Tan D A, Almaria M J G
a Section of Reproductive Medicine, Department of Obstetrics and Gynecology , St. Luke's Medical Center-Quezon City , Quezon City , Philippines.
Climacteric. 2018 Jun;21(3):249-255. doi: 10.1080/13697137.2018.1450855. Epub 2018 Apr 3.
This review aims to draw a clearer clinical picture of postmenopausal endometriosis. Based on limited literature, postmenopausal endometriosis emerges as an infrequent entity but with a clinical picture significantly unlike that of premenopausal endometriosis. In contrast to the premenopausal disease, postmenopausal endometriosis occurs in a state of ovarian estrogen deficiency, appears to have a greater predisposition to malignant change, may have a greater tendency to spread to extragonadal organs and develop into constrictive and/or obstructive lesions, and is preferably treated surgically. The need to use hormone therapy for the management of menopausal symptoms that may concomitantly affect women with postmenopausal endometriosis is an unresolved therapeutic dilemma. This is mainly because the relationships of menopausal hormone therapy to recurrence of endometriosis and, more importantly, to increased risk of malignant degeneration, remain unclear.
本综述旨在更清晰地勾勒绝经后子宫内膜异位症的临床情况。基于有限的文献资料，绝经后子宫内膜异位症虽属罕见病症，但其临床表现与绝经前子宫内膜异位症显著不同。与绝经前疾病相比，绝经后子宫内膜异位症发生于卵巢雌激素缺乏状态，似乎更易发生恶变，可能更倾向于扩散至性腺外器官并发展为狭窄性和/或阻塞性病变，且首选手术治疗。对于可能同时影响绝经后子宫内膜异位症女性的绝经症状，使用激素疗法进行管理是一个尚未解决的治疗难题。这主要是因为绝经激素疗法与子宫内膜异位症复发的关系，更重要的是与恶性变风险增加的关系仍不明确。
