Women with endometriosis more likely to experience early menopause, study finds
- The GCC Menopause Hub
- Jun 20
- 3 min read
Understanding the Hormonal Link
Endometriosis is a condition that affects around 1 in 10 women. Despite being the second most common gynaecological condition (after fibroids), it’s still underdiagnosed and often misunderstood. It can impact many areas of life, from your menstrual cycle to fertility, energy, mood, and even how you feel during menopause.
What Is Endometriosis?
Endometriosis happens when tissue similar to the lining of the womb grows in other parts of the body, such as the ovaries, fallopian tubes, bladder, or bowel. This tissue behaves like it would during a menstrual cycle, breaking down and bleeding — but unlike the womb lining, it has nowhere to go. This can cause pain, inflammation, scarring, and other symptoms such as:
Painful or heavy periods
Pelvic or abdominal pain
Pain during sex or bowel movements
Fatigue
Fertility issues
Some women may also have adenomyosis, where the same type of tissue grows into the muscular wall of the womb — often causing even heavier bleeding.
How Hormones Affect Endometriosis
Hormones — especially oestrogen, play a big role in endometriosis. Oestrogen can stimulate this tissue to grow and worsen symptoms. That’s why many treatments aim to reduce oestrogen levels or block its effects. However, finding the right balance is key, especially when moving into perimenopause or menopause.
When oestrogen starts to decline naturally during menopause, some women may notice an improvement in endometriosis symptoms. But others may continue to experience pain or flare-ups, particularly if they use certain types of hormone replacement therapy (HRT), or if any endometriosis tissue remains after surgery.
Endometriosis and Menopause: What You Should Know
Some women experience natural menopause, while others go through surgical menopause, often after a hysterectomy or removal of ovaries, which is sometimes recommended for severe endometriosis. Surgical menopause causes hormone levels to drop suddenly, which can lead to intense symptoms like hot flashes, mood swings, low libido, brain fog, and joint pain.
To manage these symptoms and protect long-term health (especially bone, brain, and heart health), HRT is often recommended, particularly for women who go into menopause before age 45.
But if you’ve had endometriosis, it’s important to work with a specialist who understands how to:
Prescribe body-identical hormones (like oestradiol and micronised progesterone)
Monitor for any recurrence of endometriosis symptoms
Adjust hormone doses to reduce inflammation and manage pain
Can I Take HRT or Testosterone If I Have Endometriosis?
Yes, and in many cases, it’s beneficial. However, the type and dose of hormone therapy matters. Synthetic oestrogens (like those in some contraceptives or older forms of HRT) may flare symptoms in some women. On the other hand, bioidentical hormones — those that closely mimic your body’s natural ones — tend to be better tolerated.
Testosterone and progesterone can help reduce inflammation, improve energy, lift mood, and support libido. Some women find it helpful to start with progesterone and testosterone before adding oestrogen.
A good hormone support plan may include:
Oestradiol via patch, gel, or spray
Micronised progesterone (oral capsule or pessary)
Testosterone cream or gel
Holistic Support for Endometriosis in Midlife
In addition to medical treatment, lifestyle strategies can also make a big difference:
Anti-inflammatory diet: Focus on whole foods, omega-3s, and reduce sugar and processed foods
Movement: Gentle exercise like walking, Pilates, and yoga can help relieve pain and improve circulation
Gut health: Supporting digestion can help hormone balance and reduce inflammation
Stress management: Mind-body practices like meditation and breathwork support hormone health and pain control
In Summary
Managing endometriosis during menopause is absolutely possible, but it requires an individualised approach. Work with a specialist who understands both conditions and will help tailor hormone therapy to your needs. With the right treatment and lifestyle changes, you can reduce pain, restore energy, and feel more in control of your health.
Have you experienced endometriosis symptoms during perimenopause or post-menopause? We would love to hear from you.
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