Table of ContentsView AllTable of ContentsMenopause Effects on EndoEndo After MenopauseDiagnosisTreatmentHRT and EndometriosisComplicationsEarly Menopause After Treatment
Table of ContentsView All
View All
Table of Contents
Menopause Effects on Endo
Endo After Menopause
Diagnosis
Treatment
HRT and Endometriosis
Complications
Early Menopause After Treatment
Endometriosistissue responds to hormones just as theendometrium(lining of the uterus) does. Estrogen stimulates its growth, while progestin inhibits its growth. Endometriosis symptoms often diminish after menopause, when estrogen levels drop.People who have been through menopause can still experience endometriosis, although less frequently than people who are still menstruating.
In some cases, endometriosis seems to develop after menopause in people who did not experience it before menopause. Research is lacking on whether these cases are largely a recurrence of premenopausal endometriosis or de novo (new) cases developing entirely after menopause.
This article will discuss if endometriosis can go away after menopause, whether it can develop after menopause, how postmenopausal endometriosis is diagnosed, how it is treated, and possible complications of postmenopausal endometriosis.
Simona Pilolla / EyeEm / Getty Images
Does Endometriosis Go Away After Menopause?
Endometriosis tissue responds to estrogen. When estrogen levels drop after menopause, endometriosis often goes into remission.
This drop in estrogen causessymptoms of endometriosisto decrease but also promotes symptoms associated with menopause, such as night sweats, hot flashes, mood swings, andvaginal dryness/atrophy.
Endometriosis can reactivate after menopause, particularly if estrogen levels rise again, such as after starting hormone replacement therapy.
The prevalence of endometriosis in reproductive-aged women is 2% to 10%, while in those who have been throughmenopause, the prevalence is an estimated 2.5%.
Note that when research or health authorities are cited, the terms for sex or gender from the source are used.
Can You Develop Endometriosis After Menopause?
Existing endometriosis can persist past menopause. In some cases, endometriosis can develop even several years after menopause. It is difficult to determine, however, whether postmenopausal cases are new or if they were previously undiagnosed and that asymptomatic endometriosis has progressed to the point of being symptomatic.
It is rare for a person to develop endometriosis several years past the onset of menopause if they are not taking menopausal hormone therapy (MHT).
Some theories as to why endometriosis could develop or recur after menopause include:
What Is Menopause?
A person is considered to be in menopause 12 months after their last menstrual period. The approximately seven to 14 years before menopause is called the menopausal transition or perimenopause. This usually happens fromage 45 to 55, but this can vary.Some medications and certain surgeries, such as the removal of the ovaries and uterus, can also trigger menopause.
Perimenopause can causesymptoms such as:
The period after menopause is called postmenopause. People who are in postmenopause are more vulnerable to heart disease and osteoporosis, a condition in which bone density and mass decrease.
Diagnosing Postmenopausal Endometriosis
The ovaries are the mostcommon area for endometriosis tissue to be foundin people who have been through menopause.
Using laparoscopy (a minimally invasive procedure) to perform a biopsy is the gold standard procedure fordiagnosing endometriosisat any age.
Other tests may be used for a less-invasive option, but their accuracy in the diagnosis of endometriosis can vary. These may include:
What Other Conditions Could Be Causing Symptoms?
The symptoms of endometriosis can be similar to those of other conditions. The risk of conditions such asovarian cancer, which can mimic endometriosis symptoms, increases with age, so checking for other conditions along with endometriosis is important, particularly in older adults.
What Endometriosis Ultrasounds Detect
Postmenopausal Endometriosis Treatment
Surgical removal of endometrial tissue is considered a first-line treatment for people who have been through menopause.
Several studies have noted significant improvement in symptoms and decreased risk ofmalignancy(cancer) aftercomplete resection(cutting out) of all visible endometrial tissue in people who have been through menopause.
If surgery is not an option, or if there is a recurrence of endometriosis after surgery, other treatment options include:
Hormone Replacement Therapy and Endometriosis
Because of insufficient data, there is currently no set recommendation on whether people with ahistory of endometriosisshould take MHT (also called hormone replacement therapy, or HRT).
While MHT may play a role in the recurrence or worsening of endometriosis, lowered estrogen levels can triggersymptomsthat may interfere with quality of life. Lowered estrogen levels also increase the risk of cardiovascular disease and bone disease. MHT can help counteract these effects.
For people who haveprematureor surgically induced menopause, the benefits of MHT may outweigh the risks, and MHT until the average age of natural menopause should be considered.
Complications of Untreated Endometriosis After Menopause
The risk of endometriosis lesions becoming cancerous is higher in people who have been through menopause than those still in their reproductive years.Malignant lesionscould spread to the ovaries, the bowels, the lungs, or other areas.
While surgery can help prevent complications from endometriosis, surgery in older adults can haveincreased risksas well, often because of the increased occurrence of comorbid (co-occurring) conditions.
Talk to your healthcare provider about what you can do to help reduce yourrisk of postmenopausal endometriosis complications.
Early Menopause as a Side Effect of Endometriosis Treatment
Symptoms of menopause can be more prevalent and more severe in people who experience the sudden drop in estrogen associated with induced menopause than in those who transition into menopause naturally.
MHT may help find a balance between the effects ofearly menopauseand the relief from endometriosis.
Can You Have Endometriosis After a Hysterectomy?
It is possible to continue to have or to develop endometriosis after a partial ortotal hysterectomy.This is more likely to occur when estrogen therapy is used.
Summary
Endometriosis typically occurs in people of reproductive age who menstruate, but it can persist into or develop after menopause.
The drop in estrogen that occurs in menopause can causeendometriosisto go into remission but also may cause other symptoms associated with menopause, such as mood swings, vaginal dryness, and hot flashes. People who have been through menopause are also at an increased risk of cardiovascular disease and bone diseases such as osteoporosis.
Endometriosis is usually diagnosed with laparoscopic surgery and biopsy. Other imaging tests, such as ultrasound, CT, or MRI, may also be used.
Endometriosiscan also be treatedwith laparoscopic surgery. If surgery is not an option, medications may be helpful. Treatments that induce menopause can help manage endometriosis.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.de Almeida Asencio F, Ribeiro HA, Ayrosa Ribeiro P, et al.Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports.Gynecol Surg. 2019;16(1):3. doi:10.1186/s10397-019-1056-xNaem A, Shamandi A, Al-Shiekh A, Alsaid B.Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report.BMC Women’s Health. 2020;20(1):190. doi:10.1186/s12905-020-01054-xSecosan C, Balulescu L, Brasoveanu S, et al.Endometriosis in menopause—renewed attention on a controversial disease.Diagnostics. 2020;10(3):134. doi:10.3390/diagnostics10030134Zanello M, Borghese G, Manzara F, et al.Hormonal replacement therapy in menopausal women with history of endometriosis: a review of literature.Medicina. 2019;55(8):477. doi:10.3390/medicina55080477National Institute on Aging.What is menopause?Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, Becker CM.The management of menopause in women with a history of endometriosis: a systematic review.Human Reproduction Update. 2017;23(4):481-500. doi:10.1093/humupd/dmx011Mathey MP, Bouquet de Jolinière J, Major A, et al.Endometriotic mass after hysterectomy in a 61 year old post-menopausal woman: a case report and update. Front Surg. 2019;6:14. doi:10.3389/fsurg.2019.00014Endometriosis.net.Menopause and endometriosis.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.de Almeida Asencio F, Ribeiro HA, Ayrosa Ribeiro P, et al.Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports.Gynecol Surg. 2019;16(1):3. doi:10.1186/s10397-019-1056-xNaem A, Shamandi A, Al-Shiekh A, Alsaid B.Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report.BMC Women’s Health. 2020;20(1):190. doi:10.1186/s12905-020-01054-xSecosan C, Balulescu L, Brasoveanu S, et al.Endometriosis in menopause—renewed attention on a controversial disease.Diagnostics. 2020;10(3):134. doi:10.3390/diagnostics10030134Zanello M, Borghese G, Manzara F, et al.Hormonal replacement therapy in menopausal women with history of endometriosis: a review of literature.Medicina. 2019;55(8):477. doi:10.3390/medicina55080477National Institute on Aging.What is menopause?Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, Becker CM.The management of menopause in women with a history of endometriosis: a systematic review.Human Reproduction Update. 2017;23(4):481-500. doi:10.1093/humupd/dmx011Mathey MP, Bouquet de Jolinière J, Major A, et al.Endometriotic mass after hysterectomy in a 61 year old post-menopausal woman: a case report and update. Front Surg. 2019;6:14. doi:10.3389/fsurg.2019.00014Endometriosis.net.Menopause and endometriosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
de Almeida Asencio F, Ribeiro HA, Ayrosa Ribeiro P, et al.Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports.Gynecol Surg. 2019;16(1):3. doi:10.1186/s10397-019-1056-xNaem A, Shamandi A, Al-Shiekh A, Alsaid B.Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report.BMC Women’s Health. 2020;20(1):190. doi:10.1186/s12905-020-01054-xSecosan C, Balulescu L, Brasoveanu S, et al.Endometriosis in menopause—renewed attention on a controversial disease.Diagnostics. 2020;10(3):134. doi:10.3390/diagnostics10030134Zanello M, Borghese G, Manzara F, et al.Hormonal replacement therapy in menopausal women with history of endometriosis: a review of literature.Medicina. 2019;55(8):477. doi:10.3390/medicina55080477National Institute on Aging.What is menopause?Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, Becker CM.The management of menopause in women with a history of endometriosis: a systematic review.Human Reproduction Update. 2017;23(4):481-500. doi:10.1093/humupd/dmx011Mathey MP, Bouquet de Jolinière J, Major A, et al.Endometriotic mass after hysterectomy in a 61 year old post-menopausal woman: a case report and update. Front Surg. 2019;6:14. doi:10.3389/fsurg.2019.00014Endometriosis.net.Menopause and endometriosis.
de Almeida Asencio F, Ribeiro HA, Ayrosa Ribeiro P, et al.Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports.Gynecol Surg. 2019;16(1):3. doi:10.1186/s10397-019-1056-x
Naem A, Shamandi A, Al-Shiekh A, Alsaid B.Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report.BMC Women’s Health. 2020;20(1):190. doi:10.1186/s12905-020-01054-x
Secosan C, Balulescu L, Brasoveanu S, et al.Endometriosis in menopause—renewed attention on a controversial disease.Diagnostics. 2020;10(3):134. doi:10.3390/diagnostics10030134
Zanello M, Borghese G, Manzara F, et al.Hormonal replacement therapy in menopausal women with history of endometriosis: a review of literature.Medicina. 2019;55(8):477. doi:10.3390/medicina55080477
National Institute on Aging.What is menopause?
Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, Becker CM.The management of menopause in women with a history of endometriosis: a systematic review.Human Reproduction Update. 2017;23(4):481-500. doi:10.1093/humupd/dmx011
Mathey MP, Bouquet de Jolinière J, Major A, et al.Endometriotic mass after hysterectomy in a 61 year old post-menopausal woman: a case report and update. Front Surg. 2019;6:14. doi:10.3389/fsurg.2019.00014
Endometriosis.net.Menopause and endometriosis.
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