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HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey

The optimal hormone replacement therapy (HRT) in women who have undergone pelvic clearance for endometriosis remains uncertain with insufficient evidence. The purpose of this case report and the national survey was to highlight the potential HRT-related risks and to establish current HRT practice in...

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Autores principales: Amer, Saad, Bazmi, Subul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821579/
https://www.ncbi.nlm.nih.gov/pubmed/36615134
http://dx.doi.org/10.3390/jcm12010336
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author Amer, Saad
Bazmi, Subul
author_facet Amer, Saad
Bazmi, Subul
author_sort Amer, Saad
collection PubMed
description The optimal hormone replacement therapy (HRT) in women who have undergone pelvic clearance for endometriosis remains uncertain with insufficient evidence. The purpose of this case report and the national survey was to highlight the potential HRT-related risks and to establish current HRT practice in this group of women. The case was a 45-year-old woman presenting with recurrence of severe chronic pelvic pain while on oestrogen-only HRT (EO-HRT) for five years after subtotal hysterectomy and bilateral oophorectomy for severe endometriosis. MRI revealed multiple peri-cervical endometriomas and severe right hydroureter/hydronephrosis with complete right renal parenchymal loss. The survey was a 21-item questionnaire administered electronically using SurveyMonkey. It was reviewed and approved by British Menopause Society and British Society of Gynaecological endoscopy and was sent to their members as well as NHS Gynaecologists. A total of 216 physicians responded including 120 (55.6%) Gynaecology Consultants and 96 (44.4%) GPs/Nurses in Menopause clinics. Overall, 68.6% of responders prescribe combined HRT (C-HRT), 11.1% tibolone, 13.0% EO-HRT and 7.8% varied HRT. Fifty-one percent prescribe the progestogen component of C-HRT indefinitely, 22% for 3–6 months and 27% for varied durations. In conclusion, this study highlights the real risk of endometriosis recurrence in EO-HRT users after pelvic clearance for endometriosis. The survey revealed that only two thirds of Gynecologists/Menopause practitioners prescribe combined HRT in this group of women.
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spelling pubmed-98215792023-01-07 HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey Amer, Saad Bazmi, Subul J Clin Med Case Report The optimal hormone replacement therapy (HRT) in women who have undergone pelvic clearance for endometriosis remains uncertain with insufficient evidence. The purpose of this case report and the national survey was to highlight the potential HRT-related risks and to establish current HRT practice in this group of women. The case was a 45-year-old woman presenting with recurrence of severe chronic pelvic pain while on oestrogen-only HRT (EO-HRT) for five years after subtotal hysterectomy and bilateral oophorectomy for severe endometriosis. MRI revealed multiple peri-cervical endometriomas and severe right hydroureter/hydronephrosis with complete right renal parenchymal loss. The survey was a 21-item questionnaire administered electronically using SurveyMonkey. It was reviewed and approved by British Menopause Society and British Society of Gynaecological endoscopy and was sent to their members as well as NHS Gynaecologists. A total of 216 physicians responded including 120 (55.6%) Gynaecology Consultants and 96 (44.4%) GPs/Nurses in Menopause clinics. Overall, 68.6% of responders prescribe combined HRT (C-HRT), 11.1% tibolone, 13.0% EO-HRT and 7.8% varied HRT. Fifty-one percent prescribe the progestogen component of C-HRT indefinitely, 22% for 3–6 months and 27% for varied durations. In conclusion, this study highlights the real risk of endometriosis recurrence in EO-HRT users after pelvic clearance for endometriosis. The survey revealed that only two thirds of Gynecologists/Menopause practitioners prescribe combined HRT in this group of women. MDPI 2023-01-01 /pmc/articles/PMC9821579/ /pubmed/36615134 http://dx.doi.org/10.3390/jcm12010336 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Amer, Saad
Bazmi, Subul
HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey
title HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey
title_full HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey
title_fullStr HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey
title_full_unstemmed HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey
title_short HRT in Women Undergoing Pelvic Clearance for Endometriosis—A Case Report and a National Survey
title_sort hrt in women undergoing pelvic clearance for endometriosis—a case report and a national survey
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821579/
https://www.ncbi.nlm.nih.gov/pubmed/36615134
http://dx.doi.org/10.3390/jcm12010336
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