The Link Between Endometriosis and Early Perimenopause

For years, endometriosis has been recognized as a painful and often misunderstood condition, affecting millions of women worldwide. But emerging research suggests that endometriosis may also be linked to early perimenopause, the transitional phase before menopause that typically begins in a woman’s 40s. Women with endometriosis often experience hormone fluctuations differently, leading to an increased risk of entering perimenopause earlier than average (National Institutes of Health, 2023).

As if endometriosis wasn't bad enough already...

How Endometriosis Affects Hormonal Balance

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, leading to inflammation, pain, and hormone imbalances. The condition is estrogen-dependent, meaning that higher estrogen levels can fuel endometrial growth, worsening symptoms. However, certain factors associated with endometriosis may also contribute to an earlier decline in ovarian function, leading to perimenopause at a younger age.

The Science Behind Early Perimenopause and Endometriosis

1. Surgical Treatments May Reduce Ovarian Reserve

   • Many women with endometriosis undergo ovarian surgery to remove cysts or lesions. While this can relieve symptoms, research shows that surgical removal of ovarian tissue can accelerate the decline of ovarian function, leading to earlier perimenopause (Fertility and Sterility, 2022).

2. Chronic Inflammation and Hormonal Disruptions

   • Endometriosis is linked to higher levels of inflammation, which can impact ovarian function. Chronic inflammation may contribute to a faster depletion of eggs, leading to early hormonal shifts associated with perimenopause (Journal of Endometriosis and Pelvic Pain Disorders, 2023).

3. Hormonal Suppression Therapy and Perimenopause-like Symptoms

   • Many women with endometriosis use hormone therapy, such as birth control pills or GnRH agonists, to suppress estrogen and control symptoms. Some of these treatments induce a temporary menopausal state, and long-term use may impact natural hormone production, triggering perimenopausal symptoms earlier than expected (Mayo Clinic, 2023).

   
   

Recognizing Early Perimenopause in Women with Endometriosis

Women with endometriosis who experience perimenopause earlier than average may notice symptoms such as:

• Irregular or shorter menstrual cycles

• Increased severity of hot flashes and night sweats

• Mood swings, anxiety, or depression

• Increased pelvic pain due to hormonal fluctuations

• Brain fog, memory lapses, or difficulty concentrating

Because these symptoms often overlap with endometriosis-related issues, early perimenopause can go undiagnosed. Many women assume their symptoms are just worsening endometriosis, when in reality, they could be entering a new hormonal phase.

Managing Early Perimenopause with Endometriosis

1. Track Symptoms and Hormone Levels

• Keeping a symptom journal and testing hormone levels (such as FSH and estrogen) can help determine if perimenopause has begun.

2. Optimize Hormone Therapy

• Some women may need adjusted hormone therapy to manage both endometriosis symptoms and perimenopausal changes. Low-dose HRT or progestin-based treatments may help regulate hormones without worsening endometriosis.

3. Focus on Anti-Inflammatory Nutrition

• Eating an anti-inflammatory diet rich in omega-3s, fiber, and antioxidants can help regulate hormones and reduce inflammation.

4. Prioritize Bone and Heart Health

• Early menopause increases the risk of osteoporosis and heart disease, so ensuring adequate calcium, vitamin D, and regular exercise is crucial.

5. Seek Specialized Care

• Women with both endometriosis and early perimenopause should work with a healthcare provider who understands both conditions to create a personalized treatment plan.

Breaking the Silence on Endometriosis and Perimenopause

Women with endometriosis already navigate a complex health journey, and the possibility of early perimenopause adds another layer to consider. Raising awareness about this connection can help women seek earlier diagnosis, better symptom management, and improved long-term health outcomes.

If you’re navigating endometriosis and experiencing new symptoms, Lyv Health is here to support you. Join our waitlist for science-backed insights, expert guidance, and a community that understands. Sign up for early access at lyvhealth.co