Although endometriosis is generally associated with women of reproductive age, it can also persist after menopause or cause new symptoms. So how does endometriosis after menopause progress and what awaits women during this period?
Why Does Endometriosis Continue in the Menopause?
Menopause is the period in which the menstrual cycle ends as oestrogen levels fall. Because oestrogen plays a key role in the growth of endometriosis tissue, menopause can lead to the symptoms decreasing or disappearing completely. In some situations, however, endometriosis can continue after menopause:
Hormone replacement therapy (HRT): Oestrogen-containing treatments used to relieve menopausal symptoms can stimulate endometriosis tissue and cause the symptoms to reappear.
Continuing production of oestrogen in the body: Some sources, such as fat tissue, continue to produce small amounts of oestrogen despite menopause.
Persistence of scar tissue and adhesions: Scar tissue and adhesions formed before menopause can cause chronic pain independently of hormonal effects.
Symptoms of Endometriosis After Menopause
In the post-menopausal period the symptoms of endometriosis can differ:
Chronic pelvic pain: Even though hormonal activity decreases, old lesions can cause pain.
Bowel and bladder complaints: If endometriosis has affected organs such as the bowel or the bladder, these symptoms can continue in the menopause.
Pain during intercourse (dyspareunia): Pelvic adhesions combined with vaginal dryness can cause pain during sexual intercourse.
Bloating and digestive problems: If the digestive system is affected, these complaints can persist.
Treatment Options
The treatment of endometriosis after menopause varies according to the severity of the symptoms, the general health of the patient and her treatment preference:
Hormone replacement therapy (HRT): When planning HRT, the history of endometriosis should be taken into account and, where possible, progesterone-based treatments should be preferred.
Pain management: Non-steroidal anti-inflammatory drugs (NSAIDs) and painkillers can be used to relieve the pain.
Surgical intervention: In severe symptoms or complications, surgical removal of the scar tissue or lesions may be required.
Alternative treatments: Methods such as physiotherapy, yoga and acupuncture can be used to relieve the symptoms.
Lifestyle Advice
Lifestyle changes are also important for coping with endometriosis after menopause:
Balanced nutrition: Prefer anti-inflammatory foods (green leafy vegetables, omega-3 fatty acids).
Regular exercise: Gentle exercise both protects your general health and can reduce pelvic pain.
Stress management: You can keep stress under control with meditation and breathing exercises.
Although endometriosis after menopause is uncommon, it can cause symptoms that affect quality of life. During this period the symptoms can be managed with the right treatment plan and specialist support.
If you are experiencing pelvic pain or other symptoms of endometriosis after menopause, it is worth having a detailed discussion with a gynaecologist who has specialised in this field in order to assess the most suitable treatment options. A healthy lifestyle and regular medical check-ups will help you get through the post-menopausal period more comfortably.