PHAR 451 Lecture Notes - Lecture 5: Danazol, Hormone Replacement Therapy, Pelvic Pain
10 Dec 2016
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Document Summary
Endometriosis and menopause: describe the clinical presentation of endometriosis, describe the goals of therapy and therapeutic alternatives for management of endometriosis, design a patient-specific therapeutic plan for a patient with endometriosis and monitor for efficacy and toxicity. Estrogen-dependent inflammatory disease (chronic and recurring) characterized by the presence of endometrial tissue outside the uterus (most commonly ovaries, pelvic peritoneum) Endometriosis is a common cause of chronic pelvic pain (35%) and infertility (38%). Pain fluctuates with cycle higher estrogen levels = more pain. First-line treatment for mild pelvic pain +/- nsaids. Low dose oc (20-35 mcg ethinyl estradiol + progestin) Nausea, bloating, breast tenderness, mood changes, thrombosis, breakthrough bleeding. First-line treatment for mild pelvic pain and dysmenorrhea. Avoid in renal disease, peptic ulcer, chf, asthma. Second line therapy for mild pelvic pain not often used anymore (first one we had) Inhibits ovarian estrogen production, causes atrophy of lesions. 6 months of therapy superior to placebo at relieving pain.
