A Systematic Review Of Clinically Progressive Postmenopausal Endometriosis Without Estrogen Intake Or Increased Production
Women with progressive and symptomatic endometriosis after menopause and women operated after menopause in whom endometriosis was found . The frequency distribution of the years after menopause and/or the age of the women is indicated
Figure illustrates that a majority of women were over 60years old and more than 10years after menopause.
The treatment of symptomatic postmenopausal endometriosis seems to be surgical excision. If this cannot be performed, a treatment with aromatase inhibitors was suggested .
Symptoms Of Endometriosis Recurrence
Accurate diagnosis of recurrence is difficult and only confirmed by second look laparoscopy, which poses particular risk to patients with prior surgery. Diagnosis of recurrence on the basis of symptoms or diagnostic imaging can be challenging. Pelvic pain and dyspareunia are the most common presenting symptoms of recurrent endometriosis after hysterectomy, although vaginal and rectal bleeding as well as low back and rectal pain may also occur . Painful defecation and severe dyspareunia may indicate deeply infiltrating lesions . For these patients, it can be difficult to identify the exact cause of pain, because the differential diagnosis is broad, including ovarian remnant syndrome, post-surgical adhesions, and recurrent endometriosis .
What Other Health Conditions Are Linked To Endometriosis
Research shows a link between endometriosis and other health problems in women and their families. Some of these include:
- Allergies, asthma, and chemical sensitivities
- Autoimmune diseases, in which the body’s system that fights illness attacks itself instead. These can include , , and some types of .
- Certain cancers, such as and breast cancer
Don’t Miss: Dizziness During Menopause
What Treatments Are Available
If you havent completely gone through menopause and your cramps indicate that your periods are tapering off, you can treat them as you would period cramps. Your doctor might recommend an over-the-counter pain reliever such as ibuprofen or acetaminophen .
Warmth can also help soothe your discomfort. Try putting a heating pad or hot water bottle on your abdomen. You can also try exercise if you are not in too much pain. Walking and other physical activities help relieve discomfort as well as ease stress, which tends to make cramps worse.
When your cramps are caused by endometriosis or uterine fibroids, your doctor might recommend a medicine to relieve symptoms. Surgery can also be an option to remove the fibroid or endometrial tissue thats causing you pain.
How cancer is treated depends on its location and stage. Doctors often use surgery to remove the tumor and chemotherapy or radiation to kill cancer cells. Sometimes, doctors also use hormone medicines to slow the growth of cancer cells.
Is Endometriosis Or A Form Of Cancer Can Endometriosis Turn Into Cancer
Endometriosis is not contagious or an infection it cannot be passed from person to person through contact. Endometriosis is NOT a form of cancer, however, every single benign tissue in our bodies has the potential to turn into cancer therefore it could be argued that deposits of endometriosis could turn into cancer. This would be an extremely rare event.
You May Like: Can You Go Into Early Menopause After Tubal Ligation
Severe Consequences For Ignoring Endometriosis
A new surgeon and another operation discovered extensive diffuse adenomyosisthe rogue endometrial cells had buried themselves deep into the uterus muscle wall.
Such adenomyosis is only treatable with a hysterectomy, but I was only 26, far too young.
In addition to severe pain, adenomyosis causes infertility, high rates of miscarriage and birth defects due to the damaged muscle and an impaired blood supply.Had doctors discovered and removed the endometriosis before it got so extreme, the adenomyosis would not have developed.
I had to cope with chronic, severe pain and undergo two more endometriosis-removal operations before I was allowed to have a hysterectomy at age 38. They still wouldn’t take my ovaries out, because I am too young.
I am now unable to have children, because my period pain was ignored by doctors.
Other Treatments For Postmenopausal Endometriosis
Other treatments for endometriosis after menopause will largely depend upon how severe signs and symptoms are.
Other than HRT or hysterectomy, whose proven risks were discussed earlier, postmenopausal women may be prescribed over-the-counter pain relievers for the discomfort or aromatase inhibitors to reduce the amount of estrogen in the body.
For those who wish to preserve their uterus and ovaries, conservative surgery may be undergone, during which a doctor may perform a laparoscopic or abdominal procedure to remove endometriosis lesions. Even so, endometrial pain after menopause post-op may return.
Nevertheless, always consult a doctor before starting any treatment regimen, natural or clinical, to ensure its safety.
You May Like: Is Dizziness A Symptom Of Menopause
Endometriotic Lesions Detected At The Time Of The Second Look Surgery
Endometriotic lesions are likely responsible for the majority of recurrent symptoms, in cases where the uterus and ovaries are removed, but deep endometriotic lesions are left behind. This was the standard of practice for many years, as it was noted early that endometriosis would atrophy in the absence of estrogenic stimulation . However, it has never been definitively shown that endometriosis completely regresses in the presence of menopausal levels of estrogen, whether surgically induced or physiologic . Moreover, in the current era of HRT, it has become increasingly important to make an effort to remove all deep lesions as they carry a risk for symptomatic recurrence and rarely malignant transformation. The most recent guidelines on the management of endometriosis reflect this change in thought .
A major challenge may lie in the visual diagnosis of endometriosis. It has been estimated that two-thirds of patients have some visual disease that many clinicians have not been trained to recognize, and this may be the only manifestation of disease . Some lesions may appear atypically or non-pigmented . Deep endometriotic lesions located in the subperitoneal space may go completely unrecognized or be particularly difficult to visualize during laparoscopy or to access during surgery. Additionally, lesions can be hidden by peritoneal adhesions of the pouch of Douglas .
Start Here What Is Endometriosis
Tissue called endometrium lines the inside of the uterus. When that type of tissue is present outside the uterus, the condition is called endometriosis. When a woman has endometriosis, that tissue responds to monthly hormonal changes in the body the same as the tissue inside the uterus. The inflamation, swelling, and scarring associated with this can cause women to have unbearable pain during menses. It’s estimated that up to 10% of women between 25 and 40 suffer from endometriosis.
Which Is The Right Treatment For Me
The right treatment is the one that works for you and helps you. Everyone is different and will respond differently to each treatment. Peoples view on surgery and side effects of medication vary, and these will need to be taken into account as well. You may have to try several types of treatment to find one that you are comfortable with. Alternatively, you may decide to not treat the endometriosis.
What Are The Symptoms Of Endometriosis
Symptoms of endometriosis can include:
- Pain. This is the most common symptom. Women with endometriosis may have many different kinds of pain. These include:
- Very painful menstrual cramps. The pain may get worse over time.
- Chronic pain in the lower back and pelvis
- Pain during or after sex. This is usually described as a “deep” pain and is different from pain felt at the entrance to the vagina when penetration begins.
- Intestinal pain
- Painful bowel movements or pain when urinating during menstrual periods. In rare cases, you may also find blood in your stool or urine.
Recommended Reading: Dr Yael Swica
Endometriosis In The Teenage Years
Although most women are not diagnosed until adulthood, it has been estimated that nearly 70% of all women with endometriosis started experiencing symptoms before 20 years old, and that the condition can be diagnosed in teenagers and very rarely in children.3,4 One challenge of diagnosing young women with endometriosis is the potential lack of menstrual pain comparison. For example, a young woman with severe pelvic pain during her period may think that this pain is normal, especially if she hasn’t experienced many periods before or hasn’t disclosed this information to others who may tell her otherwise.
Teenagers who have an immediate family member who also has endometriosis, or who got their first period at a young age are typically at a higher risk for developing the condition. Diagnosis of endometriosis in teenagers is the same as in adults and is done via laparoscopic surgery. However, a unique aspect of teenage endometriosis-related care is that there are obstetric and gynecologic physicians who specialize in the care of adolescents. These physicians may be more aware of the needs of this population, especially for young girls who have never seen a women’s health provider in the past.5
Does Endometriosis Go Away After Menopause
While it is true that premenopausal endometriosis symptoms usually subside once a woman enters postmenopause, this is not always the case.
In other words, you can have endometriosis after menopause even after the cessation of ovarian reproductive functions and the menstrual cycle.
Also, aging women should be aware that these symptoms can mirror those of other underlying health conditions common during postmenopause, such as ovarian cancer.
Read Also: Best Antidepressant For Menopause
Endometriosis And Oestrogen Dependence
Endometriosis is a disease that affects an estimated 610% of reproductive aged women, totalling approximately 176 million women worldwide . It is defined as the presence of endometrial-like tissue in extrauterine locations and is a chronic condition associated with debilitating pelvic pain, dyspareunia, dysuria, dysmenorrhoea and infertility. However, due to a lack of reliable diagnostic tools and the non-specific nature of the symptoms, there exists a widely recognized delay in diagnosis of 810 years . Consequently, the economic impact is substantial, as chronic and debilitating pain from endometriosis may hinder work productivity, while infertility can cause major psychosocial and financial strain to affected women and their partners .
Sex Is Painful Is It Making The Endometriosis Worse
Pain during or after intercourse is one of the symptoms of endometriosis. Having sex shouldnt make the condition worse but it could temporarily increase your pain. By talking with your doctor, you can both agree to explore courses of treatment which may help to alleviate this symptom. Being open and honest with your partner and communicating how you both feel, both physically and emotionally should help you both to understand what is happening. Please visit www.endometriosis.org for a useful article on painful sex and how to tackle some of the issues regarding painful intercourse.
Don’t Miss: Heightened Sense Of Smell Perimenopause
Natural Treatment For Postmenopausal Endometriosis
Women looking to naturally treat their endometriosis after menopause should first turn to their nutrition.
Diet has proven to have a significant influence on the risk of pelvic endometriosis. Studies have shown that increased consumption of green vegetables and fresh fruits decreases the risk of endometriosis, while beef and other red meats increase the risk.5
Moreover, dietary fiber and whole grain intake promotes a healthy balance of gut bacteria, which is necessary to properly regulate circulating estrogens and reduce inflammation. Find them in raspberries, pears, green peas, broccoli, lentils, black beans, barley, quinoa, and more.
However, while natural treatments for postmenopausal endometriosis do include dietary changes as an instrumental step toward relief, other alternative options should not be forgotten, like melatonin supplements, which are scientifically proven to reduce endometriosis-related pelvic pain.6
The Benefits And Dangers Of Lupron
Lupron reduces the amount of estrogen a persons body produces, which can both help manage endometriosis symptoms and have negative effects. Decreased estrogen production can cause headaches, mood swings, hot flashes, and infertility.
Oftentimes, warning labels or doctors list these side effects individually, but rarely do they use the word menopause. But menopause is the reality of Lupron for many patients. This process is permanent. Once someone reaches menopause, the changes to their body cannot be undone. These massive changes to a persons physiology can trigger mental and emotional distress that may manifest in mood disorders and even, in some cases, suicidal tendencies.
Whether or not a person has endometriosis or has taken Lupron, common symptoms of earlier-than-average menopause include increased stress, anxiety, and depression. These conditions often result from infertility and other early menopause health issues. In other words, the changes patients face when their bodies undergo this process earlier than expected take a toll on their mental health, that may be unrelated to the physiological hormone changes taking place.
What Does The Uterus Do
The uterus is part of the female reproductive system. Its where a baby grows and develops during pregnancy.
The top part of the uterus is called the body or corpus. At the end of the uterus is the cervix, which connects the uterus to the vagina. Uterine cancer refers to cancer in the body of the uterus. Cancer in the cervix cervical cancer is a separate type of cancer.
What To Do If You Are Concerned
If you are worried about any aspect of endometriosis or are worried that endometriosis may affect a part of your body or your future health, talk to your doctor.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at May 2019.
Don’t Miss: Early Menopause After Tubal Ligation
What Are The Signs And Symptoms Of Endometriosis
The main symptom of endometriosis is pelvic pain. Pain is typically worst before or during menses and may be associated with sex, bowel movements, or urination. Endometriosis may also eventually lead to constant, chronic pelvic pain. In fact, endometriosis is found in about three quarters of women with chronic pelvic pain.
The amount of pain someone has is not always associated with how severe the endometriosis is. Some women with slight pain may have significant endometriosis, and others with a lot of pain may have just a mild. In fact, in some cases endometriosis is found in women with no symptoms at all.
In addition to causing pelvic pain, endometriosis can affect fertility. Extensive endometriosis can cause scarring and blocking of the fallopian tubes. Even mild cases can reduce the chance of getting pregnant from the normal 25% per month to around 7% per month, on average. Endometriosis is found in about one third of infertile women.
Managing Fibroids And Endometriosis After Menopause
Contributed by Dr. Paul J. MacKoul, MD- Red Hot Mamas Medical Expert What Happens to Hormones and How to Tell If Something Is WrongThe Complexity of Endometriosis ResectionRemoval of Fibroids or Hysterectomy?Am I a Candidate for Minimally Invasive Surgery, and How Do I Choose a Surgeon?
You May Like: Is Lightheadedness A Symptom Of Menopause
How Menopause Can Improve The Symptoms Of Endometriosis
Many women experience a reduction in the pain of endometriosis once they have gone through menopause-while menopause does not “cure” endometriosis per se, it seems to put it to sleep for the majority of women. The reduction in estrogen seems to tame the worst of the symptoms related to endometriosis in most-but not all-women.
How Can I Take Care Of Myself After Uterine Cancer Treatment
After you finish treatment, your care team will talk to you about your follow-up visits. Its important to go to these appointments. During a follow-up visit, your provider will do a pelvic exam. Theyll also ask you about any symptoms. The goal is to make sure cancer isnt coming back and that youre feeling OK after treatment.
You can also talk to your provider about ways to live a healthier life after cancer. Eating well, getting enough sleep and exercising can help you feel your best.
A note from Cleveland Clinic
Uterine cancer includes endometrial cancer and uterine sarcoma. The disease is the most common cancer affecting a womans reproductive system. It usually happens after menopause. But it can affect younger women, too. Uterine cancer symptoms include vaginal bleeding between periods or after menopause. If healthcare providers catch uterine cancer before it spreads, surgery can cure it. If you experience any signs of uterine cancer, contact your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 01/20/2021.
Also Check: Is Dizziness A Symptom Of Menopause
Can Endometriosis Uk Recommend A Specialist Surgeon Or Treatment Centre
We are unable to recommend specific specialists, surgeons or treatment centres for legal reasons. Additionally, we are also aware that one person’s experience and needs of a consultant can hugely differ from another. We recommend seeking out institutions that have been peer-reviewed by other medical professionals and deemed centres of excellence. We feel that a good place to start looking for this information is through the British Society for Gynaecological Endoscopy website. The BSGE accredited specialist endometriosis centres have consultants who are specialists in the field of endometriosis. The centres are reviewed annually.
Endometriosis After Menopause And Hysterectomy
Hysterectomy with or without the removal of the ovaries and the fallopian tubes is often recommended as the solution for postmenopausal endometriosis.
This is commonly followed by combined HRT of estrogen and progesterone at the lowest dose possible to decrease the risk of malignant transformation of the lesions.
However, endometriosis after hysterectomy can recur, especially if surgical removal of all endometriotic lesions is not thorough. Surprisingly, it has been found that those who keep their ovaries or start HRT after a removal of the ovaries are at a higher risk for relapse the exact reasons why are unknown.4
Don’t Miss: Is Dizziness A Symptom Of Menopause