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Endometriosis in postmenopause
Ceska Gynekologie
|December 21, 2022
Summary
Endometriosis, typically affecting women of reproductive age, can recur or appear in postmenopause, affecting 2-5%. Tibolone shows promise in hormonal therapy for this rare condition.
Area of Science:
- Gynecology
- Reproductive Medicine
- Oncology
Background:
- Endometriosis is primarily a disease of women of reproductive age.
- While endometriosis foci typically atrophy postmenopause, recurrence or de novo occurrence is documented.
- Prevalence in postmenopausal women ranges from 2-5%.
Approach:
- This review synthesizes current knowledge on postmenopausal endometriosis, focusing on prevalence, risk factors, symptoms, and management.
- Diagnostic modalities include ultrasound and magnetic resonance imaging.
- Therapeutic strategies involve hormonal therapy (Tibolone recommended) and surgical intervention.
Key Points:
- Pain (43.5%) and palpable findings (28%) are common symptoms.
- Endometriotic cells exhibit proliferative, survival, and metastatic capabilities.
- Malignant transformation risk is approximately 1%, often presenting as low-grade endometrioid or clear cell ovarian carcinomas.
Conclusions:
- Tibolone is effective for hormonal therapy in postmenopausal endometriosis.
- Surgical intervention is crucial for diagnosis and excluding malignancy.
- Endometriosis poses risks including malignant transformation, necessitating vigilant diagnosis and management.
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