Menopausal hormonal therapy in surgically menopausal women with underlying endometriosis

Prasong Tanmahasamut, Manee Rattanachaiyanont, Kitirat Techatraisak, Suchada Indhavivadhana, Thanyarat Wongwananuruk, P Chantrapanichkul
Climacteric : the journal of the International Menopause Society · 2021 · doi:10.1080/13697137.2021.1998434 · PMID:34783284
other OA: closed public-domain-us
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This retrospective cohort study found no significant association between menopausal hormone therapy use and endometriosis recurrence in surgically menopausal women who underwent hysterectomy with bilateral salpingo-oophorectomy.

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Abstract

OBJECTIVE: This study aimed to investigate the relationship between menopausal hormone therapy (MHT) and endometriosis recurrence in women who underwent hysterectomy with bilateral salpingo-oophorectomy to treat endometriosis. METHOD: This retrospective cohort study included 330 women who underwent definitive surgery to treat endometriosis during 1996-2012. Follow-up data until December 2018 were analyzed. Patients were grouped as MHT non-users (non-MHT, n = 43), estrogen-only therapy (ET, n = 230), estrogen-progestogen therapy (EPT, n = 39) and tibolone (n = 18). RESULTS: The mean age at surgery was 41.5 ± 5.3 years. The overall median follow-up duration was 6.0 years (interquartile range [IQR]: 3.0-10.4), and the median duration of MHT use was 66.0 months (IQR: 36.0-116.3). The overall recurrence rate was 3.0% (95% confidence interval: 1.5-5.5) and there was no significant difference in recurrence among the study groups. Disease recurrence resolved after MHT discontinuation, or change in MHT type and/or dose. CONCLUSIONS: No significant association between MHT use and endometriosis recurrence was found in this study. The endometriosis recurrence rate was non-significantly different between ET and EPT. Recurrent endometriosis can be successfully treated without invasive measures. No study patients had malignant transformation after a median follow-up of 6 years. Our findings suggest that any of the three evaluated MHT regimens can be used in surgically menopausal Thai women with underlying endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Estrogen Replacement Therapy Estrogens Estrogens Female Hormone Replacement Therapy Humans Menopause Retrospective Studies

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References (15)

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