This is a question we hear often – probably partly because much of the information online is contradictory. The truth is far more nuanced.
In short, menopause can be a mixed bag for people with endometriosis.
For some, endometriosis symptoms worsen during perimenopause. And then again, some see their symptoms improve or even stop after menopause.
To understand how menopause might impact your endometriosis, let’s look at what’s happening in each stage of menopause, and how that can impact your symptoms.
Perimenopause often starts in the 40s. Your ovaries begin releasing fewer eggs and your oestrogen levels fluctuate. This is important for people with endometriosis because endometriosis is driven by oestrogen. The ups and downs of oestrogen can mean you have unpredictable flares of endometriosis symptoms.
If you normally have a period, it might get lighter, heavier, longer, shorter, or more irregular. This can also be difficult with people with endo as symptoms often get worse when you have your period.
If you’re using hormonal contraception, it can change or stop bleeding and sometimes keep endometriosis symptoms steadier, but you can still go through the hormone shifts of perimenopause. If you’ve had a hysterectomy but still have your ovaries, your hormones can still fluctuate, which means endometriosis symptoms can still flare or change, even without periods.
Perimenopause can also bring a range of other symptoms like hot flushes, night sweats, and brain fog. Around 80% of women experience perimenopausal symptoms. The severity of these symptoms can vary widely – from quite mild to severe.
If perimenopause symptoms are impacting your life, you might like to consider menopause treatment like hormone therapy. Hormone therapy is always individualised.
When you come to see us, we work with you to come up with a treatment plan that suits your symptoms, lifestyle, and other medical conditions. If you have endometriosis, we’ll factor this into the type of medication we prescribe, to reduce the chances of your endometriosis flaring up or being reactivated."
Technically speaking, menopause is just a moment in time when you haven’t had a period for 12 months. For lots of people, endometriosis symptoms also improve or stop completely. But some people continue to have symptoms into postmenopause.
If you don’t normally have a period, it can be hard to know whether you’re in menopause. We can talk to you about this and work out which stage of menopause you’re in – sometimes a blood test can help.
Some people with a history of endometriosis can still have pelvic symptoms after menopause. But bleeding after menopause isn’t normal. If you have any vaginal bleeding once your periods have stopped, it should always be discussed with a nurse or doctor.
When it’s been at least 12 months since your last period, you’re in postmenopause, and you’ll stay in this stage for the rest of your life.
In postmenopause, your hormones fluctuate less, and your oestrogen levels are much lower. This means your endometriosis is likely to be more predictable and stable. Lots of people find that their endo symptoms improve, while some even have symptoms stop completely.
Unfortunately, some people’s endometriosis symptoms do continue after menopause, but this is less common. This is often the case where endometriosis symptoms before menopause were severe. There are ways to treat your endometriosis symptoms in postmenopause, including some endometriosis medications, or surgery.
Most menopause symptoms also improve during postmenopause, but some may continue or get worse. This is often the case for vaginal dryness and needing to go to the toilet more often. But topical oestrogen treatments can help.
All our clinicians are specialised in sexual and reproductive health and menopause. We’re familiar with the challenges of both endometriosis and menopause, and we know how to come up with a treatment plan that works for you – and changes with you as your symptoms change.
