Re: Endometriosis and abnormal uterine bleeding
From: art fougner, md (evsono@pipeline.com)
Wed Aug 29 20:38:29 2007
Treatment of endometriosis can also result in abnormal bleeding.
Art
At Wed, 29 Aug 2007, D. Ashley Hill wrote:
>
>Thanks. I did find 2 references, one from 1956 (AJOG) that describeds
>"external endometriosis" as a cause of AUB, but I have not received the
>article yet from the library. Interestingly, if you use "endometriosis"
>as a search term in PubMed you find a lot of adenomyosis articles,
>probably due to the terminology you mentioned. Thanks again,
>
>Ashley
>
>At Wed, 29 Aug 2007, Atkinson, Samuel M wrote:
>>
>>Ashley: Your conundrum is because of the confusion between endometriosis
>>externa (classic intraperitoneal endometriosis most frequently in
>>nulliparous women) and endometriosis interna or rather adenomysis.
>>It has long been accepted (I first heard the late Charles Flowers say
>>this in the 70's) that BTB on strong progestational pills is is
>>pathognomic for adenomysis. Thus the idea has persisted that
>>"adenomyosis" is just endometriosis and does cause BTB. So MD's tell an
>>adenomyosis pt that she has endometriosis.
>>I prefer to demand that we differentiate what we mean...interna or
>>externa. Then we won't confuse each other. Interna certainly does
>>cause menorrhagia and cramps...and when I put them on Depo or pill, they
>>then cramp and spot all month long although the flooding is better.
>>Don't know if this observation is helpful but FWIW, its' free.
>>sAm
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of D.
>>Ashley Hill
>>Sent: Wednesday, August 29, 2007 12:42 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Endometriosis and abnormal uterine bleeding
>>
>>Listmembers:
>>
>>I could use a hand. I am co-authoring a monograph on abnormal uterine
>>bleeding and one of the other authors has asked me to comment on
>>endometriosis as a cause of abnormal uterine bleeding. I am unfamiliar
>>with endo as a cause of AUB and can't think of a biologic reason why
>>endo would cause AUB (outside of cervical endometriosis). A literature
>>search revealed 2 references (1956 and 1980) and both appear fairly
>>weak. I suspect it's an urban myth that endo causes AUB, but might
>>change my mind with coherent references. Does anayone really consider
>>endo as part of the differential diagnosis when a patient presents with
>>endometriosis, and what treatment stratengies would you employ to treat
>>AUB "caused" by endometriosis.
>>
>>Before someone says "Google is your friend," note that of the seemingly
>>endless number of sites that mention endometriosis as a cause of AUB,
>>none include a reference and the majority seem to be a cut and paste of
>>other web sites. One author of a peds gynecology text mentions endo as
>>a cause of AUB, but to my knowledge does not provide a reference (I
>>don't have the latest edition) to support this belief. Does anyone have
>>a valid reference describing the relationship between endometriosis and
>>AUB? Thanks very much for your help.
>>
>>Ashley
>>
>>--
>>D. Ashley Hill, MD
>>Associate Director
>>Department of Obstetrics and Gynecology
>>Florida Hospital Family Practice Residency
>>Medical Director, Loch Haven Ob/Gyn Group
>>Division Director, Dept. of Ob/Gyn, Florida Hospital Orlando
>>Orlando, Florida
>>
>--
>D. Ashley Hill, MD
>Associate Director
>Department of Obstetrics and Gynecology
>Florida Hospital Family Practice Residency
>Medical Director, Loch Haven Ob/Gyn Group
>Division Director, Dept. of Ob/Gyn, Florida Hospital Orlando
>Orlando, Florida
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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