Review the physiology of the menstrual cycle
The menstrual cycle is the process through which the ovary produces an ovum. This process is controlled by luteinizing hormone and follicle-stimulating hormone released from the pituitary gland (Crooks & Baur, 2015). Their function is to control the production of progesterone and estrogen that prepare the uterus for potential fertilization (Crooks & Baur, 2015). This cycle consists of three stages that are marked by several hormonal and physiological changes within the body (Crooks & Baur, 2015). The total duration of this process can range between 24 and 42 days. When the levels of progesterone and estrogen decline, the entire menstrual cycle begins to repeat itself.
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Define endometriosis and describe its pathophysiology
Endometriosis can be defined as the presence of stroma and endometrial glands outside the uterus. In this case, the tissue covering the inner side of the uterus begins to grow outside (Dey, 2017). The exact causes of this disease are not fully identified; this disorder is attributed to several factors such as retrograde menstruation, external toxins, vasculogenesis, immune dysfunction, and other mechanisms (Dey, 2017).
Identify classifications of endometriosis
Medical workers can adopt several approaches to the classification of endometriosis. One of them was developed by the American Society for Reproductive Medicine (ASRM). In this case, one has to consider such criteria as the location of external endometrial tissue and its amount. According to the ASRM model, there are four stages of endometriosis, namely, “minimal, mild, moderate, and severe” (Keder & Olsen, 2018, p. 186). Additionally, one can apply the ENZIAN classification that is focused mostly on infiltrating and deep endometriosis (Keder & Olsen, 2018). There are other methods of classification; however, the Enzian and the ASRM models are the most widespread.
List theories regarding the etiology of endometriosis.
There are several theories explaining the etiology of endometriosis. Among them, one can distinguish the retrograde menstruation theory, the Coelomic metaplasia model, the theory of immune dysfunction, the stem cells theory, and others (Crooks & Baur, 2015). Additionally, there are models emphasizing the role of hormones, oxidative stress, and hereditary factors (Crooks & Baur, 2015).
Identify the incidence of and risk factors for endometriosis
Endometriosis usually affects women whose age ranges from 15 to 55. They represent 98.3 percent of all cases diagnosed during 2000-2015 (Eisenberg, Weil, & Shalev, 2017). In the United States, the annual incidence rate of endometriosis is 7.2 cases per 10000 women aged between 15 and 55 (Eisenberg et al., 2017). Several risk factors can increase the probability of this disease. Firstly, women whose mothers and sisters were diagnosed with endometriosis are more likely to acquire this condition (Eisenberg et al., 2017). Furthermore, women who have not been pregnant are at a greater risk of developing this illness. Other risk factors include exposure to estrogen and dioxins.
Identify possible sequelae/consequences of endometriosis and their meaning for women
The major negative consequences of this disease include chronic pelvic pain and infertility (Crooks & Baur, 2015). Additionally, it is possible to speak about such complications as pelvic cysts, adhesions, and internal scarring. Moreover, women struggling with this disease tend to be affected by depression.
Describe the clinical presentation of endometriosis
Women affected by endometriosis usually report pelvic pain that ranges from mild to stabbing (Keder & Olsen, 2018). Moreover, they can experience pain during sex and urination (Keder & Olsen, 2018). Patients also mention infertility that may be caused by endometriosis.
List the differential diagnosis for endometriosis
The symptoms of endometriosis can be caused by other diseases, namely, interstitial cystitis, pelvic inflammatory disease, adenomyosis, ovarian cancer, and myalgia (Goodman, Heick, & Lazaro, 2017). Therefore, physicians should conduct several tests that can rule out other conditions. Several diagnostic tools will be useful in identifying the cause of the symptoms experienced by the patient. In particular, it is possible to consider laparoscopy, pelvic ultrasonography, a transvaginal ultrasound, and MRI (Goodman et al., 2017).
Describe all components of data collection necessary to diagnose endometriosis
The diagnosis of endometriosis requires several data collection procedures. At first, medical workers should examine the medical history of the patient. In this way, they can identify the causes of the symptoms (Goodman et al., 2017). The physical examination will be the second part of data collection. In many cases, physicians can detect endometriosis during this stage. However, the gold standard for diagnosing this disease is laparoscopy (Goodman et al., 2017). Although laparoscopy is an invasive tool, it can detect endometriosis when other diagnostic techniques fail.
Discuss various treatment options for endometriosis, including how they relate to various therapeutic goals. Identify these therapeutic goals. Include medical and surgical treatments. Identify the advantages and disadvantages of various treatments
At this point, there is no cure that can eradicate the underlying causes of endometriosis. Nevertheless, some interventions can make this condition more manageable. Medical workers should achieve two therapeutic goals. In particular, they should alleviate the pain caused by this disease. Furthermore, it is necessary to treat infertility resulting from endometriosis (Keder & Olsen, 2018). In most cases, physicians choose laparoscopy, an operation that is performed in the pelvis or abdomen (Keder & Olsen, 2018). This technique is useful in alleviating pain and reducing the risk of infertility. The main disadvantage of laparoscopy is the adhesions that women acquire after surgery. Furthermore, it is possible to consider hormonal medications, such as the use of birth control pills or progesterone (Keder & Olsen, 2018). The main strength of these methods is that they are non-invasive. However, they are less effective in reducing pain.
Identify the teaching and counseling and supportive measures needed by women facing this disease
The women, who struggle with endometriosis, should receive counseling that will help them overcome depression. Additionally, these patients should be told how the symptoms of this disease can be managed.
Crooks, R., & Baur, K. (2015). Our sexuality (13th ed.). Boston, MA: Cengage Learning.
Dey, P. (2017). Essentials of gynecologic pathology. London, UK: JP Medical Ltd.
Eisenberg, V., Weil, C., & Shalev, V. (2017). Epidemiology of endometriosis: A large population‐based database study from a healthcare provider with 2 million members. BJOG, 125(1), 55-62.
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Goodman, C., Heick, J., & Lazaro, R. (2017). Differential diagnosis for physical therapists: Screening for referral (6th ed.). New York, NY: Elsevier Health Sciences.
Keder, L., & Olsen, M. (Eds.). (2018). Gynecologic care. Cambridge, UK: Cambridge University Press.