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Postmenopausal endometriosis associated with hormone replacement therapy. A case report
H M Goodman1, D Kredentser, L Deligdisch
1Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
The Journal of Reproductive Medicine
|March 1, 1989
Summary
Hormone replacement therapy may mask symptoms of endometriosis, a condition causing abdominal pain, pelvic masses, and ureteral obstruction in postmenopausal women.
Area of Science:
- Gynecology
- Urology
- Oncology
Background:
- Hormone replacement therapy (HRT) is commonly used for menopausal symptom management.
- Endometriosis is a condition where uterine-like tissue grows outside the uterus.
- Ureteral obstruction can lead to kidney damage if left untreated.
Observation:
- A postmenopausal woman on HRT presented with significant abdominal pain.
- A large pelvic mass was detected during physical examination.
- High-grade ureteral obstruction was identified, indicating a serious urinary tract issue.
Findings:
- Surgical exploration revealed endometriosis as the cause of the pelvic mass and obstruction.
- HRT may have masked or altered the typical presentation of endometriosis.
- Endometriosis can present atypically in postmenopausal women, especially those on HRT.
Implications:
- This case highlights the importance of considering endometriosis in postmenopausal women with unexplained pelvic masses and obstructive uropathy.
- HRT should be carefully evaluated in patients with suspected endometriosis due to potential symptom masking.
- Prompt diagnosis and management of ureteral obstruction secondary to endometriosis are crucial to preserve renal function.