Menopause — the cessation of menstrual cycles, typically around the age of 51— may seem like a welcome event if you have endometriosis. Endometriosis is an estrogen-dependent condition in which the tissue that lines the uterus, called the endometrium, grows elsewhere in the pelvic cavity. It can cause painful symptoms that can impact your quality of life and affect your fertility.
Endometriosis symptoms are associated with menstrual periods, so it’s reasonable to wonder whether no longer having menstrual cycles from menopause means the symptoms will go away. It is a topic of conversation among many MyEndometriosisTeam members: “What happens to endo after natural menopause?” one member asked. Another member shared, “Unfortunately, even going through menopause is not stopping the pain.”
So, does menopause mean an end to endometriosis? In short, not necessarily.
Researchers believe that at least 11 percent of women in the United States have endometriosis. Although most people who have endometriosis stop experiencing symptoms when they enter menopause, 2 percent to 5 percent continue to have the condition, research shows.
Estrogen-replacement therapy may cause ongoing endometriosis after menopause. Estrogen makes endometriosis worse by stimulating the growth of endometrial tissue. Postmenopausal women, including those in surgical menopause, may take estrogen to ease the symptoms of menopause and prevent bone loss.
Pairing estrogen with progesterone, however (such as in the combination birth control pill), can lessen the effect of estrogen. “The hormones relieve the postmenopause stage,” one member said who had started on the combination following a hysterectomy.
One study found that estrogen-only replacement therapy increased the recurrence of endometriosis, as opposed to combination therapy with progestin or treatment with Tibolone. (This drug acts as estrogen to the bones but progesterone to other organs. However, it is not approved for use in the United States.)
The medication Tamoxifen is used to treat breast cancer, but it has an overall anti-estrogen effect and may act like estrogen in the uterus. It may also cause endometriosis to occur after menopause.
It’s important to understand that estrogen production does not completely stop with menopause, either. Peripheral fat is an excellent source of estrogen.
Research studying postmenopausal endometriosis symptoms is limited, though a few studies are available. In one review of other studies, researchers found that deep dyspareunia (severe pain during sex) and chronic pelvic pain were less common symptoms. The symptoms reported did not follow the cyclic patterns that premenopausal women commonly report, and related symptoms such as bloating also ceased.
Between 2 percent and 5 percent of women experience endometriosis after menopause — that means that most find relief from endometriosis with menopause. Those who don’t take hormone replacement therapy for menopause also may have less risk.
Your doctor may prescribe pain medications, such as ibuprofen or naproxen, to help alleviate endometriosis pain. Although hormonal methods of treatment are typically first-line treatments, they may not work for postmenopausal women with low estrogen. Some research suggests the first-line treatment during menopause should be surgery to remove the uterus and ovaries.
Learn more about the pros and cons of undergoing a hysterectomy with endometriosis.
Endometriosis symptoms can be very difficult to deal with, and menopause represents a huge life shift. Support can be helpful as you navigate both. On MyEndometriosisTeam, you’ll find a community of more than 120,000 members who can help you through it. Members share your concerns and can speak from personal experience about what’s to come.
Do you have questions about starting menopause? Or do you have tips for dealing with endometriosis after menopause? Share your thoughts with other members in a comment below or start a new conversation on MyEndometriosisTeam.