Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature
Hormonal replacement therapy (HRT) is effective in treating the symptoms of menopause. Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity with a tendency towards invasion and infiltration. Being an estrogen-dependent disease, it tends to regress afte...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-08-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/55/8/477 |
| _version_ | 1797717104265265152 |
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| author | Margherita Zanello Giulia Borghese Federica Manzara Eugenia Degli Esposti Elisa Moro Diego Raimondo Layla Omar Abdullahi Alessandro Arena Patrizia Terzano Maria Cristina Meriggiola Renato Seracchioli |
| author_facet | Margherita Zanello Giulia Borghese Federica Manzara Eugenia Degli Esposti Elisa Moro Diego Raimondo Layla Omar Abdullahi Alessandro Arena Patrizia Terzano Maria Cristina Meriggiola Renato Seracchioli |
| author_sort | Margherita Zanello |
| collection | DOAJ |
| description | Hormonal replacement therapy (HRT) is effective in treating the symptoms of menopause. Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity with a tendency towards invasion and infiltration. Being an estrogen-dependent disease, it tends to regress after menopause. Nevertheless, it affects up to 2.2% of postmenopausal women. Conclusive data are not available in the literature on the appropriateness of HRT in women with endometriosis or a past history of the disease. The hypothesis that exogenous estrogen stimulation could reactivate endometriotic foci has been proposed. The aim of this state-of-the-art review was to revise the current literature about endometriosis in perimenopause and menopause and to investigate the possible role of HRT in this setting of patients. An electronic databases search (MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Sciencedirect, the Cochrane Library at the CENTRAL Register of Controlled Trials, Scielo) was performed, with the date range of from each database’s inception until May 2019. All of the studies evaluating the impact of different HRT regimens in patients with a history of endometriosis were selected. 45 articles were found: one Cochrane systematic review, one systematic review, five narrative reviews, two clinical trials, two retrospective cohort studies, 34 case reports and case series. Some authors reported an increased risk of malignant transformation of endometriomas after menopause in patients assuming HRT with unopposed estrogen. Low-quality evidence suggests that HRT can be prescribed to symptomatic women with a history of endometriosis, especially in young patients with premature menopause. Continuous or cyclic combined preparations or tibolone are the best choices. HRT improves quality of life in symptomatic post-menopausal women, who should not be denied the replacement therapy only due to their history of endometriosis. Based on low-grade literature evidence, we recommend to prescribe combined HRT schemes; tibolone could be considered. |
| first_indexed | 2024-03-12T08:31:28Z |
| format | Article |
| id | doaj.art-0b2c3582ef3c46b7ac59e7dd8ab42145 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T08:31:28Z |
| publishDate | 2019-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-0b2c3582ef3c46b7ac59e7dd8ab421452023-09-02T17:31:10ZengMDPI AGMedicina1010-660X2019-08-0155847710.3390/medicina55080477medicina55080477Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of LiteratureMargherita Zanello0Giulia Borghese1Federica Manzara2Eugenia Degli Esposti3Elisa Moro4Diego Raimondo5Layla Omar Abdullahi6Alessandro Arena7Patrizia Terzano8Maria Cristina Meriggiola9Renato Seracchioli10Gynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyGynecology and Human Reproduction Physiopathology, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, ItalyHormonal replacement therapy (HRT) is effective in treating the symptoms of menopause. Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity with a tendency towards invasion and infiltration. Being an estrogen-dependent disease, it tends to regress after menopause. Nevertheless, it affects up to 2.2% of postmenopausal women. Conclusive data are not available in the literature on the appropriateness of HRT in women with endometriosis or a past history of the disease. The hypothesis that exogenous estrogen stimulation could reactivate endometriotic foci has been proposed. The aim of this state-of-the-art review was to revise the current literature about endometriosis in perimenopause and menopause and to investigate the possible role of HRT in this setting of patients. An electronic databases search (MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Sciencedirect, the Cochrane Library at the CENTRAL Register of Controlled Trials, Scielo) was performed, with the date range of from each database’s inception until May 2019. All of the studies evaluating the impact of different HRT regimens in patients with a history of endometriosis were selected. 45 articles were found: one Cochrane systematic review, one systematic review, five narrative reviews, two clinical trials, two retrospective cohort studies, 34 case reports and case series. Some authors reported an increased risk of malignant transformation of endometriomas after menopause in patients assuming HRT with unopposed estrogen. Low-quality evidence suggests that HRT can be prescribed to symptomatic women with a history of endometriosis, especially in young patients with premature menopause. Continuous or cyclic combined preparations or tibolone are the best choices. HRT improves quality of life in symptomatic post-menopausal women, who should not be denied the replacement therapy only due to their history of endometriosis. Based on low-grade literature evidence, we recommend to prescribe combined HRT schemes; tibolone could be considered.https://www.mdpi.com/1010-660X/55/8/477menopausehormone replacement therapymenopause hormonal therapyendometriosispelvic pain |
| spellingShingle | Margherita Zanello Giulia Borghese Federica Manzara Eugenia Degli Esposti Elisa Moro Diego Raimondo Layla Omar Abdullahi Alessandro Arena Patrizia Terzano Maria Cristina Meriggiola Renato Seracchioli Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature Medicina menopause hormone replacement therapy menopause hormonal therapy endometriosis pelvic pain |
| title | Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature |
| title_full | Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature |
| title_fullStr | Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature |
| title_full_unstemmed | Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature |
| title_short | Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature |
| title_sort | hormonal replacement therapy in menopausal women with history of endometriosis a review of literature |
| topic | menopause hormone replacement therapy menopause hormonal therapy endometriosis pelvic pain |
| url | https://www.mdpi.com/1010-660X/55/8/477 |
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