Menopause Health & Wellness
Managing Endometriosis in Menopause
Navigating Menopause with a History of Endometriosis
If you have lived with endometriosis, you have already navigated a complex and often painful health journey. For years, you have managed cyclical pain, inflammation, and the myriad of other challenges this condition brings. As you approach perimenopause and menopause, it’s natural to have a mix of hope and apprehension. You might be wondering: Will the pain finally stop? What will happen to my symptoms? And crucially, how will menopause and its treatments affect my endometriosis?
At MyMenopauseSupport.org, Dr. Sonia Dudeja has extensive experience in managing the unique intersection of endometriosis and the menopausal transition. We understand that your health history requires a nuanced and specialised approach. Our goal is to provide you with a safe and effective strategy to manage your menopausal symptoms while ensuring your long-term endometriosis care is prioritized.
The Science
How Menopause Affects Endometriosis
Endometriosis is an estrogen-dependent condition, meaning the endometrial-like tissue that grows outside the uterus is stimulated by estrogen. In theory, the natural decline of estrogen during menopause should lead to the inactivation of these implants and a reduction in pain.
Potential for Symptom Relief
For many women, menopause does bring a significant and welcome relief from the cyclical pain, heavy bleeding, and inflammation associated with endometriosis as periods cease and estrogen levels fall
The Persistence of Symptoms
However, this is not always the case. Some women continue to experience pain, which can be due to scar tissue (adhesions) from previous surgeries or inflammation from still-active endometrial implants. Furthermore, the body continues to produce small amounts of estrogen from other tissues, which can sometimes be enough to stimulate stubborn implants.
The HRT Consideration
This is the most critical factor for women with endometriosis. While Hormone Replacement Therapy (HRT) is the most effective treatment for menopausal symptoms like hot flushes and bone loss, unopposed estrogen can potentially reactivate any remaining endometrial tissue, leading to a recurrence of pain or, in very rare cases, malignant changes.
Your Path Forward
A Specialized & Cautious Approach
Managing menopause with a history of endometriosis requires a careful, collaborative, and expert-led strategy. Dr. Sonia Dudeja’s approach is designed to provide you with the benefits of menopausal treatment while minimizing any risks associated with your endometriosis.
Comprehensive Medical Consultation
- Your care begins with a thorough review of your endometriosis history, including past surgeries, treatments, and the severity of your symptoms. This allows us to create a highly personalized and safe management plan.
Evidence-Based Medical Treatments
- Combined Therapy is Key: If HRT is appropriate for you, the gold standard is to use a continuous combined preparation, which provides both estrogen (to manage your menopausal symptoms) and a progestin (to protect and suppress any remaining endometrial tissue).[5] Unopposed estrogen is generally avoided.
- Body-Identical Hormones: We often recommend body-identical hormones, such as transdermal estrogen (patches or gels) combined with micronized progesterone, which may offer a favorable risk profile.
Integrated Wellness & Lifestyle Support
- Anti-Inflammatory Nutrition: An anti-inflammatory diet, which can be beneficial for both endometriosis and general menopausal health, is a cornerstone of our holistic approach. We provide guidance on foods that can help manage inflammation naturally.
- Pain Management & Pelvic Health: We can connect you with resources for ongoing pain management, including pelvic floor physiotherapy, which can be very helpful for addressing pain caused by adhesions and scar tissue.
