Endometriosis is a condition where tissue similar to the lining of the uterus grows outside of the uterus, causing pain, irregular bleeding, and sometimes infertility. Hormone replacement therapy (HRT) involves taking estrogen, progesterone, or both to treat menopausal symptoms. There is conflicting evidence on whether HRT worsens endometriosis symptoms.
- Some studies have found that HRT, especially estrogen-only therapy, may stimulate the growth of endometriosis tissue and cause symptoms to flare up. The added estrogen provides a growth stimulus to any residual endometriosis implants or tissue.
- However, other research suggests that the estrogen and progesterone delivered through HRT can provide stability and even relieve endometriosis symptoms caused by fluctuating hormones during perimenopause and menopause.
Things that may impact whether HRT worsens endometriosis include:
- Type of HRT: Estrogen-only therapy poses more risk for worsening endometriosis than combination estrogen-progesterone therapy. The progesterone helps counteract the estrogen growth stimulation.
- Route of HRT: Transdermal/skin patch estrogen delivery may be less likely to exacerbate endometriosis than oral estrogen.
- Dosage: Lower estrogen doses could potentially minimize growth stimulation effects.
- Existing severity: Those with more extensive or advanced endometriosis may be more prone to worsening on HRT.
If considering HRT for menopause symptoms, patients with a history of endometriosis should have an open discussion with their healthcare provider about the potential risks and benefits. Key discussion points include:
- Carefully weighing if HRT is needed for symptom relief
- Considering alternative, non-hormonal symptom relief options first
- If used, choosing the lowest effective HRT dosages
- Monitoring closely for any worsening in symptoms
- Individualizing therapy based on the patient's unique medical history
At Optimal Hormone Solutions(), we specialize in personalized and precision hormone replacement therapy for women going through perimenopause, menopause, and beyond. Our clinicians help identify the most appropriate
hormone therapy based on your symptoms, health status, risk factors, and preferences. We offer both traditional and compounded bioidentical hormone options to help you achieve better hormonal balance and relief from symptoms. Contact us today to learn more or schedule a consultation to discuss your hormone therapy options.
The decision about using HRT with endometriosis should be an informed, shared discussion between a woman and her healthcare provider, weighing her individual risks and benefits. While some worsening is possible, low-dose HRT may be tolerated by some women with endometriosis and provide needed relief from disruptive menopausal symptoms. Each woman's situation is unique - customizing therapy and monitoring for changes is key.
