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To the Editor: —
Endometriosis and adenomyosis are now being reported by careful gynecologic surgeons and pathologists in one of five pelves. Many of those reported are symptomless, but fairly regularly the diagnosis is made and conservative surgery is used as therapeusis. Numbers of these patients then are seen by other medical practitioners who do not understand or fail to take cognizance of the implications of the diagnosis of endometriosis. These patients are subsequently placed on estrogen therapy. This therapy in turn can be in the form of minimal doses, which seem not to stimulate the endometriosis much, but I have seen numerous patients who have had large doses of estrogen and who have had decided reactivation of their endometrial symptoms.I should suggest that, whenever a diagnosis of endometriosis is proved, either at the operating table or in the pathologic laboratory, the patient be instructed that she is never
BUSHNELL LF. ENDOMETRIOSIS. JAMA. 1948;136(13):895. doi:10.1001/jama.1948.02890300045017