Risks, treatment, complications and more

Endometriosis is a condition where tissue similar to the lining of your uterus builds up on organs outside of the uterus. This tissue responds to hormones just like the lining of your uterus. It builds up and breaks down every month, but it can’t pass out of your body through your vagina. As a result, it can cause a lot of pain, heavy bleeding, and fertility issues, among other symptoms.

It may seem logical that when your periods stop, the endometriosis stops too. It’s not always the case. In 2 to 5% of cases, endometriosis persists after menopause. It’s rare, but it happens.

If you have endometriosis after menopause, it’s important to consider your treatment options. Leaving it untreated carries certain health risks.

In this article, we look at the potential causes of endometriosis after menopause, along with the diagnosis, potential complications, and treatment options.

Endometriosis after menopause is more likely if you were diagnosed with the condition earlier in life. However, endometriosis can start after your period ends. In fact, it sometimes starts up to 10 years later.

Researchers think that the growth of these womb-like cells might be “activated” by something in your genetic makeup or something in your environment that affects your genes.

Often women find out they have endometriosis when they see a doctor because they have symptoms such as:

  • increased pelvic pain
  • pain when having a bowel movement
  • pain when urinating
  • constipation

During menopause, your body produces much less of the hormone estrogen. Most of the time, this means that the symptoms of endometriosis decrease. They may even disappear completely. This is because this type of tissue generally needs estrogen to grow. But for a small number of women, endometriosis persists after menopause. If you had severe endometriosis before your period stopped, you are more likely to have symptoms afterwards.

If you are taking hormone replacement therapy (HRT) to relieve menopausal symptoms or to reduce your risk of bone loss and heart disease, the hormones in HRT can ‘reactivate’ your endometriosis.

More research needs to be done to understand the risks for women with endometriosis who wish to use HRT during menopause. It is important to discuss possible risks and gains with a healthcare professional while you consider your options.

To find out if you have endometriosis, a healthcare professional can use several tools, including:

  • Pelvic exam. This exam allows your healthcare provider to feel for any growths or scar tissue that may have formed due to endometriosis.
  • Ultrasound. An abdominal ultrasound uses sound waves to create images of cysts that may have formed in your pelvis.
  • Computed tomography (CT). A CT scan uses rotating X-rays to detect changes in the shape of organs in your abdomen.
  • Magnetic Resonance Imaging (MRI). An MRI uses a magnetic field to create detailed images of all the places where endometrial tissue has implanted in your abdomen.
  • Laparoscopy. During this procedure, a surgeon makes a small incision near your belly button and inserts a small camera that shows where the endometrial tissue is in your abdomen.

Many health specialists say that the best option for endometriosis in menopause is to surgically remove areas of endometrial tissue (called “implants”). This way there is less chance of them becoming cancerous later on and less chance that they will go on to cause other health problems.

It is important to understand that surgery will not necessarily cure the disease. It is possible that it will happen again later.

If surgery is not a good option for you, your doctor may prescribe:

These treatments can relieve pain and help slow the growth of implants.

It is important to treat endometriosis that occurs after menopause. There are proof that the condition may continue to spread to other areas of the abdomen. In some cases, it can block the intestines or urinary tract.

Untreated endometriosis after menopause can also increase your risk of cancer.

To research shows that about 1-3% of people with the disease develop cancer in the areas where they have endometriosis. Your risk may be slightly higher if you use hormone replacement therapy (HRT).

Endometriosis does not necessarily end at menopause. In fact, the condition can develop years after your period ends.

Many symptoms are the same before and after menopause, including:

  • pain
  • inflammation
  • constipation
  • urinary problems

To confirm that symptoms are related to endometriosis, you may need to have a pelvic exam, imaging tests, or laparoscopy. Treatment may include surgical removal of affected areas, pain relief medication, or both.

Accurate diagnosis and treatment can ease your symptoms and reduce the risk of the disease spreading or becoming cancerous. If you have symptoms that could be endometriosis, talk to a healthcare professional as soon as possible.

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