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Obstet Gynecol Clin North Am. 1993 Jun;20(2):349-63.

Management of endometriosis in women older than 40 years of age.

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  • 1Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York.


Endometriosis in women older than 40 years of age presents unique therapeutic challenges to the practicing physician. Management requires the evaluation of reproductive goals and a determination of the objectives of therapy, including symptomatic relief and avoidance or delay of recurrence of disease. Important considerations in this age group include diminished fertility and impending menopause. The diagnosis and treatment for endometriosis-associated infertility must be undertaken in an expedient manner. Assisted reproductive technologies may be effective therapies for these patients. Conservative surgery may be necessary to preserve reproductive potential, but definitive surgery may be indicated in women with long-standing pelvic pain. Estrogen replacement therapy may be used in menopausal women with a history of endometriosis.

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