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La endometriosis y la salud en la menopausia: una guía clínica de EMAS
C Tamer Erel1, Meletios P Nigledis2, Ipek Betul Ozcivit Erkan1
1Department of Obstetrics and Gynecology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Maturitas
|September 4, 2025
Resumen
Las mujeres con endometriosis requieren atención especializada durante la menopausia. El tratamiento se centra en la cirugía, la terapia hormonal adecuada para la menopausia (MHT, por sus siglas en inglés) y la protección ósea para abordar los riesgos de salud asociados.
Área de la Ciencia:
- Ginecología
- Manejo de la menopausia
- Investigación de la endometriosis
Sus antecedentes:
- La endometriosis es una afección ginecológica prevalente con posibles complicaciones posmenopáusicas.
- La endometriosis premenopáusica o su tratamiento pueden conducir a la menopausia prematura o temprana.
- Los proveedores de atención médica necesitan capacitación especializada para el manejo de la endometriosis durante y después de la menopausia.
Objetivo del estudio:
- Establecer una guía clínica basada en la evidencia para evaluar y administrar la salud menopáusica en mujeres con antecedentes de endometriosis.
- Proporcionar recomendaciones para una atención óptima teniendo en cuenta los riesgos y desafíos únicos que enfrentan estos pacientes.
Principales métodos:
- Revisión completa de la literatura médica existente.
- Desarrollo de consenso basado en el dictamen clínico de expertos.
Principales resultados:
- La cirugía es el tratamiento primario para la endometriosis posmenopáusica sintomática, ayudando al diagnóstico y reduciendo el riesgo de malignidad.
- Las mujeres con endometriosis se enfrentan a riesgos de menopausia temprana, enfermedades cardiovasculares, ciertos tipos de cáncer y osteoporosis.
- Se recomienda la terapia hormonal menopáusica (MHT) para el control de los síntomas y la salud ósea; la combinación continua de MHT puede ofrecer beneficios de seguridad sobre las opciones de estrógeno solo.
- Los tratamientos alternativos no hormonales y las terapias de protección ósea son cruciales para aquellos que no usan MHT o experimentan una recurrencia.
Conclusiones:
- El tratamiento eficaz de la endometriosis en mujeres menopáusicas requiere un enfoque multifacético.
- Las estrategias de tratamiento personalizadas, incluidas las opciones quirúrgicas, la MHT adaptada y las intervenciones de salud ósea, son esenciales.
- Se recomienda evitar los remedios herbales no probados debido a los riesgos potenciales.
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