Hormonal replacement therapy in surgical menopause with underlying endometriosis.
OBJECTIVE
To evaluate the effect of hormonal replacement therapy (HRT) regimens in surgical menopause patients with underlying endometriosis.


METHODS
Observational retrospective study.


METHODS
123 women with endometriosis after definite surgery (total abdominal hysterectomy with bilateral salpingo-oophorectomy) were followed in the Gynecologic Endocrinology and Menopause clinics. Patients were classified into 4 groups according to HRT regimens, i.e. control (no HRT, n=17), estrogen only (ERT, n=50), cyclic estrogen/progestin regimen (cyclic E/P, n=16), and continuous combined estrogen/progestin (ccE/P, n=24). 12 patients who received more than one regimen and 4 patients who received less than 6 months of HRT were excluded from the study. The information was obtained from the medical records.


RESULTS
Mean age at surgery of all patients was 38.9 years old. Mean duration of HRT was 41.2 months. There was no difference in age at surgery or duration of follow-up in each group. There was 1 (2%) case of recurrent endometriosis and 3 (6%) cases of recurrent symptoms in the estrogen only group; none of them required additional surgical treatment. Malignant transformation was not found.


CONCLUSIONS
Although the present series is small, it seems that HRT is safe for postmenopausal women with underlying endometriosis. Recurrence of endometriosis has rarely been a problem with HRT, especially in those who received the combination of estrogen and progestin regimens.
Rattanachaiyanont
Manee
M
Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Tanmahasamut
Prasong
P
Angsuwatthana
Surasak
S
Techatraisak
Kitirat
K
Inthawiwat
Suchada
S
Leerasiri
Pichai
P
D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D012189:Retrospective Studies