绝经期与子宫内膜异位症
Menopause and Endometriosis
DOI: 10.12677/acm.2025.15103033, PDF,   
作者: 田 滢, 周留林*:泰兴市人民医院妇科,江苏 泰兴
关键词: 绝经期子宫内膜异位症复发恶性转化Menopause Endometriosis Recurrence Malignant Transformation
摘要: 医学界对子宫内膜异位症的观念已发生转变,不再认为该病仅影响育龄期女性,这使得绝经后患者的表现形式也开始受到关注。尽管这种认知逐渐形成,但关于绝经后子宫内膜异位症的文献资料仍显匮乏,其患病率、临床意义、最佳治疗策略及预后等方面仍存在诸多不确定性。这篇综述系统梳理了现有研究成果,深入解析子宫内膜异位症与绝经之间的复杂关联,从发病机制、临床表现、肿瘤风险到治疗策略等维度展开探讨。
Abstract: The medical community has shifted its view of endometriosis, no longer believing that the disease only affects women of childbearing age, and postmenopausal patients are beginning to be concerned about their manifestations. Despite this growing awareness, the literature on postmenopausal endometriosis remains limited, with many uncertainties about its prevalence, clinical significance, optimal treatment strategies and prognosis. This review systematically reviews the existing research results and deeply analyzes the complex relationship between endometriosis and menopause, from the pathogenesis, clinical manifestations, tumor risk to treatment strategies.
文章引用:田滢, 周留林. 绝经期与子宫内膜异位症[J]. 临床医学进展, 2025, 15(10): 2466-2472. https://doi.org/10.12677/acm.2025.15103033

参考文献

[1] Lee, H.J., Lee, B., Choi, H., Lee, M., Lee, K., Lee, T.K., et al. (2024) Hormone Replacement Therapy and Risks of Various Cancers in Postmenopausal Women with De Novo or a History of Endometriosis. Cancers, 16, Article No. 809. [Google Scholar] [CrossRef] [PubMed]
[2] Lee, H.J., Lee, B., Choi, H., Kim, T., Kim, Y. and Kim, Y.B. (2023) Impact of Hormone Replacement Therapy on Risk of Ovarian Cancer in Postmenopausal Women with De Novo Endometriosis or a History of Endometriosis. Cancers, 15, Article No. 1708. [Google Scholar] [CrossRef] [PubMed]
[3] Lotz, L., Dietl, A., Hoffmann, I., Müller, A., Burghaus, S., Beckmann, M.W., et al. (2022) Endometriosis in Women Undergoing Ovarian Tissue Transplantation Due to Premature Menopause after Gonadotoxic Treatment or Spontaneous Premature Ovarian Failure. Acta Obstetricia et Gynecologica Scandinavica, 101, 771-778. [Google Scholar] [CrossRef] [PubMed]
[4] Akgün, N. and Sarıdoğan, E. (2024) Management of Menopause in Women with a History of Endometriosis. Journal of the Turkish-German Gynecological Association, 25, 107-111. [Google Scholar] [CrossRef] [PubMed]
[5] Rzewuska, N., Kunicki, M., Mechsner, S. and Kordowitzki, P. (2023) Rare Clinical Presentation of Postmenopausal Endometriosis: A New Perspective. Aging and Disease, 15, 2361-2368. [Google Scholar] [CrossRef] [PubMed]
[6] Ser, H., Au Yong, S., Shafiee, M.N., Mokhtar, N.M. and Ali, R.A.R. (2023) Current Updates on the Role of Microbiome in Endometriosis: A Narrative Review. Microorganisms, 11, Article No. 360. [Google Scholar] [CrossRef] [PubMed]
[7] Daniilidis, A., Angioni, S., Di Michele, S., Dinas, K., Gkrozou, F. and D’Alterio, M.N. (2022) Deep Endometriosis and Infertility: What Is the Impact of Surgery? Journal of Clinical Medicine, 11, Article No. 6727. [Google Scholar] [CrossRef] [PubMed]
[8] Bulun, S.E., Yilmaz, B.D., Sison, C., Miyazaki, K., Bernardi, L., Liu, S., et al. (2019) Endometriosis. Endocrine Reviews, 40, 1048-1079. [Google Scholar] [CrossRef] [PubMed]
[9] Yu, E., Lee, H., Joo, J. and Na, Y. (2024) Management of Common Benign Gynecologic Diseases in Postmenopausal Women. Journal of Menopausal Medicine, 30, 135-142. [Google Scholar] [CrossRef] [PubMed]
[10] Dave, D., Page, H.E. and Carrubba, A.R. (2024) Clinical Management of Endometriosis in Menopause: A Narrative Review. Medicina, 60, Article No. 1341. [Google Scholar] [CrossRef] [PubMed]
[11] Sima, R., Pleş, L., Socea, B., Sklavounos, P., Negoi, I., Stănescu, A., et al. (2021) Evaluation of the SF-36 Questionnaire for Assessment of the Quality of Life of Endometriosis Patients Undergoing Treatment: A Systematic Review and Meta-Analysis. Experimental and Therapeutic Medicine, 22, Article No. 1283. [Google Scholar] [CrossRef] [PubMed]
[12] Yang, P., Heitkemper, M.M. and Kamp, K.J. (2021) Irritable Bowel Syndrome in Midlife Women: A Narrative Review. Womens Midlife Health, 7, Article No. 4. [Google Scholar] [CrossRef] [PubMed]
[13] Amer, S. and Bazmi, S. (2023) HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey. Journal of Clinical Medicine, 12, Article No. 336. [Google Scholar] [CrossRef] [PubMed]
[14] Gremillet, L., Netter, A., Sari-Minodier, I., Miquel, L., Lacan, A. and Courbiere, B. (2023) Endometriosis, Infertility and Occupational Life: Women’s Plea for Recognition. BMC Womens Health, 23, Article No. 29. [Google Scholar] [CrossRef] [PubMed]
[15] Öberg Westin, M., Wikberg, C., Björkelund, C., Ariai, N., Lindahl, A. and Hange, D. (2024) Laying the Groundwork: A Pilot Study Exploring Improved Endometriosis Management Strategies in Primary Healthcare. International Journal of General Medicine, 17, 1325-1333. [Google Scholar] [CrossRef] [PubMed]
[16] Gosset, A., Susini, M., Vidal, F., Tanguy-Le-Gac, Y., Chantalat, E., Genre, L., et al. (2022) Quality of Life of Patients with Bilateral Oophorectomy before the Age of 45 for the Treatment of Endometriosis. Maturitas, 162, 52-57. [Google Scholar] [CrossRef] [PubMed]
[17] Lobo, R.A. and Franco Quaresma de Moura, K. (2016) The Use of Hormone Therapy after Surgery for Endometriosis: An Analysis. Journal of Endometriosis and Pelvic Pain Disorders, 8, 152-156. [Google Scholar] [CrossRef
[18] Giannella, L., Marconi, C., Di Giuseppe, J., Delli Carpini, G., Fichera, M., Grelloni, C., et al. (2021) Malignant Transformation of Postmenopausal Endometriosis: A Systematic Review of the Literature. Cancers, 13, Article No. 4026. [Google Scholar] [CrossRef] [PubMed]
[19] Kamani, M., Akgor, U. and Gültekin, M. (2022) Review of the Literature on Combined Oral Contraceptives and Cancer. Ecancermedicalscience, 16, Article No. 1416. [Google Scholar] [CrossRef] [PubMed]
[20] Murakami, K., Kotani, Y., Shiro, R., Takaya, H., Nakai, H. and Matsumura, N. (2019) Endometriosis-Associated Ovarian Cancer Occurs Early during Follow-Up of Endometrial Cysts. International Journal of Clinical Oncology, 25, 51-58. [Google Scholar] [CrossRef] [PubMed]
[21] Jaeger, M., Niederkrotenthaler, T., Till, B. and Werneck, H. (2024) Associations between Health-Related Quality of Life, Infertility-Related Psychological Well-Being, and Relationship Quality in Individuals with Endometriosis: A Cross-Sectional Study. BMC Womens Health, 24, Article No. 657. [Google Scholar] [CrossRef] [PubMed]
[22] Rozenberg, S., Antoine, C., Vandromme, J. and Fastrez, M. (2015) Should We Abstain from Treating Women with Endometriosis Using Menopausal Hormone Therapy, for Fear of an Increased Ovarian Cancer Risk? Climacteric, 18, 448-452. [Google Scholar] [CrossRef] [PubMed]
[23] Becker, C.M., Bokor, A., Heikinheimo, O., et al. (2022) ESHRE Guideline: Endometriosis. Human Reproduction Open, 2022, hoac009.
[24] Vercellini, P., Bandini, V., Viganò, P., Ambruoso, D., Cetera, G.E. and Somigliana, E. (2023) Proposal for Targeted, Neo-Evolutionary-Oriented Secondary Prevention of Early-Onset Endometriosis and Adenomyosis. Part II: Medical Interventions. Human Reproduction, 39, 18-34. [Google Scholar] [CrossRef] [PubMed]
[25] Lin, P., Chern, C., Li, C., Lin, P., Tsui, K. and Lin, L. (2024) Improvement of Early Miscarriage Rates in Women with Adenomyosis via Oxytocin Receptor Antagonist during Frozen Embryo Transfer—A Propensity Score-Matched Study. Reproductive Biology and Endocrinology, 22, Article No. 79. [Google Scholar] [CrossRef] [PubMed]
[26] Shirafkan, H., Moher, D. and Mirabi, P. (2024) The Reporting Quality and Spin of Randomized Controlled Trials of Endometriosis Pain: Methodological Study Based on CONSORT Extension on Abstracts. PLOS ONE, 19, e0302108. [Google Scholar] [CrossRef] [PubMed]
[27] Allen, C.L., Banerjee, S., Karoshi, M., Humaidan, P. and Tahmasebi, F. (2025) The Efficacy of Progestins in Managing Pain Associated with Endometriosis, Fibroids and Pre-Menstrual Syndrome: A Systematic Review. Archives of Gynecology and Obstetrics, 311, 1511-1533. [Google Scholar] [CrossRef] [PubMed]
[28] Mick, I., Freger, S.M., van Keizerswaard, J., Gholiof, M. and Leonardi, M. (2024) Comprehensive Endometriosis Care: A Modern Multimodal Approach for the Treatment of Pelvic Pain and Endometriosis. Therapeutic Advances in Reproductive Health, 18, 1-23. [Google Scholar] [CrossRef] [PubMed]
[29] Yin, D. and Jiang, Y. (2023) Case Series and a Literature Review: Two Ovarian Clear Cell Carcinoma Cases with Recurrent Endometriosis. International Journal of Womens Health, 15, 1611-1619. [Google Scholar] [CrossRef] [PubMed]
[30] Gardella, B., Rispoli, E., Pasquali, M.F., Mauri, M., Musacchi, V. and Dominoni, M. (2023) Aromatase Inhibitors in the Pharmacotherapy of Endometriosis. Expert Opinion on Pharmacotherapy, 24, 1067-1073. [Google Scholar] [CrossRef] [PubMed]
[31] Naem, A., Shamandi, A., Al-Shiekh, A. and Alsaid, B. (2020) Free Large Sized Intra-Abdominal Endometrioma in a Postmenopausal Woman: A Case Report. BMC Womens Health, 20, Article No. 190. [Google Scholar] [CrossRef] [PubMed]
[32] Ebrahimi, M., Akbari Asbagh, F., Davari Tanha, F., Pakniat, H., Feizabad, E. and Rasouli, Y. (2022) Co-Treatment of Gonadotropin and Letrozole in Infertile Women with Endometriosis: A Double-Blind Randomized Clinical Trial. International Journal of Reproductive BioMedicine (IJRM), 20, 483-490. [Google Scholar] [CrossRef] [PubMed]
[33] Jakson, I., Hirschberg, A.L. and Gidlöf, S.B. (2023) Endometriosis and Menopause—Management Strategies Based on Clinical Scenarios. Acta Obstetricia et Gynecologica Scandinavica, 102, 1323-1328. [Google Scholar] [CrossRef] [PubMed]
[34] Tanmahasamut, P., Rattanachaiyanont, M., Techatraisak, K., Indhavivadhana, S., Wongwananuruk, T. and Chantrapanichkul, P. (2021) Menopausal Hormonal Therapy in Surgically Menopausal Women with Underlying Endometriosis. Climacteric, 25, 388-394. [Google Scholar] [CrossRef] [PubMed]
[35] Uehara, M., Wada-Hiraike, O., Hirano, M., Koga, K., Yoshimura, N., Tanaka, S., et al. (2022) Relationship between Bone Mineral Density and Ovarian Function and Thyroid Function in Perimenopausal Women with Endometriosis: A Prospective Study. BMC Womens Health, 22, Article No. 134. [Google Scholar] [CrossRef] [PubMed]
[36] Chen, L., Lo, W., Huang, H. and Wu, H. (2023) A Lifelong Impact on Endometriosis: Pathophysiology and Pharmacological Treatment. International Journal of Molecular Sciences, 24, Article No. 7503. [Google Scholar] [CrossRef] [PubMed]
[37] Uehara, M., Wada-Hiraike, O., Hirano, M., Koga, K., Yoshimura, N., Tanaka, S., et al. (2022) Relationship between Bone Mineral Density and Ovarian Function and Thyroid Function in Perimenopausal Women with Endometriosis: A Prospective Study. BMC Womens Health, 22, Article No. 134. [Google Scholar] [CrossRef] [PubMed]
[38] Dillon, G.A., Stanhewicz, A.E., Serviente, C., Flores, V.A., Stachenfeld, N. and Alexander, L.M. (2022) Seven Days of Statin Treatment Improves Nitric-Oxide Mediated Endothelial-Dependent Cutaneous Microvascular Function in Women with Endometriosis. Microvascular Research, 144, Article ID: 104421. [Google Scholar] [CrossRef] [PubMed]
[39] Fini, E., Argento, F.R., Borghi, S., Giurranna, E., Nencini, F., Cirillo, M., et al. (2024) Fibrinogen Structural Changes and Their Potential Role in Endometriosis-Related Thrombosis. Antioxidants (Basel), 13, Article No. 1456. [Google Scholar] [CrossRef] [PubMed]
[40] Vu, T.H., Nakamura, K., Shigeyasu, K., Kashino, C., Okamoto, K., Kubo, K., et al. (2024) Apolipoprotein-b mRNA-Editing Complex 3B Could Be a New Potential Therapeutic Target in Endometriosis. Scientific Reports, 14, Article No. 24968. [Google Scholar] [CrossRef] [PubMed]
[41] Velarde, M.C., Bucu, M.E.M. and Habana, M.A.E. (2023) Endometriosis as a Highly Relevant Yet Neglected Gynecologic Condition in Asian Women. Endocrine Connections, 12, e230169. [Google Scholar] [CrossRef] [PubMed]
[42] Vaduva, P., Laouali, N., Fagherazzi, G., Gelot, A., Bonnet, F. and Kvaskoff, M. (2023) Association between Endometriosis and Risk of Type 2 Diabetes: Results from the Prospective E3N Cohort. Maturitas, 177, Article ID: 107805. [Google Scholar] [CrossRef] [PubMed]