, allowing them to recirculate. Less protein, high-fiber organic vegetarian diet: decreases plasma active unconjugated estrogens; reduce intake of proinflammatory arachidonic acid. Vegetable protein, soy, nut butters (almond), salmon are preferred. Emphasize phase 2 liver support vegetables: carrots, beets, artichokes, lemons, dandelion greens, watercress, bur-dock root, cabbage family vegetables. Indole-3-carbinol, in broccoli, Brussels sprouts, cabbage, cauliflower, favors less-active estrogen metabolites. Onions, garlic, and leeks contain immunity-enhancing organosulfur compounds and bioflavonoids (quercetin) that protect against oxidation, block inflammation, and inhibit tumor growth. • Phytoestrogens: soy isoflavones and flaxseed lignans help alleviate endometriosis symptoms. • Seasonings: Turmeric (curcumin) protects against environmental carcinogens, decreases inflammation, increases bile secretion. Milk thistle seeds soaked and ground helps liver function. Fresh flaxseeds increase antiinflammatory fatty acids. Fucus (seaweed) stimulates T-cell production and absorbs toxins.
Endometriosis
DIAGNOSTIC SUMMARY
Diagnostic Considerations
Therapeutic Considerations
Diet
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
Basicmedical Key
Fastest Basicmedical Insight Engine
