Should we abstain from treating women with endometriosis using menopausal hormone therapy, for fear of an increased ovarian cancer risk?

S Rozenberg, Serge Rozenberg, Caroline Antoine, Antoine C, C Antoine, Vandromme J, Jean Vandromme, J Vandromme, M Fastrez, Maxime Fastrez, Fastrez M
Climacteric : the journal of the International Menopause Society · 2015 · vol. 18(4) , pp. 448–452 · doi:10.3109/13697137.2015.1041905 · PMID:25958744 · W1942946328
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This paper proposes a decision algorithm for treating women with endometriosis and menopausal symptoms using hormone therapy, considering risks of recurrence and ovarian cancer subtypes.

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Abstract

Women suffering from endometriosis often have an early menopause, resulting in severe menopausal symptoms and an increased risk of osteoporosis. They are therefore candidates for menopausal hormone therapy (MHT). Unfortunately, MHT may increase the risk of endometriosis recurrence. Moreover, endometriosis patients are at increased risk of ovarian cancer, which may be further enhanced by MHT use. It is unknown, however, whether MHT more frequently increases type I (low-grade serous tumors), which seem to be increased when endometriosis is present, or type II (the more aggressive high-grade serous) tumors. We propose the following decision-making algorithm for endometriosis patients considering MHT. Those who have been treated with bilateral salpingo-oophorectomy, and in whom there is no residual endometriotic disease, can probably be treated using MHT without risk of endometriosis recurrence or fear of ovarian cancer. For women with significant, residual endometriosis lesions, the benefit may outweigh the risks, when menopause is reached before the age of 45 years or when severe symptoms are present.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Estrogen Replacement Therapy Ovarian Neoplasms Adult Aged Age Factors Endometriosis Estrogen Replacement Therapy Estrogen Replacement Therapy Female Humans Menopause, Premature Middle Aged Ovarian Neoplasms Ovarian Neoplasms Recurrence

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.

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License: CC0 · commercial use OK