Τίτλος:
EMAS position statement: Managing the menopause in women with a past history of endometriosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Introduction: Endometriosis is a common disease in women of reproductive age. The symptoms usually disappear after a natural or a surgical menopause. Estrogen-based hormone therapy is required in women with premature or early menopause until the average age of the natural menopause and should be considered in older women with severe climacteric symptoms. However use of hormone therapy raises concerns about disease recurrence with pain symptoms, need for surgery and possibly malignant transformation of residual endometriosis. Aim: To formulate a position statement on the management of the menopause in women with a past history of endometriosis. Materials and methods: Literature review and consensus of expert opinion. Results and conclusions: The data regarding hormone therapy regimens are limited. However it may be safer to give either continuous combined estrogen-progestogen therapies or tibolone in both hysterectomised and nonhysterectomised women as the risk of recurrence may be reduced. The risk of recurrence with hormone therapy is probably increased in women with residual disease after surgery. Management of potential recurrence is best monitored by responding to recurrence of symptoms. Women not wanting estrogen or those who are advised against should be offered alternative pharmacological treatment for climacteric symptoms or skeletal protection if indicated. Herbal preparations should be avoided as their efficacy is uncertain and some may contain estrogenic compounds. © 2010 Elsevier Ireland Ltd. All rights reserved.
Συγγραφείς:
Moen, M.H.
Rees, M.
Brincat, M.
Erel, T.
Gambacciani, M.
Lambrinoudaki, I.
Schenck-Gustafsson, K.
Tremollieres, F.
Vujovic, S.
Rozenberg, S.
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
clonidine; estradiol; estrogen; gabapentin; herbaceous agent; medroxyprogesterone acetate; Muellerian inhibiting factor; norethisterone acetate; progesterone; serotonin uptake inhibitor; tibolone, breast cancer; cancer risk; climacterium; clinical trial; drug efficacy; early menopause; endometriosis; endometrium hyperplasia; estrogen therapy; female; follow up; herbal medicine; high risk population; hormonal therapy; hot flush; human; hysterectomy; malignant transformation; medical history; menopause; minimal residual disease; nonhodgkin lymphoma; obesity; ovariectomy; ovary cancer; ovary insufficiency; pelvis pain syndrome; recurrent disease; review
DOI:
10.1016/j.maturitas.2010.04.018
