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Many women who have had endometriosis choose to use hormone replacement therapy.
This may be required when a woman becomes menopausal naturally or as a result
of surgery when the ovaries are removed.
There is often concern that oestrogen which is used as HRT may stimulate any
residual disease.
Following the observation that constant oestrogen levels do not usually
increase endometriosis activity, this is not necessarily the case.
There can be some situations where pain and endometriosis symptoms do increase
when HRT is used.
To deal with this problem there are a number of options:
- The dose of oestrogen can be reduced to the absolute minimum required
- Progestagens can be added to the existing treatment to reduce the activity of any residual endomentriosis
- A new drug, tibolone, can be used instead of oestrogen as HRT
Tibolone has no activity in endometrial tissue and hence does not stimulate
endometriosis tissue.
This agent is probably the drug of choice for women who have had a diagnosis of
endometriosis and are considering HRT.
Tibolone has the additional advantage of not causing breast symptoms as
it does not stimulate breast tissue in the same way that oestrogen does.
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