Marie-Scemama Lydia, Even Marc, De La Joliniere Jean Bouquet, Ayoubi Jean-Marc
Obstetrics & Gynecology, 40 rue Worth Suresnes, France.
Foch Hospital, Suresnes, France.
Horm Mol Biol Clin Investig. 2019 Mar 26;37(2):hmbci-2018-0071. doi: 10.1515/hmbci-2018-0071.
As an estrogen-dependent disease, endometriosis was thought to become less active or regress with the onset of the menopause. However, based on some new data, we are discovering that this pathology can emerge or reappear at this period of life. Clinicians must consider it as a possible cause for cases of pelvic pain, and heavy bleeding. Authors have described a possibility of transformation of the intraperitoneal proliferation into a malignant type with ovarian, bowel and even lung metastasis. The risk of transformation into an ovarian cancer is around 2 or 3%. The role of menopausal hormonal therapy will be discussed as in recurrence in the case of residue existence, especially after incomplete surgery. Is it possible to prescribe hormonal therapy to a menopausal women suffering climacteric symptoms as it could trigger a recurrence of endometriosis and even an increased risk of malignant degeneration? This remains unclear. It is an unresolved therapeutic dilemma; the choice between surgery or medical treatment?
作为一种雌激素依赖性疾病，子宫内膜异位症曾被认为在绝经后会变得不那么活跃或消退。然而，基于一些新数据，我们发现这种病理状况在这个生命阶段可能会出现或复发。临床医生必须将其视为盆腔疼痛和大量出血病例的一个可能病因。作者们描述了腹膜内增生转变为恶性类型并伴有卵巢、肠道甚至肺部转移的可能性。转变为卵巢癌的风险约为2%或3%。绝经后激素治疗的作用将在存在残留灶复发的情况下进行讨论，尤其是在不完全手术后。对于患有更年期症状的绝经后女性，开具激素治疗是否可能引发子宫内膜异位症复发甚至增加恶性变风险？这仍不清楚。这是一个未解决的治疗难题：手术还是药物治疗的选择？
