Poster Session

P300. Evaluation of risk factors for osteoporosis in post-menopaused women with background of endometriosis and submitted to hormonal treatment.

Luis Sakamoto (BR), Nilson Melo (BR)

[Sakamoto] Women's Health Reference Center, São Paulo, [Melo] Women's Health Reference Center, São Paulo

Authors: Sakamoto LC, Melo NR, Pompei LM, Andrade MM, Malvasi A, Gebrin LH. Objective: to evaluate the risk factors for osteoporosis in postmenopausal women with a history of endometriosis and submitted to hormonal treatment. Methods: Fifty-eigth women in the Endometriosis Sector of the Reference Center for Women's Health between January 2005 and December 2016 were evaluated, with a confirmed diagnosis of endometriosis through histological examination by surgery and who subsequently underwent clinical treatment with a levonorgestrel endoceptive, medroxyprogesterone acetate injection or desogestrel pill, compared to patients who were observed until the postmenopausal period, which were denominated as groups A, B, C and D, respectively. The suspicion of menopause occurred clinically with the stop of the menses and / or presence of vasomotor symptoms, or through serial laboratory control in the women in amenorrhea, and later diagnostic confirmation through the elevated serum levels of FSH and LH, and low estradiol. Bone densitometry and dosage of 25 (OH) D were performed, and the need for alendronate was evaluated. Results: Menopause occurred in 6 (10.3%), 23 (39.7%) and 29 (50.0%) patients in a surgical, clinical and laboratory manner, and the mean age was 46.9, 49.9 and 45 years, respectively. The diagnosis of ovarian endometriosis was the most prevalent in 44 patients (75.9%), mainly due to oophoroplasty and / or oophorectomy surgeries. Groups A, B, C and D were represented by 4 (6.9%), 18 (31.0%), 19 (32.8%) and 17 (29.3%) patients, respectively. Normal values of 25 (OH) D were observed in only 12 patients (20.7%). Bone densitometry of the lumbar spine was normal in 75%, 55.6%, 55.6% and 52.9%, in groups A, B, C and D, respectively. And, femoral neck was normal in 75%, 77.8%, 73.7% and 47.1% in groups A, B, C and D, respectively. The worsening of bone mineral density was higher in group D in 58.8% of the cases of the lumbar spine and 64.7% of the neck of the femur, the group that most needed to use alendronate (70.6%). Conclusions: The hormonal treatment of women with endometriosis does not suggest to be a risk factor for osteoporosis, inversely to vitamin D deficiency and ovary surgeries. However, further studies should be performed for better elucidation.