It is no secret that when you have endometriosis, you may have a hard time being received, diagnosed, and treated in the healthcare system. Most accounts by women who suffer from the debilitating pain that comes with endometriosis hold that it can be years before a proper diagnosis is given, mostly due to medical practitioners underestimating women’s pain and watering down their symptoms to just ‘a bad period’.
This, coupled with how endometriosis is underfunded and under-researched, usually leaves women doing their research as well as sharing their symptoms on online forums to aid their diagnosis.
What Is Endometriosis?
Endometriosis is an ‘invisible’ condition in which the same tissue, the endometrium, lining the womb can grow in other places, such as the fallopian tubes, the pelvic cavity, and the ovaries. This tissue is also found in different body organs, including the lungs, intestines, and the brain.
The debilitating pain is caused when the endometrium swells, breaks down, and sheds with each menstrual cycle, regardless of where it is in the body. When this happens outside of the uterus, it irritates the surrounding tissue, forming lesions that eventually lead to tissue scarring.
Many people hold the belief that endometriosis is a premenopausal issue. However, that belief is far from the truth. Up to 5% of women who suffer from endometriosis pre-menopause will continue to suffer from it post-menopause.
“The pain started about two years after my first period, I was 15 years old,” says Elaine, a grade 5 teacher in South Africa. “I was told that it was just bad period pain and that it was a normal consequence of becoming a woman. I have suffered with this for the majority of my adult life. What I did not expect was to continue suffering two years into menopause.”
Elaine describes her symptoms post-menopause as being the same as when she was pre-menopause. This includes being riddled with pain, nausea, bloating, and constipation, as well as having to explain how it’s possible to faint from endometriosis even after your period stops happening.
It should also be noted that postmenopausal women are more prone to disorders like fibromyalgia, asthma, and chronic fatigue syndrome, among others, due to their immune system weakening with aging.
Causes of Endometriosis
The exact causes of endometriosis are unknown. When you are premenopausal, some of the possible explanations for it include the immune system being unable to recognize endometrium cells outside of the uterus and thus being unable to destroy them. Retrograde menstruation is when menstrual blood containing endometrium cells flows through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrium cells then stick to the surfaces of pelvic organs and start to grow, break down, and shed just as they would in the uterus.
When you are postmenopausal, these causes may continue to be present in the body due to elevated levels of estrogen or exposure to the hormone. Taking plant-based estrogen, as well as having hormone replacement therapy to aid with menopause symptoms, may contribute to the high levels of estrogen in the body even when menopause has already set in.
Treatments For Postmenopausal Endometriosis
Looking at one’s diet for treatment is always a good place to start. Studies have shown that increasing an intake of fresh fruits, green vegetables, and balanced dietary fiber decreases the risk and symptoms of endometriosis while maintaining a good balance of gut bacteria. So, a diet that includes broccoli, lentils, black beans, quinoa, raspberries, and more will achieve this.
A much more invasive treatment involves getting a hysterectomy, which is the removal of the fallopian tubes, ovaries, and the uterus in rare cases. Getting a hysterectomy will mean having to take estrogen and progesterone at the lowest doses possible to not increase estrogen levels in the body, which could again lead to a relapse. This is because, in rare cases, endometriosis has been confirmed to come back even after a successful hysterectomy.
Having said the above, it is always best to consult with your general practitioner for the safest options to manage endometriosis post-menopause. At the same time, more can indeed be done for people who have endometriosis; a lot more needs to be done for those who suffer from endometriosis post-menopause. In the meantime, continue to advocate for your health and have loved ones who can advocate strongly for your health when you cannot.
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