Witt B R, Barad D H
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York.
Obstet Gynecol Clin North Am. 1993 Jun;20(2):349-63.
Endometriosis in women older than 40 years of age presents unique therapeutic challenges to the practicing physician. Management requires the evaluation of reproductive goals and a determination of the objectives of therapy, including symptomatic relief and avoidance or delay of recurrence of disease. Important considerations in this age group include diminished fertility and impending menopause. The diagnosis and treatment for endometriosis-associated infertility must be undertaken in an expedient manner. Assisted reproductive technologies may be effective therapies for these patients. Conservative surgery may be necessary to preserve reproductive potential, but definitive surgery may be indicated in women with long-standing pelvic pain. Estrogen replacement therapy may be used in menopausal women with a history of endometriosis.
40岁以上女性的子宫内膜异位症给执业医师带来了独特的治疗挑战。治疗需要评估生殖目标并确定治疗目的，包括缓解症状以及避免或延缓疾病复发。该年龄组的重要考虑因素包括生育能力下降和即将绝经。必须尽快对子宫内膜异位症相关的不孕症进行诊断和治疗。辅助生殖技术可能是这些患者的有效治疗方法。可能需要进行保守手术以保留生殖潜力，但对于长期盆腔疼痛的女性，可能需要进行根治性手术。有子宫内膜异位症病史的绝经后女性可使用雌激素替代疗法。
