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All Journal Asian Journal of Fertility, Endocrinology, and Reproduction
Elviara Martha Tinova Suprapto
Department of Obstetrics and Gynecology, Faculty of Medicine, Brawijaya University/Dr. Saiful Anwar General Hospital, East Java, Malang, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Social Sciences

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Comparative Effectiveness of Hormone Suppression Therapy and Surgery in Postmenopausal Endometriosis: A Systematic Review Elviara Martha Tinova Suprapto; Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 2 (2026): April 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i2.34

Abstract

Introduction: Postmenopausal endometriosis is a rare condition that presents diagnostic and therapeutic challenges, requiring evidence from various study designs. This systematic review evaluates the quality of available case reports and interventional studies to determine the reliability of evidence supporting hormonal suppression therapy and surgical management in postmenopausal endometriosis. Case Presentation: Risk of bias was assessed using the JBI Critical Appraisal Checklist for Case Reports and the Cochrane RoB 2 tool for randomized or quasi-experimental studies. Each domain was evaluated to determine methodological rigor and reporting completeness. Result: Included studies demonstrated that hormonal and surgical therapies offer varying degrees of effectiveness in managing postmenopausal endometriosis. Retrospective findings showed that menopausal hormone therapy may reduce symptoms, although adjustments to dose or regimen were sometimes required due to recurrence. Randomized and comparative trials evaluating different hormonal regimens reported symptom improvement without significant changes in metabolic parameters, although stimulation of residual endometriotic tissue remained a consideration. Controlled trials comparing hormonal therapy with surgical intervention indicated that treatment decisions should be individualized and carefully monitored. Case reports consistently documented favorable outcomes following surgical removal of lesions, with long-term follow-up showing no recurrence in several patients. Reports of medical therapy, including aromatase inhibition with supportive bone-protective treatment, demonstrated reductions in lesion activity and stabilization of bone density. Overall, both medical and surgical approaches were associated with symptom relief and stable clinical outcomes, with no major complications reported across studies. Conclusion: Evidence on treatment effectiveness in postmenopausal endometriosis remains limited by methodological weaknesses in interventional studies. While case reports support the potential benefits of surgical and hormonal therapies, more rigorous prospective studies are needed to strengthen clinical recommendations.
Incidental Cutaneous Endometriosis Discovered During Cesarean Section: A Case Report Elviara Martha Tinova Suprapto; Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 2 (2026): April 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i2.35

Abstract

Introduction: Cutaneous endometriosis is a rare form of extragenital endometriosis characterized by the presence of endometrial tissue within the skin, most commonly associated with previous gynecologic or obstetric surgical scars, particularly cesarean section. The diagnosis is often challenging due to nonspecific clinical manifestations and variable symptomatology. Case Presentation: A 31-year-old woman, gravida 2 para 1, with a history of cesarean section 14 years prior, underwent a repeat cesarean section for the same indication of cephalopelvic disproportion. During the second pregnancy, the patient did not report any palpable abdominal mass or menstrual abnormalities, except for mild dysmenorrhea. Intraoperatively, a well-defined mass was incidentally identified within the subcutaneous fat layer, firmly attached to the fascia, measuring 4.7 × 2.9 × 2.7 cm. The mass appeared yellowish with partially brownish areas and had a firm–elastic consistency. Complete surgical excision was performed. Histopathological examination revealed adipose and connective tissue containing nodular aggregates of decidualized cells, with no evidence of malignancy. Postpartum follow-up for three months showed complete resolution of symptoms without recurrence. Conclusion: Cutaneous endometriosis may present as an incidental intraoperative finding and can remain asymptomatic, particularly during pregnancy due to decidualization. A prior history of cesarean section is a significant risk factor. Complete surgical excision remains the treatment of choice and is associated with excellent clinical outcomes. Increased awareness of this rare entity is essential to ensure accurate diagnosis and appropriate management.
Co-Authors Sutrisno