2) This program is supported by an independent educational grant from Sumitomo, and meets accreditation standards ????????. @academiccme is a global leader in delivering highest-quality, accredited #MedEd across X–bringing education to #HCP learners where they are!
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
3b) They’re the ones hearing the 1st “my periods are killing me” story, deciding whether it’s “normal” or a red flag for #endometriosis. There are ~10-15,000 women’s‑health–focused #NPs + 1–2,000 OB‑GYN #PAs, w/both groups ⬆️as APPs fill gaps in the women’s health workforce.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
4b) . . . to, screen for impact on work, school, relationships, and fertility, and then coordinate imaging, #gynecology referral, and shared decision‑making over years, not weeks.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
5b) . . . and, at best, inconsistent use of evidence‑based #hormonal options (from #OCPs and #progestins to newer #GnRH‑antagonist combinations). Too many patients are told to “tough it out” rather than offered a structured, stepwise pain strategy.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
6b) The goal: help frontline #APPs close practical gaps in evaluation and stepwise #pain control so fewer patients live for years with “normalized” but disabling pelvic pain.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
8) Following are the survey questions, an opportunity for YOU to respond followed by the responses from 96 #NPs and 44 #PAs who self-report a women’s health practice focus, and some teaching pearls along the way. Let’s get going!
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
9b) What is your response to Q1? Which statement ⤴️ best reflects current understanding of endometriosis‑related pain?
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
9d) Here are the answers given by the APPs who participated in this survey: pic.twitter.com/zkvC9mp4N7
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
9f) These peripheral inputs drive both peripheral and central #sensitization, which helps explain why #pain can be severe even with small or “minimal” disease. See ?https://t.co/uYeim08PpU. pic.twitter.com/PHHpvNimiA
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
9h) 30–50% of pts w/#endometriosis have difficulty conceiving; mechanisms of infertility include distorted pelvic anatomy, chronic inflammatory changes in the peritoneal & endometrial environment, & reduced ovarian reserve. See ?https://t.co/kJeGujn2Zi.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
10b) What is your response to Q3? A 27‑year‑old presents with chronic pelvic pain and dysmenorrhea. Which initial evaluation step ⤴️ is most appropriate in primary/women’s health practice?
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
10d) Here are the answers given by the APPs who participated in this survey: pic.twitter.com/a2qNP7Mkws
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
10f) If first‑line medical therapy is ineffective or fertility is a priority, referral to #gynecology or an #endometriosis center is recommended for further evaluation and discussion of surgical, fertility, and multidisciplinary options. See ?https://t.co/obvouNauRx pic.twitter.com/CyDG286bMa
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
10h) See ?https://t.co/mWO48QaAR5. pic.twitter.com/WavuZeqnSf
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
11b) What is your response to Q5? For a patient with suspected endometriosis and moderate cyclic pelvic pain, which initial pharmacologic approach ⤴️is most appropriate?
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
11d) Here are the answers given by the APPs who participated in this survey: pic.twitter.com/2CChNsQ7ZC
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
11f) Contemporary reviews on #endometriosis‑related pain management describe a stepwise approach: begin with #NSAIDs and conservative measures for milder presentations, escalate to hormonal suppression (e.g., combined OCPs or progestins) . . .
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
11h) The correct answer for Q6 is B. #NSAIDs help many pts with #endometriosis‐related pain because they ⬇️prostaglandin‑driven cramping & other inflammatory mediators, but they do not treat the underlying disease or reliably control moderate‑to‑severe symptoms on their own.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
12a) There were two questions about when to add #hormonal therapy for #pain associated with #endometriosis: pic.twitter.com/BR44MJaVGS
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
12c) What is your response to Q8? Which of the above ⤴️ best describes a clinical scenario where a #relugolix‑based #GnRH antagonist combination could be considered?
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
12e) The correct answer for Q7 is B. When a pt w/suspected #endometriosis has only partial relief on optimized NSAIDs & is not trying to conceive soon, the next evidence‑based step is to add or switch to hormonal therapy (e.g., combined OCPs or progestin‑based regimens).
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
13a) As to Q8, which asks about a #relugolix‑based #GnRH antagonist combination: WHOA! Let’s level-set and make it clear what that is.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
13c) Relugolix quickly and reversibly suppresses #pituitary #GnRH signaling, which lowers ovarian estrogen production and quiets #endometriosis lesions; the low‑dose hormone add‑back helps balance symptom relief with long‑term tolerability. See https://t.co/C7styIKWPh pic.twitter.com/2ByR4fwzf9
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
13e) In that setting, oral GnRH antagonists with add‑back can offer stronger, reversible #estrogen suppression and meaningful pain relief while balancing bone and vasomotor side effects. Ph 3 & extension studies ➡️relugolix combination therapy . . .
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
14a) Finally, there were two questions about safety, monitoring, and counseling for patients with #endometriosis who are prescribed a GnRH antagonist combination for pain management: pic.twitter.com/gbHgCH61iI
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
14c) What is your response to Q10? For a patient starting a #relugolix‑based combination for #endometriosis pain, which monitoring strategy ⤴️is most appropriate?
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
14e) The correct answer for Q9 is B. #GnRH antagonists work by ⬇️ estrogen, which ⬇️#endometriosis pain, but that #hypoestrogenic state can ➡️ vasomotor symptoms & ?loss. It’s crucial to counsel pts up front about potential hot flashes, mood & sleep changes …
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
14g) … sustained pain relief with only a small (<1%) early drop in lumbar‑spine bone mineral density that then stabilizes—when appropriate add‑back is used and patients are monitored. See ?https://t.co/IGbyhizUYw.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
15a) So what have we learned? #Endometriosis‑related pain is not just about visible lesions; it reflects chronic inflammation & nervous‑system sensitization, often ➡️ persistent pain despite “normal” exams or imaging.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
15c) … oral #relugolix‑based #GnRH antagonist combinations ➡️?suppression of ovarian estrogen & calm #endometriosis activity, while built‑in add‑back hormones help protect bone & mitigate hot flashes, mood changes, & other hypoestrogenic effects.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
16b) … deciding when it’s time to escalate to a #GnRH antagonist combination vs pursue surgery or specialty referral. Their longitudinal relationships with patients make shared decisions around these trade‑offs possible.
— @womenshealth_ce (@ce_womenshealth) March 18, 2026
17) Congratulations! ??You just earned 0.75hr ? CE/#CME! Point your ?️to https://t.co/7I0YN4z4s4 to grab your certificate. Thank you ?for joining us!
— @womenshealth_ce (@ce_womenshealth) March 18, 2026