Endometriosis hidden behind menopause, a new paradigm

In: Gynecology & Obstetrics · 2021 · W3211801945
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This review summarizes updates on the scarce literature regarding endometriosis in postmenopausal women, highlighting diagnostic challenges, potential risks, and treatment uncertainties.

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This paper summarizes the limited literature on endometriosis in postmenopausal women, focusing on how disease may be exacerbated if previously undiagnosed or may develop de novo, though the underlying mechanisms remain uncertain. It describes the clinical presentation as nonspecific (ranging from asymptomatic to pelvic pain, ovarian cysts, and intestinal symptoms) and notes that no specific diagnostic biomarkers have been identified, with imaging (ultrasound and MRI) not yet providing a noninvasive accurate diagnostic method. It states that laparoscopic surgery with biopsy of suspicious lesions remains the gold standard for definitive diagnosis and possible treatment, and highlights ongoing controversy about menopausal hormone therapy, as well as the unclear optimal management of de novo postmenopausal cases. This paper is centrally about endometriosis — it reviews key diagnostic and management uncertainties in postmenopausal endometriosis.

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conferenceseries.com Volume: 00Gynecology & Obstetrics Page 8 Reproduction Fertility 2021 July 21, 2021 | Webinar July 21, 2021 | Webinar 3rd International Conference on Womens HealtH , RepR oduction and FeRtility Mariana Robalo Cordeiro et al., Gynecol Obstet (Sunnyvale) 2021, ISSN: 2161-0932 Endometriosis hidden behind menopause, a new paradigm Mariana Robalo Cordeiro1, Fernanda Geraldes1, Margarida Figueiredo-Dias1,2 1 Gynecology Department, Universitary Hospital Center of Coimbra, Portugal 2 Universitary Clinic of Gynecology, Faculty of Medicine, University of Coimbra, Portugal Endometriosis is known to be an estrogen-dependent chronic inflammatory disease, classically characteristic of reproductive-age women. In postmenopausal patients it is a rare condition, reported to affect up to 2-5% of women worldwide. The pathophysiologic mechanisms responsible for either the exacerbation of previous undiagnosed disease or the development of de novo endometriotic lesions remain uncertain. Clinical presentation of endometriosis in postmenopausal women is very unspecific, ranging from asymptomatic to pelvic pain, ovarian cysts and to intestinal symptoms. To date, there are no specific biomarkers identified for the endometriosis diagnosis, even though inflammatory markers and CA-125 levels can be modified, highlighting the need for novel diagnostic biomarkers. Imaging techniques, such as ultrasound and magnetic resonance imaging can possibly diagnose endometriotic lesions, nevertheless a non-invasive accurate diagnostic method is not yet available. Due to difficulties in diagnosing endometriosis in postmenopausal women, laparoscopic surgery and biopsy of suspicious lesions is the gold standard for its definitive diagnosis, having the additional therapeutic potential. The use of menopausal hormone therapy in women with a history of endometriosis is controversial, and further studies are needed to outweigh its risks and benefits. Besides, the ideal therapeutic approach in de novo endometriosis is also not clarified for women after menopause. It is also believed that postmenopausal women with endometriosis have an increased risk for malignant tumours, apart from the ovarian cancer. This presentation pretends to summarize the main updates on the scarce literature related to endometriosis in postmenopausal women, which merits full medical attention. Biography Mariana Robalo Cordeiro has completed her Master Degree in Medicine at the age of 24 years from Faculty of Medicine of the University of Coimbra and has a Post-graduation in Artificial Intelligence in Healthcare from Massachusetts Institute of Technology. She is a Gynecology and Obstetrics Resident at Universitary Hospital Center of Coimbra [email protected]

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