Endometriosis In Postmenopausal Woman Research Articles

Endometriosis in Postmenopausal Women

There is functional endometrial tissue anywhere other than the uterine cavity and uterine mucosa with a penchant for infiltration and invasion. It is labeled as endometriosis. It is a chronic inflammatory condition. It can occur anywhere, but the most common site is the ovary. It is also labeled as endometrioma or Chocolate cyst. Other common sites for endometriosis are the pouch of Douglas (POD), posterior leaf of the broad ligament, uterosacral ligament, fallopian tube. Barin is the least common site for Endometriosis. Endometriosis is never seen in the spleen. This condition, which impacts 10–15 percent of women of childbearing age, is characterized by pelvic pain and infertility. Dysmenorrhoea, adnexal mass, and infertility are the classical triad of clinical features. This classical triad is mainly seen in the women of childbearing age but can also be seen in the women after menopause. Endometriosis is an estrogen-dependent condition that tends to go away on its own or after surgery. It tends to regress after menopause because it is an estrogen-dependent condition. Endometriosis is associated with cellular and humoral immunity also. Impaired immune function may contribute to the development of endometriosis. Despite this, up to 2.2 percent of women after menopause are affected. Endometriosis in postmenopausal women is seen mainly after elevated systemic estrogen concentrations or excess exogenous estrogen intake. In most women, symptomatic endometriosis after menopause begins more than ten years after menopause in the absence of elevated systemic estrogen concentrations or exogenous estrogen intake. This is necessary to understand the pathophysiology and management of endometriosis after menopause.

The role of estrogen and progesterone receptors in women with adenomyosis in postmenopause

Adenomyosis (AD) is an urgent medical problem of the present. The issues of etiology and pathogenesis of internal endometriosis remain controversial. The purpose of the work is to define the role of estrogen (ER) and progesterone (PR) receptors in the pathogenesis of adenomyosis (AD) in postmenopausal women. Selection criteria: established diagnosis of AD, postmenopausal period (no menstruation for more than 1 year) and absence of concomitant endometrial pathology. An immunohistochemical (IHС) study was performed to determine the state of the receptor apparatus for markers of estrogen and progesterone. The IНC study of the eu- and ectopic endometrium receptor apparatus revealed the presence of ER and RR expression both in epithelial cells and stromal cells, indicating the hormonal dependence of AD foci and the key role of steroid hormones in the development and preservation of intraocular endometriosis in postmenopausal women. Nearly a third of women in the epithelial cells of the eutopic endometrium found a normal correlation between ER and PR, respectively leading to 1. In stromal cells, a decrease in ER was observed with an increase in RR (ER / PR <1) in 9 out of 15 patients. Analysis of the distribution of the ratio of expression ratios of ER and PR in ectopic endometrium revealed the predominance of the role of PR in ER in the pathogenesis of internal endometriosis. The components of the ectopic endometrium in most women were characterized by an increase in PR and a decrease in ER (ER / PR <1).

Active Endometriosis in Postmenopausal Women: A Descriptive Case-Series

Active Endometriosis in Postmenopausal Women: A Descriptive Case-Series

Retroperitoneal endometriosis in postmenopausal woman causing deep vein thrombosis: case report and review of the literature

Endometriosis is an uncommon disease in postmenopausal women (PMW), ranging from 2% to 5% of cases, and it is very important to exclude neoplastic transformation of the endometrium. The authors would like to introduce the case of a 63-year-old overweight patient with abdominal pain associated to pain and swelling of the left inferior limb occurring for approximately six weeks. The CT X-ray of the abdomen revealed the presence of a retroperitoneal mass causing deep vein thrombosis because of extrinsic compression of the left iliac vein. Following removal of the pelvic masses with laparotomy, the histological exam revealed an endometriosis. The CT X-ray carried out after a month postoperatively revealed the root canal treatment of the left femoral vein with a considerable decrease of the thrombosis of homolateral external iliac veins. Despite the endometriosis, it is uncommon in women who have reached menopause and must be considered in the differential diagnosis of pelvic masses.

Aromatase inhibitors in the treatment of endometriosis.

Endometriosis is a chronic inflammatory condition in which foci of endometrial tissue grow outside of the uterine cavity. Endometriosis was estimated to affect 176 million women of childbearing potential all over the world in 2010. The presence of extrauterine endometrial tissue is associated with pain and infertility. Typical symptoms of endometriosis include dysmenorrhoea, dyspareunia, heavy menstrual periods (menorrhagia), pelvic pain that is not related to menstrual cycles, dysuria, and chronic fatigue. Medical treatments for endometriosis include combined oral contraceptive pills, danazol, gestrinone, medroxyprogesterone acetate, and gonadotropin-releasing hormone agonists (aGnRHs). A new class of medications called aromatase inhibitors has been identified in recent years as potential therapeutic agents for endometriosis. This article provides general information about aromatase inhibitors, their use in gynaecology, and their adverse effects. In particular, the paper discusses the use of aromatase inhibitors in the treatment of endometriosis in postmenopausal women. Unlike oral contraceptives, gestagens, aGnRHs, and danazol, which suppress ovarian oestrogen synthesis, aromatase inhibitors inhibit mainly extra-ovarian synthesis of oestrogens. Therefore, the use of aromatase inhibitors seems to be particularly relevant in older patients, as most of the body's oestrogen is produced outside the ovaries after menopause. The paper discusses also the use of aromatase inhibitors in the treatment of pain associated with endometriosis and infertility caused by endometriosis.

Prevalence of Endometriosis in Postmenopausal Women with Chronic Pelvic Pain

Endometriosis is a benign, estrogen-dependent, chronic gynecological disorder associated with pelvic pain. The disease most commonly affects women during the reproductive age and postmenopausal endometriosis is a rare clinical condition. The purpose of this presentation is to laparoscopically evaluate the pelvis of patients with chronic pelvic pain at least 1 year after menopause, to determine any associated factors to the pain.

Endometriosis in menopause: a single institution experience

This study aims to present the clinical characteristics of a series of postmenopausal women with endometriosis and to evaluate the preferential location, extension and histopathological features of the lesions. We retrospectively examined the clinical records of 72 postmenopausal women with endometriosis who underwent surgery between January 1998 and December 2010. The median age of patients at the time of surgery was 58.5 years. Eleven patients (15.3%) had previous history of endometriosis and five patients had previously undergone surgery for this reason. Only two patients included in the study were using hormone replacement therapy at the time of surgery. The most frequent location of endometriotic lesions was the ovary and among patients with endometriomas, 35% (20/57) had different grades of metaplasia, hyperplasia, atypia and endometrioid carcinoma arising in endometriosis. The proportions of epithelium, stroma and hemorrhage in endometriotic lesions were higher in patients with concomitant endometrial or ovarian cancer. Endometriosis should be considered in the differential diagnosis of postmenopausal cystic lesions of the ovary. The administration of exogenous estrogen is not a prerequisite for the presence of endometriosis in postmenopausal women, and histological signs of functionally active lesions were also observed in the absence of exogenous hormone intake.

エストロゲン製剤使用中の閉経女性に発生した尿管子宮内膜症の１例

A 56-year-old woman was admitted to our hospital due to gross hematuria. Cystoscopy and contrast-enhanced abdominal CT scan revealed a solid tumor at the right terminal ureter. She underwent transurethral resection of the right ureteral tumor. The ureteral tumor included proliferative endometrial stroma and glands under urothelial cells, and the histopathological diagnosis was ectopic endometriosis. Before the surgery, the patient had underwent hormone replacement therapy using estrogen patches to treat menopausal disorders, however, the dose of estrogen was five times higher than regular dose. Therefore, in this case, the serum level of estrogen was elevated over the normal value. Ectopic endometriosis is rare in urinary tract especially ureter. Furthermore, endometriosis is an uncommon disease in women during postmenopausal period. Our case suggests that an excessive hormone replacement therapy might cause endometriosis in postmenopausal women.

Endometriosis in postmenopausal women without previous hormonal therapy: report of three cases

Introduction Endometriosis is a benign, estrogen-dependent, chronic gynecological disorder associated with pelvic pain and infertility. The disease most commonly affects women during the reproductive age, although postmenopausal patients do rarely present it. These rare occurrences are generally associated with hormonal use.Material and methods We present three cases of endometriosis in postmenopausal patients who have no history of hormone therapy and no previous history of endometriosis or infertility.Case reports In case 1, a 62-year-old woman presented with acyclic pelvic pain and a left ovarian homogeneous cystic mass. After laparoscopic salpingoophorectomy and histological analysis, an ovarian endometriotic cyst was confirmed. In case 2, a 78-year-old woman presented with a painful abdominal wall mass that was confirmed by ultrasound and tomography. Her past medical history included an abdominal hysterectomy 20 years prior to the discovery of this mass. The lesion was surgically excised and histological analysis showed areas of endometrial stroma and glands surrounded by fibrosis, compatible with endometriosis. In case 3, a 54-year-old woman presented with chronic pelvic pain and a nodule in the rectovaginal septum was noted during gynecological examination. Menopause occurred at 48 years of age. She had no previous dysmenorrhea. Ultrasound confirmed the nodule in the rectovaginal septum. The patient was submitted to a diagnostic colonoscopy that revealed a friable lesion, which was subsequently biopsied. The histological diagnosis was endometriosis.Conclusions These three cases of postmenopausal endometriosis support the celomic metaplasia theory for the genesis of this disease.

Distale Stenose des Ureters durch extrinsische Endometriose bei einer postmenopausalen Frau

Endometriosis in postmenopausal women is rare, especially in the urinary tract. Only a few cases have been described. A postmenopausal woman presented with left-sided ureteric obstruction. Intraoperatively an extrinsic endometriosis was found. In contrast to other cases, the patient had no history of endometriosis or estrogen therapy. This rare disease should also be considered in female patients in non-reproductive age with symptoms of unclear hydronephrosis.

Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman

We report the case of a postmenopausal woman with a synchronous obstructing intrinsic endometrioma of the left ureter and a coexistent periurethral leiomyoma. Endometriosis in postmenopausal women is a rare clinical entity usually associated with exogenous estrogen use. Urethral leiomyomas are also rare, with only 40 cases reported in the literature. Ovarian hormones are believed to influence the growth of leiomyomas. We report the genitourinary presentation of 2 separate disease entities with known hormonal influence in a postmenopausal woman receiving estrogen replacement therapy. We believe the patient's hormonal milieu affected the development of her concurrent pathology.

A case of cutaneous endometriosis developed in postmenopausal woman receiving hormonal replacement

Cutaneous endometriosis is characterized by the presence of extrauterine endometrial tissue in or under the skin. We report a case of cutaneous endometriosis in postmenopausal woman who was receiving hormonal replacement. (J Am Acad Dermatol 1999;41:327-9.)

Ureteral endometriosis in post menopausal women

Ureteral obstruction secondary to endometriosis is an infrequently observed phenomenon, particularly in post-menopausal women. Two patients with obstructive uropathy, aged fifty-five and seventy-four, underwent ureteroplasty procedures with pathologic documentation of endometriosis. The possible pathogenetic mechanisms of ureteral endometriosis and previously reported cases are cited.

External endometriosis in 801 operated patients.

Details of medical history, symptomatology, operative findings and certain other special features are reported for patients with external endometriosis treated operatively during the period 1969-76. The incidence of endometriosis in this survey was 19% of all gynecological laparotomies. The mean age of the patients at the time of the operation was 36.7 years. The most common sites of endometriosis were the retrocervix and the ovaries. Of the patients, 559 (70%) had complained of dysmenorrhea; the pain generally began before the bleeding. Also typical was the exacerbation of the pain with increasing age. Twenty-seven per cent of the patients also complained of infertility. Surgery was performed because of acute abdominal symptoms in 6% of cases. The incidence of endometriosis in postmenopausal women was 2.5% and that in young women, 1%. Endometriosis recurred in 15% of the cases during the follow-up period. Gestagen therapy after the operation had no effect on the recurrence rate.

Ureteral endometriosis in postmenopausal woman

A case of ureteral endometriosis in a fifty-eight-year-old, postmenopausal woman is reported. It is postulated that exogenous estrogen stimulated the growth of endometrial tissue which causes the obstruction of the ureter.