Keeping an Eye on Perimenopausal and Postmenopausal Endometriosis

Abstract

Introduction: We aimed to describe and review the epidemiological aspect of the disease pattern of a series of perimenopausal and postmenopausal women with a histology confirmation of endometriosis. Material and Methods: We retrospectively examined the clinical records of 184 perimenopausal and 46 postmenopausal women with endometriosis. Data were collected and analyzed from 1100 patients’ charts with confirmed endometriosis and involved cases from two different geographical areas, New Haven (US) and Greece. The statistical methods included ×2 and the Mann-Whitney U test. In the perimenopausal group (age 45–54 years), there were 184 patients (16.7%) and the postmenopausal group (55–80 years) had 46 (4.2%). The average age of diagnosis was (49 ± 2.3) and (61.2 ± 5.1), respectively (p < 0.01). Results: Advanced endometriosis was more aggressive in the perimenopausal group (p < 0.05); in the same group, we observed a higher left-sided predisposition of endometriosis in comparison with the right side (p < 0.01). Endometrioma was the most common gynecological condition among patients with perimenopausal endometriosis in relation to the postmenopausal group (p < 0.001). Additionally, we found uterine leiomyomata more prominent in the perimenopausal group (p < 0.05). In contrast, adenomyosis was found higher in postmenopausal patients (p < 0.05); further, 24 cases with dry eye we observed. Conclusions: Postmenopausal endometriosis is an important underestimated condition. Although the reported situation is not common, various clinicopathological characteristics were observed in both groups. Clinicians should be aware that there is a correlation between endometriosis and endometriosis-associated ovarian cancer in perimenopausal and postmenopausal age.

Microbiome & Endometriosis

“…It was found that endometrioma and uterine leiomyoma were the most common condition among women with perimenopausal endometriosis compared to the postmenopausal group and adenomyosis was found to be higher in postmenopausal patients. In both the groups, endometriosis-associated ovarian cancer and uterine cancer were similar (Table 2) [34].…”

Polycystic Ovary Syndrome and Endometriosis as Reasons for Women’s Admission to Outpatient Specialist Care in Poland—A Retrospective Analysis

“…The literature on the subject increasingly emphasizes the issue of endometriosis in the perimenopausal period. It is a severe disease, which is increasingly occurring and has serious long-term health consequences, including a negative impact on the women’s quality of life and functioning [ 45 , 46 , 47 , 48 , 49 ].…”

Rare extragenital endometriosis: pathogenesis and therapy

“…A third theory involves lymphovascular spread which explains cases in which hepatic endometriomas are only intraparenchymal [126]. A last theory is that of survival of the intrahepatic Mullerian rest: the Mullerian structures believed to be in the hepatic parenchyma maintain their functional potential, even surviving the long hormonal silence between the fall of placental hormones and the onset of puberty [127,128]. As regards the rare cases of postmenopausal HE, it is thought [128] that they may be linked to the reactivation of endometrial implants following the administration of hormone replacement therapy in patients with previous history of endometriosis.…”