子宫内膜异位症只影响育龄妇女这一观念的转变引起了人们对其在绝经后患者中表现的关注。尽管人们的认识不断提高，但文献中仍然缺乏有关绝经后子宫内膜异位症的信息，其患病率、临床意义、最佳治疗策略和预后存在不确定性。绝经期患者子宫内膜异位症的临床表现缺乏特异性，疼痛可能在生命的任何阶段出现。有症状的绝经后子宫内膜异位症的主要方法仍然是手术切除，以达到诊断和治疗目的，同时降低共存恶性肿瘤的风险。由于更年期激素治疗可能存在禁忌症以及复发和恶变风险升高，绝经后妇女的疾病管理面临挑战。然而，关于患有子宫内膜异位症或有该病史的女性是否适合更年期激素治疗，目前尚缺乏结论性数据。目前的建议倾向于优先考虑联合更年期激素治疗制剂或替勃龙，而不是仅使用雌激素的治疗​​，因为它们潜在的更高的恶性肿瘤风险。患有子宫内膜异位症的绝经后妇女患骨质疏松症和心血管疾病的风险可能增加，这可能与较早年龄的手术绝经史有关，但还需要更多的研究。这篇叙述性综述总结了现有文献，并提供了对子宫内膜异位症与更年期之间复杂联系的见解，阐明了发病机制、症状、肿瘤风险、诊断和治疗。版权所有 © 2024 Elsevier B.V. 保留所有权利。

The shift in paradigm from the belief that endometriosis exclusively affects women of reproductive age has brought attention to its manifestation in postmenopausal patients. Despite this emerging awareness, there remains a dearth of information in the literature regarding postmenopausal endometriosis, with uncertainties surrounding its prevalence, clinical significance, optimal management strategies, and prognosis. Clinical manifestations of endometriosis in menopausal patients lack specificity, with pain onset possible at any stage of life. The primary approach for symptomatic postmenopausal endometriosis continues to be surgical excision, serving both diagnostic and therapeutic purposes while mitigating the risk of coexisting malignancies. Managing the disease in postmenopausal women presents challenges due to possible contraindications for menopausal hormone therapy and the elevated risk of recurrence and malignant transformation. However, conclusive data regarding the appropriateness of menopausal hormone therapy in women with endometriosis or a history of the disease are lacking. Current recommendations lean towards prioritizing combined menopausal hormone therapy formulations or tibolone over estrogen-only therapies due to their potentially higher malignancy risk. The possible increased risk of osteoporosis and cardiovascular disease in postmenopausal women with endometriosis is likely linked to a history of surgical menopause at an earlier age, but more research is warranted. This narrative review summarizes the available literature and provides insights into the intricate connection between endometriosis and menopause, shedding light on pathogenesis, symptoms, oncologic risk, diagnosis, and treatment.Copyright © 2024 Elsevier B.V. All rights reserved.