Topical estrogens for the treatment of superficial dyspareunia related to genitourinary syndrome of menopause in women with a history of endometriosis: A clinical dilemma

Cetera GE, Giulia Emily Cetera, G E Cetera, Merli CEM, Camilla Erminia Maria Merli, C E M Merli, Veronica Boero, V Boero, Boero V, Caia C, C Caia, Carlotta Caia, Paolo Vercellini, P Vercellini
European journal of obstetrics, gynecology, and reproductive biology · 2023 · vol. 288 , pp. 12–17 · doi:10.1016/j.ejogrb.2023.06.025 · PMID:37421742 · W4382051735
Review OA: closed CC0 ⤵ 1 in-corpus citation
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This paper discusses the potential benefits and risks of topical estrogens for treating genitourinary syndrome of menopause in women with a history of endometriosis, highlighting the need for more evidence.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Estrogen withdrawal, which occurs with the cessation of ovulation, causes genitourinary syndrome of menopause in up to 50-85% of women. Symptoms may profoundly impact quality of life and sexual function, interfering with enjoyment of sex in up to three out of four individuals. Topical estrogens have been found to provide symptom relief with minimal systemic absorption and appear to be superior to systemic therapy as what regards genitourinary symptoms. However, conclusive data on their appropriateness in postmenopausal women with a history of endometriosis is not available and the hypothesis that exogenous estrogen stimulation may reactivate endometriotic foci or even promote their malignant transformation is still open. On the other hand, endometriosis affects around 10% of premenopausal women, many of which may be exposed to an acute hypoestrogenic depletion even before spontaneous menopause occurs. This considered, excluding on principle patients with a history of endometriosis from first-line treatment for vulvovaginal atrophy would mean excluding a considerable percentage of the population from adequate care. More robust evidence is urgently needed in these regards. Meanwhile, it would appear reasonable to tailor the prescription of topical hormones in these patients, taking into account the entity of symptoms and the impact such symptoms have on patients' quality of life, as well as the form of endometriosis and the possible risks hormonal may entail. Moreover, the application of estrogens on the vulva instead of the vagina could be efficacious, while outweighing the possible biological cost of hormonal treatment in women with a history of endometriosis.

My notes (saved in your browser only)

Condition tags

dyspareuniaendometriosis

MeSH descriptors

Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (100)

Cited by (1)

Source provenance

europepmc
last seen: 2026-10-14T06:08:39.101224+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-10-14T06:07:52.445481+00:00
unpaywall
last seen: 2026-10-14T06:23:58.021457+00:00
License: CC0 · commercial use OK