Perimenopause - Menopause - Endometriosis

Some lucky women breeze through Perimenopause and Menopause with very few symptoms, but for many women their fluctuating hormones create all sorts of symptoms. Perimenopause is the transitional phase leading up to menopause, which marks the end of your menstrual cycles. Menopause is diagnosed when you've gone 12 months without a menstrual period.

Perimenopause and menopause are a natural biological process all women go through. Unfortunately, the physical symptoms a lot of women go through, such as hot flushes, and the emotional symptoms of menopause may disrupt your sleep, lower your energy levels or affect your emotional health.

If you have endometriosis, your periods may be heavier and more frequent during perimenopause. Which means you may find your endometriosis symptoms flare up more frequently and may worsen during this time. There are many effective treatments available to help you manage perimenopause, ranging from lifestyle and dietary adjustments, supplements, or hormonal therapy. Many women find some relief using the Mirena IUD, or hormonal birth control pills.

The good news is that some women find relief from their endometriosis symptoms after menopause. However, not every woman finds themselves pain-free after menopause, there can still be problems with chronic pelvic pain and unfortunately endometriosis can still persist. Endometriosis has been found in about 2.2% of postmenopausal women (Zanello et al., 2019). Postmenopausal endometriosis should be managed surgically according to Streuli et al. (2017) and Zanello et al. (2019).

Some of the symptoms you might experience:

• Changes in periods, heavier or lighter bleeding

• Irregular periods, shorter or longer cycles

• Weight gain and slowed metabolism

• Bloating

• Vaginal dryness, pain during sex

• Loss of libido

• Hot flushes

• Chills

• Night sweats

• Overactive bladder

• Sleep problems, insomnia

• Brain fog, memory issues

• Lack of concentration

• Headaches, migraines

• Mood changes, depression

• Anxiety, panic attacks

• Heart palpitations, racing heart

• Joint pain

• Thinning hair and dry skin

• Loss of breast fullness, breast pain

Not everyone experiences all of these symptoms, as everyone is different. For most women symptoms will settle and calm down after a few years. If your symptoms are really bothering you and affecting your daily life, speak to your doctor about the best available course of action to follow. And always seek medical advice if you have bleeding from your vagina after menopause. Women who have had endometriosis and women with residual endometriosis after surgery, should discuss the use of HRT with their doctor, and discuss the risk of recurrence, before starting an estrogen-based hormonal replacement therapy after menopause.