Bakgrund: I Sverige lider ca 5 – 15 % av fertila kvinnor i åldern 30 – 40 år av endometrios. Det kan ta upp till 10 år innan den korrekta diagnosen ställs. Många kvinnor lider av bland annat stark smärta, smärtor vid ägglossning och djupa samlagssmärtor. Det finns endast behandling som kan lindra kvinnornas symtom. Behandlingen medför stora sjukvårdskostnader som påverkar samhällets ekonomi. Syfte: Syftet var att belysa kvinnors upplevelser av att leva med endometrios. Metod: Litteraturöversikten har genomförts av resultatet från 10 vetenskapliga kvalitativa artiklar som hämtats från databasen Cinahl Complete och Medline. Resultat: Ur resultatet framkom två huvudteman. (1) Leva med långvarig smärta med undertemat; Påverkan på det sexuella livet, Oro kring fertilitet och Hur smärtan påverkade kvinnornas arbetssituation. (2) Möten med vården med undertemat; Vårdens olika värderingar och Att vara sin egen expert. Slutsats: Resultatet av den här litteraturöversikten visar att endometrios är en diagnos där det saknas kunskap och utbildning från vårdens håll och där kvinnor lider både fysiskt och psykiskt, vilket påverkar deras liv i stor utsträckning. Sjukvården måste ta kvinnor som söker vård på allvar och kunskapen måste ökas för samtliga vårdkategorier för att kunna bygga en relation samt hjälpa dem till ett värdigt liv.

Abstract Because endometriosis is considered to be the primary cause of infertility in women and the diagnosis is known to be delayed by many years, it is important to understand the association between endometriosis and infertility. The purpose of this cross-sectional, secondary data analysis study was to determine whether there was an association between the age of women when diagnosed with endometriosis and infertility. Using the general model of total patient delay (i.e., the Andersen model) as a theoretical foundation, data for this study was collected by assessing patient medical records of women with endometriosis at multiple OB-GYN clinics in Eastern North Carolina. Multiple logistic regression was conducted to determine potential association between variables. The results presented that diagnosis at an older age and presence of uterine fibroids are significant risk factors for infertility among women with endometriosis. From the results, it can be concluded that infertility may be preventable in women diagnosed with endometriosis and uterine fibroids in younger age. This study presents positive social change by preventing infertility amongst women who suffer from both endometriosis and uterine fibroids; potentially creating preventative programs aimed at better educating women on the risks of endometriosis and uterine fibroids (especially when presented together).

No description available.

No description available.

Existing self-tracking tools for women concentrate on one’s general well-being and keeping track of ovulation and periods. With around 10% of women worldwide suffering from endometriosis there is an unmet need to leverage self-tracking for women whose cycles are affected by more variables. The disease is enigmatic with an unknown cause and cure and the ill­ness differs for each individual in symptoms and working treatments. It is therefore critical to understand how women can learn about their bodies and how to treat their condition. In this research I work with two sufferers to identify their secret de­sires through a workshop and a series of interviews. Results suggest that women with endometriosis could benefit from ex­perimenting with different habits and make personalized routines to suit their own needs. Finally I present design implica­tions for an existing menstrual app in the form of an add-on. The steps of the add-on tool included three steps. Firstly, choosing variables of one’s well being to track (mood, energy, pain etc.), choosing activities for one or more cycles (gluten-free diet, exercising etc.), and lastly viewing an analysis of any changes in the body. / Nuvarande self-trackers för kvinnor är centrerade kring användarens allmänna hälsa, ägglossning och menstruation. Cirka 10% av kvinnor i världen lider av endometrios, en vanligt förekommande men okänd sjukdom. Bland många tillgängliga ap­plikationer för kvinnor är få fokuserade på endometrios. Sjukdomen skiljer sig i symptom bland de drabbade. Därför är det viktigt att förstå hur kvinnor själva kan lära sig hur deras menstruationscyklar ser ut och behandla deras egna symptom med hjälp av self-trackers. I denna studie arbetar jag med två kvinnor för att förstå deras behov. Resultaten visar att kvinnor med sjukdomen kan dra nytta av att experimentera med olika vanor för att hitta en personlig rutin. Jag presenterar ett designför­slag på ett tillägg till en nuvarande mens-applikation. Tillägget är ett verktyg för att experimentera med olika vanor för att se hur det kan påverka ens välmående. Verktyget innehöll tre steg: Användaren får välja en eller ett par variabler att studera (humör, smärta etc.) samt en eller ett par rutiner att följa (ny matvana, träningsvana etc.) under en eller flera menscyklar. Därefter får användaren se en analys över hur rutinerna kan ha påverkat kroppen.

Endometriosis is a steroid-dependent common gynecological condition characterized by the growth of endometrial epithelial and stromal cells outside of its cavity. Estrogen dependence, progesterone resistance, in situ estrogen production, increased inflammation, resistance to apoptosis, active cell growth and proliferation, and overall disease’s heterogeneity makes it challenging to treat patients without compromising fertility. BDNF and its high affinity receptor TrkB has been shown to be dysregulated in women with endometriosis suggesting their role in disease progression. Immunocompromised mice (Rag2γc) (n=25) underwent an implantation surgery during which a cell suspension consisting of human endometrioma cells was injected into the animals’ peritoneal cavity. Upon lesion stablishment all animals were divided into five groups and treated with either high (7.5mg/kg/day), medium (5mg/kg/day) or low (2.5mg/kg/day) dose of TrkB inhibitor cyclotraxin-b, negative control (saline) or 0.04mg/kg/day letrozole. After four weeks of treatment all animals were sacrificed, all major organs were collected and assessed with routine histology for potential adverse effects of the treatment, all endometriotic implants were analyzed with routine histology and IHC for a panel of markers: BDNF, TrkB, anti-human mitochondrial protein, CD31, VEGFa, VEGFR1, VEGFR2. Treatment did not cause any significant side effects. There was a dose-dependent trend in reduction of endometriotic implants’ volume and number. IHC confirmed expression of the angiogenic markers within endometriotic implants. A larger study may be required to replicate results and advance the search for novel non-hormonal endometriosis treatment. / Thesis / Master of Science in Medical Sciences (MSMS) / Endometriosis is a chronic pain condition affecting more than 176 million women worldwide. Despite its commonality and severity its gold standard diagnosis is performed through invasive laparoscopy and there is no cure resulting in low quality of both physical and mental health of the affected individuals. Levels of a neurotrophic factor - BDNF and its high affinity receptor TrkB have been found increased in women with endometriosis and thus, BDNF-TrkB signaling cascade appears to be a promising therapeutic target. This study investigated an effect of TrkB inhibitor – cyclotraxin-b on reduction of endometriotic lesion number and volume within an immunocompromised model. Replication of results and increase of sample size may provide more details about cyclotraxin-b clinical relevance for treatment of endometriosis.

Background Endometriosis affects about one in ten women and is a chronic disease. The endometrium grows outside the uterus cavity and causes pain and suffering that leads to a reduced quality of life. Aim The aim of this study was to investigate women´s experience of pain when living with endo-metriosis. Method The method used was a qualitative integrative compilation inspired by meta-synthesis where nine qualitative articles were analyzed. Results In this study three main themes and six sub-themes emerged. These showed that pain, infertility, heavy and long periods as symptoms when diagnosed with endometriosis affects woman in her daily life. This contributes to lost function and isolation when it comes to social relationships, love life, work, studies and everyday life. Conclusion Women with endometriosis need to receive care based on their individual problems and meet healthcare professionals who has knowledge and competence regarding endometriosis. This to provide the best possible conditions to alleviate suffering for these women.

Bakgrund: Endometrios drabbar nästan var tionde kvinna i fertil ålder, ungefär 250 000 kvinnor i Sverige. Endometrios kan leda till funktionsnedsättning på grund av kronisk bäckensmärta och andra endometriosrelaterade symtom som smärtsamma menstruationer, rikliga blödningar, smärta vid samlag och infertilitet. Syfte: Syftet var att beskriva kvinnors upplevelser av endometrios. Metod: En litteraturöversikt - innehållsanalys av elva originalstudier för att beskriva kunskapsläget inom aktuell forskning. Datainsamlingen genomfördes med hjälp av två elektroniska forskningsdatabaser Cinahl Complete och PubMed och studier analyserades med hjälp av Fribergs fyrstegsmodell. Resultat: Endometrios har negativ inverkan på kvinnors liv i flera aspekter: fysiskt, psykiskt och socialt. Huvudsakligen handlar kvinnors upplevelser om smärta och dess effekter på det dagliga livet.Fastställning av diagnos kan ta lång tid för många kvinnor, detta harmed sig ofördelaktiga effekter på kvinnornas fysiska och psykiskahälsa, därför listas endometrios som en dold sjukdom i behov avmycket stöd från samhälle och familj. Sammanfattning: Litteraturöversikten har påvisat en klar bild av otillräckliga kunskap och information om endometrios både inom vården och samhället, en normalisering av symtompåverkan som har med sig ogynnsamma effekter på kvinnornas liv och välbefinnande. För att undvika normaliseringen av endometrios behövs ökade kunskapsinsatserfrämst hos sjukvårdspersonal. Trots att det finns mängder av beprövade kunskaper om endometrios, ändå hittas fortfarande brister på stöd i fokus att utforska endometrios omvårdnaden. Med den anledning tycks att endometrios ska vara ett intressant ämne för framtida forskningen. / Background: Endometriosis affects almost one in ten women of reproductive age, approximately 250,000 women in Sweden. Endometriosis can lead to disability due to chronic pelvic pain and other endometriosis related symptoms such as painful periods, heavy bleeding, pain during intercourse and infertility. Aim: The aim was to describe women's experiences of endometriosis. Method: A literature review - content analysis of eleven originalstudies to describe the state of knowledge in current research. Data collection was conducted using two electronic research databases Cinahl Complete and PubMed and studies were analysed using Friberg's four-step model. Results: Endometriosis has a negative impact on women's lives in several aspects: physical, psychological, and social. Mainly, women's experiences relate to pain and its effects on daily life. Diagnosis can take a long time for many women, which has unfavourable effects on their physical and mental health, therefore endometriosis is listed as a hidden disease in need of much support from society and family. Summary: The literature review has revealed a clear picture of inadequate knowledge and information about endometriosis in both health care and society, a normalisation of symptoms that has unfavourable effects on women's lives and well-being. In order to avoid the normalisation of endometriosis, there is a need to increase knowledge, especially among healthcare professionals. Even though there is a lot of proven knowledge about endometriosis, there is still a lack of support in the focus of exploring endometriosis care. Therefore, it seems that endometriosis should be an interesting topic for future research.

No description available.

Endometriosis is a heterogeneous chronic pain and inflammatory disease associated with negative impacts on quality of life. Among the phenotypes of endometriosis, deep endometriosis (DE) is the most aggressive form of the disease, associated with complex disease states, such as adhesions within the pouch of Douglas (POD) and bowel DE. The most common site of DE is the uterosacral ligaments (USLs), which are bilateral structures between the uterus and sacrum conjoined by the torus uterinus (TU), with a prevalence of 20 to 70%. The USLs have historically been the hardest to visualize using non-invasive modalities, such as transvaginal ultrasound (TVS), resulting in poor identification of endometriosis when present on/within the USLs, contributing to the significant diagnostic delay associated with the disease. This thesis details a novel diagnostic approach, utilizing TVS within the posterior vaginal fornix as the index test and laparoscopic visualization as the reference standard, aiming to evaluate the diagnostic accuracy of TVS for DE of the USLs and TU. Additionally, the USLs and TU are commonly associated with complex disease presentations, including POD obliteration and bowel DE, though the impact on diagnostic accuracy remains unknown. We theorize that these concurrent complex disease states will lead to the distortion of the anatomical environment and, in turn, negatively alter the diagnostic performance of the novel posterior approach. This thesis further aimed to determine the impact of concurrent complex disease states on diagnostic performance. We found enhanced diagnostic accuracy in the detection of endometriosis in the left USL, right USL, and TU compared to previous studies, with our sensitivity ranging from 75.0-100%, specificity of 100%, positive predictive values of 100%, and negative predictive value ranging from 88.6-100%. Furthermore, contrary to our hypothesis, diagnostic performance appeared unaffected by the presence of complex disease states. The ability to diagnose USL DE non-invasively can have profound implications for introducing personalized treatment plans in a timely manner, which should improve patient outcomes. With this enhanced diagnostic performance, fewer people will require a surgical diagnosis, which reduces the burden on the health system and decreases surgical complications associated with diagnostic surgery. / Thesis / Master of Science (MSc) / Endometriosis is a common gynecological disease involving the abnormal growth of uterine-like cells outside the uterus, causing significant negative impacts on quality of life and diagnostic delays. Deep endometriosis (DE) is the most aggressive form, infiltrating surrounding tissues and leading to complex disease states. The uterosacral ligaments (USLs; connective structures between the lower spine and uterus) are the most common site for DE, but diagnosing them non-invasively remains challenging, aiding the diagnostic delay. Following updated classification guidelines, the overarching aim of this thesis is to enhance our understanding of transvaginal ultrasound (TVS) as a safe and rapid diagnostic for DE of the USLs and TU. In doing so, this thesis aims to assess the accuracy of a new TVS technique for DE of the USLs and determine how other related health conditions might affect the accuracy of this diagnostic approach. The findings from this study indicate that using TVS could greatly assist in diagnosing DE in the USLs, potentially leading to more personalized treatment approaches by healthcare providers and better outcomes for individuals with endometriosis. In summary, this research contributes significantly to our understanding and management of this complex condition.