Endometriosis after the age of 40 years
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Management of endometriosis during midlife
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Endometriosis after the age of 40 years
- 1. 20.11.2018 1 Endometriosis beyond late reproductive age Tevfik Yoldemir MD BSc MA Prof. Marmara University, School of Medicine, Dept. of Obs Gyn, Istanbul, Turkey Adjunct Prof. Eastern Mediterranean University, School of Medicine, Dept. of Obs Gyn, Famagusta, North Cyprus Photo (compulsory) I have no financial relationships to disclose. I have no conflict of interest. Age pattern in 42,079 patients with endometriosis Arch Gynecol Obstet (2012) 286:667–670 Incidence of endometriosis in a UK-based population analysis THE EUROPEAN JOURNAL OF CONTRACEPTION & REPRODUCTIVE HEALTH CARE, 2017 https://doi.org/10.1080/13625187.2017.1374362 Epidemiology of endometriosis computerised databases of Maccabi Healthcare Services (MHS), the second largest of four recognised healthcare providers in Israel. MHS has approximately 2 million active members BJOG 2018;125:55–62. Time to Endometriosis Diagnosis JOURNAL OF WOMEN’S HEALTH, 2017 DOI: 10.1089/jwh.2016.6003
- 2. 20.11.2018 2 Distribution of 3 typical endometriosis-related symptoms across age groups Gynecol Obstet Invest DOI: 10.1159/000452660 Association of endometriosis-related infertility with age at menopause Maturitas 69 (2011) 279– 283 Data for 24,153 pre- and postmenopausal women who were enrolled in the JNHS at ages of 40–59 years were used for analysis Association of endometriosis-related infertility with age at menopause Maturitas 69 (2011) 279– 283 key recommendations for endometriosis care. Human Reproduction, 2016 doi:10.1093/humrep/dew078 Human Reproduction, 2016 doi:10.1093/humrep/dew078 Annual prescription of the most commonly used (A) hormonal or other pharmacological treatments and (B) pain medications THE EUROPEAN JOURNAL OF CONTRACEPTION & REPRODUCTIVE HEALTH CARE, 2017 https://doi.org/10.1080/13625187.2017.1374362
- 3. 20.11.2018 3 Rate of recurrent procedures for endometriosis by age group THE EUROPEAN JOURNAL OF CONTRACEPTION & REPRODUCTIVE HEALTH CARE, 2017 https://doi.org/10.1080/13625187.2017.1374362 THE EUROPEAN JOURNAL OF CONTRACEPTION & REPRODUCTIVE HEALTH CARE, 2017 https://doi.org/10.1080/13625187.2017.1374362 The rates of retreatment, defined by endometriosis-related reoperation JOURNAL OF WOMEN’S HEALTH, 2017 DOI: 10.1089/jwh.2016.6043 When use of medical treatment (OCs, NSAIDs, GnRH, progestin, or danazol) considered in the retreatment definition JOURNAL OF WOMEN’S HEALTH, 2017 DOI: 10.1089/jwh.2016.6043 The cumulative recurrence rate of endometrioma according to use of postoperative medications by age group European Journal of Obstetrics & Gynecology and Reproductive Biology 208 (2017) 81–85 Age-related differences in the sonographic characteristics of endometriomas Human Reproduction, Vol.31, No.8 pp. 1723–1731, 2016
- 4. 20.11.2018 4 Human Reproduction, Vol.31, No.8 pp. 1723–1731, 2016 Human Reproduction, Vol.31, No.8 pp. 1723–1731, 2016 Human Reproduction, Vol.31, No.8 pp. 1723–1731, 2016 Human Reproduction, Vol.31, No.8 pp. 1723–1731, 2016 Human Reproduction, Vol.31, No.8 pp. 1723–1731, 2016 Improving strategies for diagnosing ovarian cancer Simple Rules -International Ovarian Tumor Analysis (IOTA) group Ultrasound Obstet Gynecol 2013; 41: 9–20
- 5. 20.11.2018 5 Ultrasound Obstet Gynecol 2013; 41: 9–20 Predicting the risk of malignancy in adnexal masses Simple Rules - International Ovarian Tumor Analysis (IOTA) group Am J Obstet Gynecol 2016;214:424-437 Am J Obstet Gynecol 2016;214:424-437 Assessment of Different Neoplasias in the adneXa (ADNEX) model http://www.iotagroup.org/adnexmodel/site%20iota.html Differentiation of seromucinous borderline tumour from endometriosis-related malignant ovarian tumour Results of MR quantitative evaluation Eur Radiol DOI 10.1007/s00330-016-4533-x apparent diffusion coefficient : ADC Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management Human Reproduction Update, Vol.21, No.3 pp. 329–339, 2015 Clear indications to DIE Surgery *Severe Pain *Bowel/ureteral stenosis *Infertility with no compliance to ART Relative indications to DIE surgery *Infertility after 2 or more IVF failures before egg donation Malzoni 2017
- 6. 20.11.2018 6 Roman H, Endometriosis Summit, Iceland 2017 Surgery versus hormonal therapy for deep endometriosis: is it a choice of the physician? European Journal of Obstetrics & Gynecology and Reproductive Biology 209 (2017) 67–71 NETA 2.5 mg/ day European Journal of Obstetrics & Gynecology and Reproductive Biology 209 (2017) 67–71 19-nortestosterone derivative progestins The pharmacological differences between the two compounds are limited: NETA has “strongly effective” progestogenic activity and androgenic activity, whereas dienogest has “effective” progestogenic activity and antiandrogenic activity Human Reproduction, 2016 doi:10.1093/humrep/dew078 Algorithm of endometriosis management in postmenopausal women Climacteric, 2017;20:2:138-143, DOI: 10.1080/13697137.2017.1284781 Pain perception in women according to different conditions/confounders at age 46 years Pressure-Pain Threshold The Journal of Pain 2018 https://doi.org/10.1016/j.jpain.2018.02.005
- 7. 20.11.2018 7 Pain perception in women according to different conditions/confounders at age 46 years The Journal of Pain 2018 https://doi.org/10.1016/j.jpain.2018.02.005 Aromatase inhibitors in post-menopausal endometriosis Reproductive Biology and Endocrinology 2011, 9:90 http://www.rbej.com/content/9/1/90. Aromatase inhibitors in post-menopausal endometriosis Reproductive Biology and Endocrinology 2011, 9:90 http://www.rbej.com/content/9/1/90. Postmenopausal Deep InfiltratingEndometriosis of the ColonPostmenopausal Deep InfiltratingEndometriosis of the ColonPostmenopausal Deep InfiltratingEndometriosis of the ColonPostmenopausal Deep InfiltratingEndometriosis of the Colon • A course of conjugated estrogen/ bazedoxifene (CE/BZA) (Duavee: 0.45–20mg, Pfizer) Case Reports in Gastrointestinal Medicine Volume 2018, Article ID 9587536, 5 Impact of endometriosis on risk of further gynaecological surgery and cancer BJOG 2017; https://doi.org/10.1111/1471-0528.14793. Endometriosis and risks for ovarian, endometrial and breast cancers Gynecologic Oncology (2016) http://dx.doi.org/10.1016/j.ygyno.2016.07.095 45,790 women with a clinical diagnosis of endometriosis during 1977–2012.
- 8. 20.11.2018 8 Gynecologic Oncology (2016) http://dx.doi.org/10.1016/j.ygyno.2016.07.095 Endometriosis recurrence in women on HRT Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 Dosages and regimens associated with recurrent postmenopausal endometriosis Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 malignant transformation of endometriotic foci after HRT in women with a history of endometriosis Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017
- 9. 20.11.2018 9 Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 Quality assessment of observational and clinical trials assessing risk of endometriosis recurrence after HRT Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 effects of estrogen exposure on endometriosis recurrence and risk of malignant transformation Climacteric, 2017;20:2:138-143, DOI: 10.1080/13697137.2017.1284781 effects of estrogen exposure on endometriosis recurrence and risk of malignant transformation Climacteric, 2017;20:2:138-143, DOI: 10.1080/13697137.2017.1284781 effects of estrogen exposure on endometriosis recurrence and risk of malignant transformation Climacteric, 2017;20:2:138-143, DOI: 10.1080/13697137.2017.1284781 Nezhat F, 12th Turkish German Gynecologic Congress 2018
- 10. 20.11.2018 10 Nezhat F, 12th Turkish German Gynecologic Congress 2018 Nezhat F, 12th Turkish German Gynecologic Congress 2018 Nezhat F, 12th Turkish German Gynecologic Congress 2018 Nezhat F, 12th Turkish German Gynecologic Congress 2018 Nezhat F, 12th Turkish German Gynecologic Congress 2018 Nezhat F, 12th Turkish German Gynecologic Congress 2018
- 11. 20.11.2018 11 Suggested clinical approach to postmenopausal patients with a history of endometriosis Human Reproduction Update, Vol.23, No.4 pp. 481–500, 2017 Emerging treatment of endometriosis • GnRH antagonists • Aromatase inhibitors • Selective estrogen receptor modulators • Progesterone antagonist • Selective progesterone receptor modulators • Angiogenesis inhibitors • Immunomodulators • Matrix metalloproteinase • 5-Fluorouracil • Thiazolidinediones • Metformin Middle East Fertility Society Journal (2015) 20, 61–69 Thank you for your attention Tevfik Yoldemir MD BSc MA tevfik.yoldemir@marmara.edu.tr Photo (compulsory)