Endometriosis in Peri- and Postmenopausal Year

Endometriosis is known as an estrogen-dependent disease; that is why for decades it was considered to regress and most frequently disappear after menopause occurred. More recent information showed that estrogen deprivation in menopause doesn’t cause the regression of all endometriosis lesions. Many case series of symptomatic endometriosis in menopausal patients with particular microscopic features have been described in the literature. However, peri- and postmenopausal endometriosis is a rare disease, more frequent in women undergoing hormone replacement therapy. In these patients, endometriosis lesions can appear de novo or as recurrent disease. It carries a risk of malignant transformation higher than endometriosis present in fertile patients, around 1%, even higher in patients treated with estrogen for the climacteric syndrome. Moreover, menopausal patients with endometriosis carry a higher risk for ovarian and, some research affirms, other gynecological malignancies. The recommended treatment is primarily surgical, consisting of total hysterectomy and bilateral adnexectomy. Even if there isn’t any solid evidence, the risk of malignant transformation appears to be lower in patients undergoing also hysterectomy, compared to those receiving only bilateral adnexectomy. Although it is a rare disease, peri- and postmenopausal endometriosis should be taken into account, because of the risk of disease recurrence and malignant transformation. In these patients, hormone replacement therapy is reserved only for severe climacteric syndrome and should consist of combined estrogen-progesterone therapy. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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(eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_17 Download citation DOI: https://doi.org/10.1007/978-3-030-97236-3_17 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-97235-6 Online ISBN: 978-3-030-97236-3 eBook Packages: MedicineMedicine (R0)