After completing this case study, the reader should be able to:
Identify the signs and symptoms associated with endometriosis.
Compare and contrast the benefits and risks associated with various hormonal medications used for the treatment of endometriosis-associated pelvic pain.
Determine a treatment approach for this case taking into account other health issues and potential health benefits.
Discuss possible side effects associated with treatment for endometriosis.
“Although the pain associated with my menstrual period is better, the naproxen upsets my stomach, and I am still having pain in my lower abdomen at other times during the month.”
Lisbeth Anderson is a 30-year-old woman who was diagnosed with endometriosis 3 months ago based on a history of dysmenorrhea, intermittent pain with defecation, and past history of dyspareunia. She presents to the nurse practitioner today for evaluation and management of continued endometriosis-related pain despite treatment with naproxen.
Mother (aged 57 years) has a history of endometriosis, no other health conditions; father (aged 58 years) has hypertension and elevated cholesterol; one female sibling (aged 25 years) is healthy
Patient is a freelance photographer. She has one child. She is single; currently not sexually active. She does not smoke and consumes no more than two alcohol-containing beverages per week. She exercises 30 minutes most days of the week.
(+) For moderate pain in pelvic region, (–) for constipation, menstrual periods occur at regular intervals of 29 days
BP 115/70 mm Hg, P 65 bpm, RR 15, T 37°C; Wt 72 kg, Ht 5′11″; patient has maintained same weight prepregnancy and postpregnancy
Supple, no bruits, no adenopathy, no thyromegaly
Soft; patient states, ...