OB-GYN University Clinic, University Hospital of Larissa, Larissa, Greece.
Reprod Biol Endocrinol. 2011 Jun 21;9:90. doi: 10.1186/1477-7827-9-90.
Postmenopausal endometriosis is a rare clinical condition. The diagnosis and treatment of an endometriotic lesion in postmenopausal women is complicated. First line treatment choice should be surgical, given that there is a potential risk of malignancy. Medical treatment may be considered as second line or as an alternate first line treatment whenever surgery is contradicted and aims to alter the hormonal pathway leading to endometriosis progress. Different hormonal regimens have been administered to these patients, with conflicting however results. Aromatase inhibitors (AIs) represent one of the most recently used drugs for postmenopausal endometriosis. Clinical data for the use of (AIs) in postmenopausal patients is scarce. Up to date only 5 case reports are available regarding the use of these agents in postmenopausal women. Although definite conclusions may be premature, AIs appear to considerably improve patients' symptoms and reduce endometriotic lesions size. Nonetheless the subsequent induced reduction in estrogen production, leads to certain short-term and long-term adverse effects. Despite the limited available data, AIs appear to represent a new promising method which may improve symptoms and treat these patients, either as first line treatment, when surgery is contraindicated or as a second line for recurrences following surgical treatment. However, careful monitoring of patients' risk profile and further research regarding long-term effects and side-effects of these agents is essential prior implementing them in everyday clinical practice.
绝经后子宫内膜异位症是一种罕见的临床病症。绝经后妇女的子宫内膜异位症病变的诊断和治疗较为复杂。鉴于存在恶性肿瘤的潜在风险，一线治疗选择应是手术。如果手术受到限制，并且旨在改变导致子宫内膜异位症进展的激素途径，则可以考虑药物治疗作为二线或替代一线治疗。已经向这些患者施用了不同的激素方案，但结果却存在冲突。芳香酶抑制剂（AIs）是绝经后子宫内膜异位症最近使用的药物之一。关于（AIs）在绝经后患者中的使用的临床数据很少。迄今为止，只有 5 例关于这些药物在绝经后妇女中使用的病例报告。尽管可能还为时过早，但 AIs 似乎可以明显改善患者的症状并减少子宫内膜异位症病变的大小。然而，随后雌激素产生的减少会导致某些短期和长期的不良反应。尽管可用数据有限，但 AIs 似乎代表了一种新的有前途的方法，它可以改善症状并治疗这些患者，无论是作为手术禁忌时的一线治疗，还是在手术后复发时的二线治疗。然而，在将这些药物应用于日常临床实践之前，必须仔细监测患者的风险状况，并对这些药物的长期效果和副作用进行进一步研究。
