Late-Onset Endometriosis Diagnosis and Management

Risk Factors and Clinical Presentation

The use of tamoxifen therapy in postmenopausal women increases the risk of late-onset endometriosis, with a relative risk of 4.0 1

The American College of Radiology recommends that if a postmenopausal woman is experiencing pain from endometriosis, it is likely secondary to scarring or reactivation due to postmenopausal hormonal therapy 2
Consider MRI pelvis as the preferred imaging modality for comprehensive evaluation of late-onset endometriosis, although transvaginal ultrasound with expanded protocol can be used as first-line imaging 3
Transvaginal ultrasound with expanded protocol can be used as first-line imaging for late-onset endometriosis, though MRI provides superior detection of deep infiltrating disease 4