Endometriosis after menopause: physiopathology and management of an uncommon condition

Streuli I, Isabelle Streuli, I. Streuli, Gaitzsch H, H Gaitzsch, Hélène Gaitzsch, Wenger JM, J-M. Wenger, P Petignat, Patrick Petignat
Climacteric : the journal of the International Menopause Society · 2017 · vol. 20(2) , pp. 138–143 · doi:10.1080/13697137.2017.1284781 · PMID:28286987 · W2586765139
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This paper reviews the physiopathology and management of postmenopausal endometriosis, highlighting potential extra-ovarian estrogen production and the need for surgical intervention due to malignancy risk.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-10-09 · read from full text ⓘ

This review article examines the pathophysiology and clinical management of endometriosis in postmenopausal women, a condition that persists or recurs after menopause due to local estrogen production. The authors discuss how adipose tissue aromatization contributes to disease activity and evaluate therapeutic options, including hormonal interventions and surgical approaches. They highlight the challenges associated with hormone replacement therapy in these patients and emphasize the need for tailored treatment strategies based on individual risk profiles. This paper is centrally about endometriosis — specifically focusing on its physiopathology and management in the postmenopausal population.

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Abstract

Endometriosis is a hormone-dependent inflammatory disease that is usually characterized by infertility and pain symptoms. This disease mainly occurs during the reproductive years and is rarely diagnosed after menopause. We discuss the physiopathology of this condition after menopause as well as treatment options and the risk of malignant transformation. Occurrence or progression of postmenopausal endometriosis lesions could be related to extra-ovarian production of estrogen by endometriosis lesions and adipose tissue, which becomes the major estrogen-producing tissue after menopause. Postmenopausal women with symptomatic endometriosis should be managed surgically because of the risk of malignancy; medical treatments can be used in cases of pain recurrence after surgery. Aromatase inhibitors act by decreasing extra-ovarian estrogen production and by blocking the feed-forward stimulation loop between inflammation and aromatase within endometriosis lesions. The evidence is currently insufficient to support a conclusion about the optimal hormone replacement therapy for women with endometriosis. The question of malignant transformation of endometriosis in response to hormone replacement therapy in women with a history of endometriosis remains unanswered and needs a long-term follow-up study to evaluate the risk of an adverse outcome. Further studies should be performed to determine the optimal management of menopausal women with endometriosis.
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Endometriosis after menopause: physiopathology and management of an uncommon condition Published inClimacteric, vol. 20, no. 2, p. 138-143 Publication date2017 Abstract Keywords - Adipose Tissue/drug effects/metabolism - Aromatase Inhibitors/pharmacology - Disease Management - Endometriosis/drug therapy/pathology/physiopathology - Estrogen Replacement Therapy/adverse effects - Estrogens/biosynthesis - Female - Humans - Middle Aged - Postmenopause UNIGE research groups Citation (ISO format) STREULI, Marie Isabelle et al. Endometriosis after menopause: physiopathology and management of an uncommon condition. In: Climacteric, 2017, vol. 20, n° 2, p. 138–143. doi: 10.1080/13697137.2017.1284781 Main files (1) Article (Published version) Identifiers - PID : unige:99607 - DOI : 10.1080/13697137.2017.1284781 - PMID : 28286987 Journal ISSN1369-7137

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Condition tags

endometriosisinfertility

MeSH descriptors

Aromatase Inhibitors Disease Management Disease Management Endometriosis Endometriosis Postmenopause Postmenopause Adipose Tissue Adipose Tissue Adipose Tissue Adipose Tissue Aromatase Inhibitors Aromatase Inhibitors Endometriosis Endometriosis Endometriosis Estrogen Replacement Therapy Estrogen Replacement Therapy Estrogen Replacement Therapy Estrogens

Citation neighborhood (2-hop)

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