Comparison of transdermal estradiol and tibolone for the treatment of oophorectomized women with deep residual endometriosis

Study objective: To compare the effect of HRT with transdermal estradiol an d that of treatment with tibolone in post-menopausal women with residual en dometriosis. Materials and Methods: 21 women with residual pelvic endometri osis after bilateral oophorectomy with or without hysterectomy were enrolle d in the study and were randomized to HRT with transdermal estradiol 50 mg twice weekly (n = 10) associated with cyclic medroxyprogesterone acetate 10 mg daily in women who preserved uterus, and to treatment with tibolone 2.5 mg administered orally once a day (n = 11). The duration of both treatment s was scheduled to last at least 12 months. Residual endometriosis was loca ted in the bowel wall in four patients, in the rectovaginal septum in six a nd deeply in the retroperitoneal pelvic space in six. All women were sympto matic before oophorectomy. Results: All the women were followed for 12 mont hs. No patient suspended therapy because of side effects. Four patients of the estradiol group experienced moderate pelvic pain during treatment compa red with only one patient in the tibolone group. One patient in the estradi ol group reported severe dyspareunia. Conclusion: Although our series is ve ry small, it seems that tibolone may be a safe hormonal treatment for post- menopausal women with residual endometriosis. (C) 1999 Elsevier Science Ire land Ltd. All rights reserved.