Endometriosis in the perimenopause
Have you ever been told all your endometriosis symptoms will stop when you reach menopause?
I was and at the time I had another 20 or 30 years to go until menopause so it wasn’t much comfort! We also know that it’s not always as simple as that.
I’m now in the early phase of perimenopause and I’m noticing some shifts – not so much in my endometriosis, but in other new hormonal symptoms I’m getting.
If you have endometriosis, fibroids, adenomyosis or PCOS and find that your symptoms get worse in your 40s or 50s or that you start getting new symptoms – then it could be the perimenopause hormones that are to blame.
The best way of explaining the impact of perimenopause on these conditions is to look at the different phases of the perimenopause and what happens to the hormone levels. We often think of perimenopause as a stage that we all go through, but in fact it is three stages.
Initially our progesterone levels drop – this can cause symptoms like low mood, anxiety and lack of sleep. Automatically this pushes us into oestrogen dominance as there is less progesterone around to balance our oestrogen levels. Then our oestrogen levels start to go very high – this can cause periods to become more frequent, heavier or go on for longer. This is the high risk stage for anyone with a hormonal condition that is driven by oestrogen, such as endometriosis, adenomyosis or fibroids and the point at which you may notice that your symptoms feel worse.
Then we go into a stage of fluctuating oestrogen levels – first they go really high, then really low, then really high again. This is when you can really start to feel all over the place and go from short cycles to long cycles. You may find that as fast as you feel you have dealt with one symptom, another new one comes along. This stage is sometimes known as the second puberty as we have the same extreme hormone fluctuations as we did when we were teenagers. You may find lots of changes in conditions like endometriosis, fibroids and adenomyosis as they respond to the fluctuating hormones.
Finally, the hormone fluctuations start to calm down and we go into a phase of low oestrogen and progesterone. At this stage your periods may be less frequent, lighter and you may not have a period some months. Once you haven’t had a period for 12 months, you are then classed as having reached menopause.
For many people, reaching menopause does mean a reduction or end to their symptoms as there is a lot less oestrogen around to feed the condition.
However, low oestrogen does not mean no oestrogen! By the time we reach menopause, the ovaries will no longer be producing oestrogen, but there will be a small amount produced by the adrenal glands. We also make a small amount of oestrogen from fat cells. In some people, the endometriosis, adenomyosis or fibroids can still grow from this oestrogen supply. Therefore, if you are in your 50s and post-menopause but feeling like you are getting symptoms again, do get it checked out. Whilst it may not happen that often, it does not mean that these conditions do not still cause problems post menopause.
How to manage the risk
It is not just oestrogen levels that fuel conditions like endometriosis, fibroids and adenomyosis. Levels of inflammation in the body, gut health, the strength of our immune system, how well our liver works, and stress levels all play a part in the development of these conditions too. By working on these other factors too, we can reduce the risk that these conditions will continue to develop.
You may also find that whatever you did to manage your endometriosis, fibroids or adenomyosis in your 20s or 30s may no longer work in your 40s or 50s.
This has certainly been my own experience. I’d got my endometriosis well managed by my 30s and had stayed on the same diet, supplement and lifestyle plan for many years. Once I reached my mid 40s this wasn’t working as well for me, and I had to make changes. In fact, I keep having to make changes and adapting as my body throws out new symptoms. I have to be much more careful about my diet and lifestyle again, in the way that I was when I was first diagnosed with endo. But so far, I’m keeping on top of the symptoms. Fingers crossed it stays that way. As ever living with these conditions is not simple!
If you would like some help with managing your endo, adenomyosis or fibroids through the perimenopause, do get in touch or book in for a free hormone health review to find out how a nutritional therapy approach can help.
The information contained above is provided for information purposes only. The contents of this blog are not intended to amount to advice and you should not rely on any of the contents of this blog. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this blog. Emma Belton Nutrition disclaims all liability and responsibility arising from any reliance placed on any of the contents of this blog.