WorksheetsEndogolix
Total questions: 15
Worksheet time: 8mins
Tissue that normally lines the inside of the uterus grows in places other than the uterus, such as:
Ovaries
Fallopian tubes
Bowel/ bladder
Rectum
endometriosis is an --------- dependent chronic inflammatory disease
(a)
Endometriosis causes are
Retrograde Menstruation
Alcohol & Smoking
Celomatic Metaplasia
Lymphatic & Vascular Metaplasia
Three distinct forms of endometriosis are:
Peritoneal
Vaginal
Seminal vesicle
Recto-vaginal
Endometriosis has the following clinical presentations:
dysmenorrhea
dyspareunia
non-menstrual pelvic pain
pregnancy
Signs & symptoms of endometriosis
Infertility
Pain, menstrual cramps, heavy bleeding
Dyspareunia
Fatigue
Diarrhea, constipation & /or low back pain, nausea
What are the medical management options available for endometriosis?
Combined OC pills
Progestins (dinogest/dydrogesterone)
GnRH agonist
GnRH antagonist
Aromatase inhibitors
Shortcomings of OC pills/ Progesterone
33% symptomatic patients are
non-responders
Efficacy decreases over time
Side effects such as weight gain, mood swings, irregular uterine bleeding
Venous/ arterial embolism
Shortcomings of Progastrin-only formulations
progesterone resistance
drug-induced breakthrough bleeding
permanent decreases in BMD
limited efficacy
Shortcomings of GnRH Agonists (Leuprorelin, Goserelin, Triptorelin)
Flare-up effect
Excessive suppression / inability to titrate E2 levels
Unpredictable reversibility of the treatment
Side effects such as hot flushes / BMD loss
Main Advantages of GnRH antagonists such as Elagolix
Immediate gonadotropin suppression.
No flare-up effect.
Dose-dependent estrogen suppression.
Rapid reversibility & recovery of hormone secretion after stopping the treatment.
Possibility of individual dose tailoring to balance efficacy and safety.
Elagolix received approval from the US FDA in 2018 and the DCGI in 2024.
True
False
Elagolix is available in 2 SKU forms: 150 mg and 200 mg.
True
False
The dosage of Elagolix is 150 mg once daily for 24 months or 200 mg twice daily for 6 months.
True
False
Advantages of Elagolix
Oral agent, titratable estrogen suppression, which is not possible with injectable GnRH agonists.
Individual treatment based on tolerability and clinical presentation.
Does not suppress normal endometrium.
Does not completely suppress ovulation.
Appropriate empiric therapy for endometriosis.
