Early menopause risk for endometriosis patients

GPs should monitor patients with endometriosis for the type and timing of menopause, as new research shows they face a higher risk of premature and early menopause, as well as a seven-fold risk of surgical menopause.
 
Published in Human Reproduction, the University of Queensland (UQ) study analysed data from nearly 280,000 women in Australia, the United Kingdom, Sweden and Japan between 1996 and 2022.
 
It explored the association between endometriosis and menopause type (surgical versus natural) as well as age at menopause.
 
Results showed women with endometriosis had a seven-fold increased risk of undergoing surgical menopause rather than natural menopause and were more likely to experience premature or early menopause, both surgically and naturally.
 
Lead author and UQ epidemiologist Dr Hsin-Fang Chung said while it is known that endometriosis and its treatment can reduce egg quality and quantity, research on its effect on the timing of menopause is limited.
 
‘We were able to quantify the timing of menopause: surgical menopause occurs, on average, 19 months earlier in women with endometriosis, while natural menopause happens five months earlier,’ she told newsGP.
 
‘Women with endometriosis are twice as likely to experience surgical menopause under the age of 40, or 1.4 times more likely to have natural menopause before 40.’
 
Dr Chung encouraged GPs to help endometriosis patients understand the enhanced risk and impact of early or premature menopause.
 
‘These new findings highlight the importance of GPs monitoring women with endometriosis for the timing and type of menopause, as they are at a higher risk of experiencing premature and early menopause, either naturally or due to surgery,’ she said.
 
‘It was already known that early and surgical menopause are associated with adverse health outcomes such as cardiovascular disease.  
 
‘We encourage GPs to raise awareness of this increased risk among women with endometriosis and to arrange regular check-ups to assess and manage long-term chronic disease risk factors associated with early or surgical menopause.’
 
Associate Professor Magdalena Simonis, a GP with a special interest in women’s health, said this study confirms that endometriosis is a disease that affects many aspects of a woman’s life and like any chronic disease, ‘we need to take a life course approach’.
 
‘When women are in pain and have heavy menstrual bleeding, with their daily life interrupted, it seems a long way off to think about menopause and perimenopause, but what we also need to consider is that identifying the disease, treating and managing this effectively will improve outcomes,’ she told newsGP.
 
‘Surgical menopause rates were higher which we should be able to prevent if diagnosis occurs earlier and progression of disease is arrested.’
 
The researchers said they hoped this study will inform updates to clinical guidelines, which primarily focus on pain, infertility, and surgical treatment following diagnosis.
 
Associate Professor Simonis added that the management guidelines for endometriosis are ‘living guidelines’ for this very reason.
 
‘We are only now making headways into women’s health and endometriosis, being so complex, is proving to be a lifelong project.’
 
The UQ research is part of InterLACE, an international collaboration examining women’s reproductive health and chronic disease across their lifetime.
 
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endometriosis menopause preventive health women’s health