Endometriosis During Perimenopause: What Changes?

Transcript:

Jamie Forward: Dr. Piasta, this person wants to know, how does perimenopause affect endometriosis state?

Dr. Jackie Piasta: Oh, well that’s a difficult question. So, we thought for many, many years that actually endometriosis goes away in menopause.

But again, our – maybe that’s going to be the theme of today, this evolving nature of understanding just … welcome to women’s health. But our understanding of endometriosis is rapidly changing. We thought for a while that it was always just retrograde endometrium where it was the lining of the uterus sort of implanting itself outside of the uterus. Well, now we have a differing understanding of what it is and the inflammatory component and the potential autoimmune component. So, the answer to that question is, we really don’t have a full understanding of the interplay between endometriosis and perimenopause and menopause.

We know that most likely, it does not go away with age and that symptoms can morph. They can turn more from pelvic pain and pain with intimacy to more of bowel symptoms and IBS-type symptoms. And so, I think, again, not to send people on this quest to find a needle in a haystack, but it’s really important that if you are somebody that has endometriosis, that you’re working very closely with an endometriosis specialist or at least somebody in menopause that has a very hefty gynecologic background and can really shepherd you though those choices.

Because it’s not – again, it’s one of those very yellow light areas. Endometriosis, like having a family history of breast cancer, is not a contraindication to utilizing hormone therapy, but there are more complex decisions that we have to make when somebody has that history and we need to make menopausal, particularly in this situation, hormone therapy discussions. So, again, this is an area that needs so much more funding and so much more studying.