Re: Endometriosis and abnormal uterine bleeding
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Wed Aug 29 22:29:43 2007
I had the privilege of training at the University of Alabama during Dr.
Flowers' last 3 years. It is nice to hear his name in reference.
Garry
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
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
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