Keeping an Eye on Perimenopausal and Postmenopausal Endometriosis

Area of Science:

• Gynecology
• Epidemiology
• Oncology

Background:

• Endometriosis is a common gynecological condition.
• Its presentation and characteristics can vary significantly across different menopausal stages.
• Understanding these variations is crucial for accurate diagnosis and management.

Purpose of the Study:

• To describe and review the epidemiological aspects and disease patterns of endometriosis in perimenopausal and postmenopausal women.
• To compare the clinicopathological characteristics of endometriosis between these two groups.
• To investigate potential correlations between endometriosis and other gynecological conditions, including cancer.

Main Methods:

• Retrospective examination of clinical records from 184 perimenopausal and 46 postmenopausal women with histologically confirmed endometriosis.
• Data analysis from 1100 patient charts across two geographical areas (US and Greece).
• Statistical analysis using chi-squared (ײ) and Mann-Whitney U tests.

Main Results:

• Perimenopausal endometriosis (age 45-54) was diagnosed earlier (average 49 years) and showed more aggressive behavior compared to postmenopausal endometriosis (age 55-80, average 61.2 years).
• Left-sided predisposition and endometrioma were more common in perimenopausal women, while adenomyosis was more prevalent in postmenopausal women.
• Uterine leiomyomata were more prominent in the perimenopausal group, and 24 cases of dry eye were noted.

Conclusions:

• Postmenopausal endometriosis is an important, yet underestimated, condition with unique clinicopathological features.
• While not common, significant differences exist in disease presentation between perimenopausal and postmenopausal women.
• Clinicians must recognize the potential correlation between endometriosis and endometriosis-associated ovarian cancer in these age groups.