EMAS position statement: Managing the menopause in women with a past history of endometriosis.
Level 5 - mechanism / opinion, no new human data
Expert consensus position statement and narrative review with no new empirical data
PubMed 20627430 · doi:10.1016/j.maturitas.2010.04.018
What was done
The European Menopause and Andropause Society (EMAS) formulated a position statement on managing menopause in women with a history of endometriosis using a literature review and expert consensus.
What was found
The abstract reports no numerical data, statistics, or effect estimates. It qualitatively concludes that evidence on hormone therapy regimens is limited, continuous combined estrogen-progestogen or tibolone may be safer for both hysterectomised and non-hysterectomised women to lower recurrence risk, recurrence risk with hormone therapy is probably elevated with residual disease, alternative pharmacological treatments should be offered when estrogen is contraindicated or declined, and herbal preparations should be avoided due to uncertain efficacy and potential estrogenic activity.
Why it matters
It provides expert clinical guidance for managing menopausal symptoms while attempting to minimize the risk of endometriosis recurrence and malignant transformation.
Limits
This is a consensus position statement and narrative literature review containing no primary patient data or quantitative syntheses. The abstract explicitly notes that data regarding hormone therapy regimens in this population are limited.
Cited by
- supports Postmenopausal estrogen replacement therapy without progesterone can reactivate residual endometriotic implants in patients with a history of endometriosis even after hysterectomy.