Endometriosis: seeking optimal management in women approaching menopause

L Alio, S Angioni, Stefano Angioni, Salvatore Arena, S Arena, Ludovica Bartiromo, L Bartiromo, V Bergamini, Valentino Bergamini, Nicola Berlanda, V Bonanni, Valentina Bonanni, C Bonin, Cecilia Bonin, Laura Buggio, Massimo Candiani, M Candiani, Gabriele Centini, G Centini, M N D'Alterio, Maurizio Nicola D’Alterio, Francesca De Stefano, F De Stefano, A Di Cello, Annalisa Di Cello, C Exacoustos, C. Exacoustós, Luigi Fedele, Maria Pina Frattaruolo, E Geraci, E Lavarini, Lucia Lazzeri, L Lazzeri, Stefano Luisi, S Luisi, A Maiorana, Antonio Maiorana, Sofia Makieva, S Makieva, F Maneschi, Francesco Maneschi, F Martire, Francesco Giuseppe Martire, Claudia Massarotti, Alberto Mattei, A Mattei, Ludovico Muzii, L Muzii, J Ottolina, Jessica Ottolina, L Pagliardini, Luca Pagliardini, A Perandini, Alessio Perandini, F Perelli, Federica Perelli, Ida Pino, I Pino, M G Porpora, Maria Grazia Porpora, V Remorgida, Valentino Remorgida, G Scagnelli, Giuseppe Scagnelli, R Seracchioli, Renato Seracchioli, Eugenio Solima, E Solima, Edgardo Somigliana, Giuseppe Sorrenti, G Sorrenti, A Ticino, Adele Ticino, R Venturella, Roberta Venturella, Paola Viganò, M Vignali, Fabrizio Zullo, F Zullo, Errico Zupi, E Zupi
Climacteric : the journal of the International Menopause Society · 2019 · vol. 22(4) , pp. 329–338 · doi:10.1080/13697137.2018.1549213 · PMID:30628469 · W2909889657
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review assesses therapies for endometriosis in women approaching menopause, noting progestins' effectiveness for pain and recommending hysterectomy with bilateral salpingo-oophorectomy if medical therapy fails in those who have completed childbearing.

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Abstract

The incidence of endometriosis in middle-aged women is not minimal compared to that in the reproductive age group. The treatment of affected women after childbearing age to the natural transition toward menopause has received considerably poor attention. Disease management is problematic for these women due to increased contraindications regarding hormonal treatment and the possibility for malignant transformation, considering the increased cancer risk in patients with a long-standing history of the disease. This state-of-the-art review aims for the first time to assess the benefits of the available therapies to help guide treatment decisions for the care of endometriosis in women approaching menopause. Progestins are proven effective in reducing pain and should be preferred in these women. According to the international guidelines that lack precise recommendations, hysterectomy with bilateral salpingo-oophorectomy should be the definitive therapy in women who have completed their reproductive arc, if medical therapy has failed. Strict surveillance or surgery with removal of affected gonads should be considered in cases of long-standing or recurrent endometriomas, especially in the presence of modifications of ultrasonographic cyst patterns. Although rare, malignant transformation of various tissues in endometriosis patients has been described, and management is herein discussed.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Menopause Clinical Decision-Making Endometriosis Female Humans Hysterectomy Ovariectomy Salpingectomy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (84)

Cited by (33)

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