Hormonal Replacement Therapy in Surgical Menopause with Underlying Endometriosis
MANEE RATTANACHAIYANONT, MD*, PRASONG TANMAHASAMUT, MD*, SURASAK ANGSUWATTHANA, MD*, KITI RA T TECHA TRAISAK, MD*, SUCHADA INTHAWIWAT,MD*, PICHAI LEERASIRI, MD*
Affiliation : * Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Objective : To evaluate the effect of hormonal replacement therapy (HRT) regimens in surgi cal menopause patients with underlying endometriosis.
Design : Observational retrospective study.
Materials and Methods : 123 women with endometriosis after definite surgery (total abdo minal hysterectomy with bilateral salpingo-oophorectomy) were followed in the Gynecologic Endocrino logy 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 postmeno pausal 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.
Keywords : Surgical Menopause, Endometriosis, HRT
