Endometriosis After Menopause: What to Know

Is it possible to be diagnosed with endometriosis after menopause? Here, we answer all your questions about this often misunderstood condition.

When menopause ends, a lot of the discomfort you’ve been feeling over the last few years is likely to come to an end, too.

In most women, menopausal symptoms like hot flashes get milder, and eventually stop completely.

But what about endometriosis after menopause?

If you’ve had endometriosis earlier in your life, is it possible that it won’t go away?

And if you haven’t, is it possible for endometriosis to start after menopause?

We’re here to answer your questions.

In this article: 📝

What is endometriosis?

Before you go through menopause, your body grows endometrial tissue every month to line your uterus, in case you get pregnant and need to carry a baby.

If this tissue grows in the wrong place, however, such as inside your fallopian tubes and ovaries, around the ligaments in your pelvis, or around certain organs, like your bladder, it grows and sheds the same way your uterine endometrial tissue.

Because the blood can’t flow out of your vagina, it becomes trapped and can cause discomfort, heavy bleeding, fertility problems, and severe pain.

Endometriosis is a complex chronic and often frustrating condition since it so often goes mis- or undiagnosed.

We’re here to help you.

We’ve written pieces on the difference between PCOS and endometriosis, and have an endometriosis support community you can turn to, too.

Can you have endometriosis after menopause?

If you’re diagnosed with endometriosis earlier in life, it’s likely that, after menopause, when your period has stopped completely, your endometriosis will most likely stop as well.

That’s because the endometrial tissue depends on estrogen to grow, and because your body stops producing estrogen during menopause, your endometriosis should subside or go away altogether.

Unfortunately, though, this isn’t the case in every instance.

Some women—about 2 to 5%—continue to experience endometriosis symptoms after menopause.

If your endometriosis was particularly severe before menopause, you’re more likely to have symptoms after menopause.

According to this study, it’s also possible that hormone replacement therapy (HRT) could “reactivate” endometriosis after menopause.

This is because HRT reintroduces estrogen into the body.

But it doesn’t mean that HRT isn’t an option.

In fact, this study argues that HRT shouldn’t be denied to women based on their history of endometriosis.

When it comes to HRT, it’s important that you chat to your doctor about your unique case before deciding on a course of treatment.

They’ll be able to help you weigh up the pros and cons.

What if you’ve never had endometriosis before?

While it’s more likely for you to carry on having endometriosis if you’ve had it before, it is possible for you start having endometriosis after you go through menopause.

In a study published in 2019, researchers found that in 61% of the 36 women they assessed through case reports and a literature review, endometriosis symptoms started more than 10 years after menopause.

But due to the very small sample size, more research is needed to verify this percentage and establish what could be causing this.

It’s suspected that both genetic and environmental factors that influence how estrogen is used and produced in the body could play a part.

What are the symptoms of endometriosis after menopause?

Women who have endometriosis after menopause typically experience similar symptoms to women who get it during their reproductive years.

Although there are some women who have no symptoms at all.

Here’s what you might expect:

• Discomfort or pain in your pelvis
  
• Pain when having a bowel movement
  
• Pain when urinating
  
• Ovarian cysts
  
• Digestive issues, including nausea, diarrhea, and constipation

To confirm whether your symptoms are caused by endometriosis, you’ll need to speak to your doctor.

They might choose to carry out one of several non-invasive procedures, such as a pelvic exam, an ultrasound, a CT scan, or an MRI.

While they work differently, these techniques all reveal whether there are any changes to your abdomen—whether any cysts have formed, for example, or if the shape of your organs has changed.

A laparoscopy, which is only slightly more invasive, is also an option.

That’s where your doctor makes a small incision near your belly button and inserts a tiny camera to see if and where there is any endometrial tissue visible.

How do you treat endometriosis after menopause?

There are a few different options available for treating endometriosis after menopause.

Research has shown that postmenopausal endometriosis is more likely to become cancerous, and may also spread to other organs or cause blockages in the body, too.

If you look into research on endometriosis after menopause, a lot of the literature speaks about “malignant transformation.”

This is when cells start to acquire the characteristics of cancerous tumors.

This study suggests that the risk of endometriosis transforming into ovarian cancer is around 2 to 3%.

Because of this risk, most doctors recommend that women treat endometriosis after menopause by surgically removing the endometrial tissue in the body.

Having surgery doesn’t necessarily mean that your endometriosis will go away completely.

It could come back at a later stage, but it should reduce the risk of cancer.

There are other, non-surgical options available to you, too. You could take:

• Progesterone, the other reproductive hormone, which may have benefits after menopause.
  
• Aromatase inhibitors, which can lower the estrogen levels in your body.
  
• Non-steroidal anti-inflammatory drugs, which reduce inflammation.

Does endometriosis go away after menopause?

In most cases, yes, endometriosis does go away after menopause.

But for a small percentage of women, it remains.

And some women may even develop endometriosis a decade or more after menopause.

If you think you might have endometriosis, be sure to speak to your doctor as soon as you can.

It’s important that endometriosis is diagnosed and treated properly, especially since there’s a potential risk that cancer might develop.

Pay attention to any signals your body gives and take good care of yourself during this time.

And remember that you’re not alone.

Your friends at Peanut are here to support you.