Obravnava endometrioze v pomenopavznem obdobju Belak Magdalenić, Urška; Frangež, Helena Ban; Korošec, Sara
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
12/2023, Letnik:
92, Številka:
11-12
Journal Article
Recenzirano
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Endometrioza je bolezen, ki lahko prizadene 2–5 % vseh žensk v pomenopavznem obdobju. Gre za bolezen, pri kateri se endometrijske žleze in stroma nahajajo zunaj maternice. O pomenopavzni endometriozi ...je zaenkrat v literaturi še malo znanih podatkov. V sklopu diagnosticiranja je v tem obdobju v ospredju predvsem skrb, da gre morda za maligno bolezen. Poročila v literaturi opisujejo ponovitev endometrioze v pomenopavznem obdobju kot tudi nastanek endometrioze »de novo«. Zdravljenje izbire simptomatske endometrioze v pomenopavzi je kirurško z odstranitvijo vsega vidnega endometriotičnega tkiva zaradi višjega tveganja za ponovitev bolezni in preobrat v maligno bolezen. Hormonsko zdravljenje po menopavzi (MHZ) se pogosto uporablja za lajšanje simptomov in preprečevanje izgube kostne mase. Obstajajo raziskave, ki dokazujejo, da MHZ lahko ponovno aktivira endometriotična žarišča in celo spodbuja maligno preoblikovanje žarišč pri ženskah z anamnezo endometrioze. Glede na ne povsem razjasnjena tveganja MHZ pri tovrstnih bolnicah se svetuje dodatna previdnost.
Background: Due to the defficiency of sex hormone estrogen after the menopause, the quality of woman's life dramatically decreases. Atrophic vaginitis in particular is a frequent cause of problems in ...these women's sex life. Methods: The gynecologist can detect the problems related to atrophic vaginitis using directed medi- cal history; clinical picture is also easily recognized. Atrophic vaginits is treated with locally applied hormone preparations, 17 beta Estradiol in the form of vaginal tablets having been proven as the safest providing the highest compliance. Safety, efficinecy and good compliance of 17 beta Estradiol vaginal tablets in the treatment of atrophic vaginitis was also confirmed by Slovene gyencologists in an observational study. In the next step we used a survey to evaluate the extent of sexual activity, their attitude to sexuality, and their subjective notion of the treatment they received from their gynecologists among the menopausal women coming to outpatient clinics. Conclusions: The quality of sexual life in women with atrophic vaginitis can be improved by local hormone treatment. A proactive approach is required, using a directed medical history concerning sexual activity. It is clear that for too many postmenopausal women sexuality is still a taboo which they will reluctantly talk about.
