Menopause may cause a slow shrinking of endometriosis growths and an end to symptoms of the condition. However, symptoms may continue for some people due to hormone therapy.

Menopause causes the body to stop producing as much estrogen. As endometriosis is an estrogen-dependent, chronic condition, symptoms typically disappear after a person goes through menopause.

However, for some people, symptoms may continue. This is often due to hormone therapy treatments.

This article reviews what happens to endometriosis during menopause, whether it can start postmenopause, and more.

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A person drinking a hot beverage in a kitchen. while most people stop experiencing endometriosis symptoms after menopause, some people will still get symptoms.Share on Pinterest
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The prevailing thought among experts is that going through menopause puts a gradual end to endometriosis. Endometriosis is an estrogen-dependent condition, and menopause causes a reduction in estrogen levels.

This means that for most people with endometriosis, their symptoms will improve when menopause occurs. However, people may experience additional, menopausal symptoms. They can include:

A 2020 study suggests that it is possible for some people to develop endometriosis following menopause. Experts think this is primarily caused by hormone replacement therapy (HRT), which some menopausal people undergo.

HRT contains estrogen, and estrogen is the main hormone that causes endometriosis growths to spread and grow. Therefore, HRT may cause a continuation of endometriosis symptoms in some people going through menopause.

The study reports only a small minority of endometriosis occurring spontaneously after menopause. They note that about 2–5% of incidents of endometriosis occur after menopause.

If endometriosis continues past menopause, often due to hormone replacement therapy, a person may experience non-specific symptoms that may include:

Even if a person’s endometriosis improves following menopause, they may still experience menopause symptoms. These can include:

  • hot flushes
  • mood swings
  • vaginal atrophy
  • night sweats

Diagnosing endometriosis can be difficult because there is no specific test to check for it. A healthcare professional will likely start with a thorough history and review of a person’s symptoms, as well as a physical exam.

Imaging tests such as ultrasound and MRI scans can diagnose endometriosis. However, normal imaging does not necessarily rule out the presence of endometriosis.

The most accurate way to diagnose endometriosis is to perform a laparoscopy, a type of surgery where a small camera is placed in the abdomen to look for endometriosis tissue.

Healthcare professionals may also want to perform a biopsy on the tissue due to the risk of cancer development.

Cancer and endometriosis share similar risk factors, such as:

According to a 2020 study, very little evidence and guidelines are available for treating and managing endometriosis during and after menopause. The study authors noted that combined estrogen and progesterone therapy may be a better option than estrogen alone.

However, they stated that the best method may be for healthcare professionals to be aware of and monitor for signs of worsening endometriosis symptoms.

They suggest that new cases of endometriosis growths following menopause should be surgically removed. They also state that about 12% will eventually require a hysterectomy to relieve symptoms.

Medical therapies, such as progesterone administration and aromatase inhibitors, may help. However, there is still limited evidence about their overall effectiveness and safety.

People with endometriosis may want to speak with a health professional about HRT before starting it. They may be able to answer questions about the risks and how it may affect their endometriosis.

If a person develops symptoms of endometriosis after menopause, they should speak with a healthcare professional. If a healthcare professional discovers a growth on the person’s ovaries or other areas, they will likely recommend a biopsy to help rule out cancer.

Some healthcare professionals may presume that endometriosis cannot occur past childbearing years and so may not think symptoms are related to the condition. A person may need to self-advocate if their symptoms persist or if they suspect endometriosis may be an underlying cause.

Here are some answers to frequently asked questions about endometriosis and menopause.

Does endometriosis get worse with menopause?

Typically, endometriosis symptoms gradually get better for people not receiving HRT. Those who do receive it may experience continuing or worsening symptoms.

Does endometriosis affect the age a person has menopause?

According to a 2022 study, a statistically significant portion of people with confirmed endometriosis underwent early menopause, defined as starting before the age of 45.

In other words, it may increase the likelihood that a person will go through early menopause.

Endometriosis often improves with menopause, however, undergoing hormone replacement therapy may cause worsening symptoms.

A person with endometriosis should be aware of possible menopause symptoms that may develop, such as mood swings and vaginal atrophy.

Endometriosis can worsen or start postmenopause. Most literature suggests it occurs in people undergoing hormone replacement therapy. If it does occur, little is standardized in terms of treatment. However, people will likely benefit from surgical removal of the growths.