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Thomas Lyons, MD

Medical Director HealthSouth Surgery Center Gainesville, GA

Dr. Lyons is considered a surgical pioneer and has received numerous awards for his breakthroughs in gynecologic surgery since 1980; he authored the LSH procedure, or Laparoscopic Supracervical Hysterectomy. He also developed the Laparoscopic Burch procedure for stress urinary incontinence. His areas of research include both alpha and beta site activities involving surgical devices and procedures, multiple activities in the area of adhesion prevention, endometriosis, tissue removal, vascular occlusion, dysfunctional uterine bleeding, managing menopausal symptomology, and female surgical sterilization

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woman with pelvic pain from endometriosis
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Endometriosis and Hormone Therapy

Ask the Expert

Q:

I had endometriosis for years. Now that I'm past menopause, is there any reason I shouldn't use hormone therapy?

A:

If you've had endometriosis for years, then you probably know that it is a condition in which cells from the lining of the uterus—the endometrium—grow outside the uterus. These cells are activated by hormones (estrogen and progesterone) produced by the ovaries in your body. When estrogen is high, the cells are stimulated, causing pain and other symptoms. That's why women with endometriosis find their condition greatly improves once they reach menopause and their body's estrogen production drops.

There are few studies on the effects of supplemental hormones (known as hormone therapy or "HT") after menopause on women previously diagnosed with endometriosis, and the few available focus on women who had surgical menopause (in which the ovaries are removed) or premature menopause (in which the ovaries stop working earlier than normal). Most of these studies show a greater risk of relapse in women who use hormone therapy than in those who don't, although the risk is relatively small (about three percent). The actual risks might be related to the dose of estrogen given; higher doses will increase the risk of recurrence more so than lower doses.

So, bottom line? Talk to your health care professional about your interest in and concern about using HT and about other options for managing any menopause-related or other symptoms you're having. For instance, certain antidepressants can help with hot flashes, while lubricants and targeted hormone therapy (such as vaginal tablets) can help with vaginal dryness. There are also lifestyle options that can make a difference, including something as simple as exercise.

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