A 52-year-year-old woman attends the GP with vaginal dryness and dyspareunia but no vasomotor symptoms. She has a history of endometriosis treated wit...

Question

A 52-year-year-old woman attends the GP with vaginal dryness and dyspareunia but no vasomotor symptoms. She has a history of endometriosis treated with laparoscopic excision. She is concerned about whether oestrogen will reactivate her endometriosis. She has a uterus. Which is the single most appropriate advice?

Accepted Answer

Vaginal oestrogen can be offered for urogenital symptoms - it has minimal systemic absorption and is unlikely to reactivate endometriosis

Answer

HRT is absolutely contraindicated with a history of endometriosis

Answer

She must take continuous combined systemic HRT even for vaginal symptoms only

Answer

Oestrogen-only HRT is safe as she has had surgical treatment for endometriosis

Answer

Only tibolone can be used after endometriosis

uk-drcog MCQ (SBA): Vaginal Oestrogen After Endometriosis