Obravnava endometrioze v pomenopavznem obdobju

Urška Belak Magdalenić, Helena Ban Frangež, Sara Korošec
In: Slovenian Medical Journal · 2023 · pp. 1–8 · doi:10.6016/zdravvestn.3420 · W4388911974
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper discusses the diagnosis and surgical treatment of postmenopausal endometriosis, noting that hormone replacement therapy may reactivate endometrial lesions and increase malignancy risk, thus requiring caution.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper reviews endometriosis in postmenopausal women, focusing on management considerations, diagnostic concerns, and the roles of estrogen and malignant transformation. It summarizes that endometriosis occurs in about 2–5% of postmenopausal women, that malignancy is a key concern prompting diagnostic vigilance, and that endometriosis can recur after menopause or arise de novo. It states that for symptomatic endometriosis in menopause, surgical removal of all visible disease is the treatment of choice due to relatively higher risks of recurrence and conversion to malignancy, while postmenopausal hormone therapy may reactivate endometriotic foci and potentially promote malignant transformation, with the risks not fully known. The paper is centrally about endometriosis — it specifically addresses endometriosis management and malignant transformation risk in the menopausal/postmenopausal period.

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Abstract

Endometrioza je bolezen, ki lahko prizadene 2–5 % vseh žensk v pomenopavznem obdobju. Gre za bolezen, pri kateri se endometrijske žleze in stroma nahajajo zunaj maternice. O pomenopavzni endometriozi je zaenkrat v literaturi še malo znanih podatkov. V sklopu diagnosticiranja je v tem obdobju v ospredju predvsem skrb, da gre morda za maligno bolezen. Poročila v literaturi opisujejo ponovitev endometrioze v pomenopavznem obdobju kot tudi nastanek endometrioze »de novo«. Zdravljenje izbire simptomatske endometrioze v pomenopavzi je kirurško z odstranitvijo vsega vidnega endometriotičnega tkiva zaradi višjega tveganja za ponovitev bolezni in preobrat v maligno bolezen. Hormonsko zdravljenje po menopavzi (MHZ) se pogosto uporablja za lajšanje simptomov in preprečevanje izgube kostne mase. Obstajajo raziskave, ki dokazujejo, da MHZ lahko ponovno aktivira endometriotična žarišča in celo spodbuja maligno preoblikovanje žarišč pri ženskah z anamnezo endometrioze. Glede na ne povsem razjasnjena tveganja MHZ pri tovrstnih bolnicah se svetuje dodatna previdnost.

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