A 26-year-old female complained of severe, dull, aching pain, and cramping in th

Question

A 26-year-old female complained of severe, dull, aching pain, and cramping in the lower abdomen. There were no other physical findings. A laparoscopy revealed the presence of ectopic endometrial tissue on the uterine wall and ovaries. Danazol (a synthetic androgen and inhibitor of gonadotropins), 600 mg/day, was prescribed for up to nine months to inhibit ovulation, suppress the growth of the abnormal endometrial tissue, and achieve appreciable symptomatic relief, with a 30% possibility of conception after withdrawal of the therapy.

1a. What is this condition called?

1b. What causes it?

2. What is ectopic endometrial tissue?

3. What is the rationale for using danazol, a gonadotropin inhibitor?

4. Why do you think oral contraceptives could also be used as a treatment?

Explanation / Answer

1 a. This condition is called as endometrosis.

1b. It may be caused by various factors such as ;

(i) Flow of menstrual tissue back through the uterine tubes.

(ii) Metaplasia induced due to hormonal imbalance.

2. Ectopic endometrial tissue is endometrial tissue that occur in a place other than the uterus, such as uterine tubes.

3. Danazol is a gonadotropin inhibitor which blocks Gn-RH output. This in turn results in decrease in FSH and LH output, thus decreasing circulating estrogen and progesterone. Deficiency of estrogen and ptogesterone will prevent endometrial growth, vascularization, and menses, and allow the aberrant endometrial implants to regress.

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