Endometrióza v postmenopauze

Endometrioza v postmenopauze- raritní onemocnění

Abstract

In our review article, we focused on the rare topic of endometriosis in postmenopause. Endometriosis is primarily a disease of women of reproductive age. In postmenopause, atrophy of endometriosis foci usually occurs. However, recurrence or even de novo occurrence of endometriosis in postmenopause has also been described. The prevalence of postmenopause has been reported to be around 2-5 %. Factors that may account for the recurrence of endometriosis are exogenously administered estrogens, self-production of estrogens in peripheral adipose tissue, or aromatase activation in the endometriosis lesion. When hormone therapy is required, the best results are achieved by the administration of Tibolone. Risk factors for recurrence and subsequent difficulties are the extent of endometriosis, retained uterus, and adnexa. The pain was the most common symptom in 43.5 % and palpation in 28 %. Endometriotic cells are capable of proliferation, survival in ectopic localization, and metastasis to distant localizations. The risk of malignant transformation is around 1 % and ovarian tumors are the most common. Endometriosis-associated ovarian tumors are typically low-grade disease, histologically endometrioid, or clear cell carcinomas. Diagnosis is based on ultrasound and magnetic resonance imaging. The mainstay of therapy for newly developed endometriosis or when symptoms associated with endometriosis risk appear is surgery, primarily to exclude the cancerous process.