The use of Hormone Therapy after Surgery for Endometriosis: An Analysis

Roger A. Lobo, Katia Franco Quaresma de Moura
In: Journal of Endometriosis and Pelvic Pain Disorders · 2016 · vol. 8(4) , pp. 152–156 · doi:10.5301/je.5000256 · W2541845934
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This review of postmenopausal endometriosis and hormone therapy found that while some risk of recurrence exists, especially with estrogen-only therapy, it may be reasonable to prescribe hormone therapy to women with a history of surgical endometriosis, particularly estrogen plus progestogen.

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Abstract

Introduction Estrogen dependence is considered central to the development and progression of endometriosis, which is often viewed as a disease of the premenopausal years, normally regressing after menopause. However, there have been several reports of postmenopausal endometriosis occurring with and without the use of hormone therapy (HT). Objective This review aimed to answer the question of whether it is prudent to offer HT for women with a past history of surgical endometriosis. What are the risks? What type of HT should be given? Methods A review of the medical literature available in Pubmed, EMBASE, Google scholar, Lilacs, Medline and Cochrane Library databases was performed by selecting articles published in the last ten years, written in any language. The keywords used were endometriosis, menopause, and hormone therapy. In all, 36 articles were found from 2006 to 2016, and their potential relevance to this review was examined. We found 20 literature reviews, 2 retrospective studies, 2 randomized controlled trials and 12 case reports. Results There is some risk of endometriosis recurrence after the menopause in patients who receive HT; particularly with estrogen-only therapy. Conclusions The existing literature is inadequate to firmly answer our questions. However it is clear that some risk of recurrence exists. Nevertheless, it is suggested that it is reasonable to prescribe HT to women with a history of surgical endometriosis. Recurrences may occur even in the absence of using HT. It is suggested that in women with severe disease the use of estrogen plus progestogen is safer than estrogen alone. Malignant transformation may occur 1% of the time and may be of greater concern with using estrogen alone, warranting close surveillance in all women.

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Condition tags

endometriosis

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 ]

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