Endometriosis Doesn’t Always End With Menopause: What Every Woman Over 50 Should Know
By Dr Jennifer Singh, a specialist in integrative women’s health and bioidentical hormone balancing for the Marion Gluck Clinic
For decades, endometriosis has been viewed as a condition that affects younger women with painful periods. It’s often portrayed as something that only matters during the reproductive years, with many assuming that menopause naturally brings relief. The reality is far more complex.
Endometriosis affects around one in ten women, yet it still takes an average of 9 years and 4 months to diagnose[1]. During that time, many women are told their pain is normal, dismissed as having irritable bowel syndrome (IBS), or left believing they simply have to tolerate symptoms that significantly impact their quality of life.
For women in their 50s and beyond, understanding endometriosis remains just as important. While symptoms may improve after menopause for some, others continue to experience pain and inflammation long after their periods have stopped. In some cases, women reach midlife without ever having received a diagnosis, despite living with symptoms for decades.
One of the biggest misconceptions is that endometriosis is simply “bad period pain.” Endometriosis is a whole-body inflammatory disease, while severe period pain is one of the most recognised symptoms, it can affect multiple organs throughout the body, which is why women often experience such a wide range of symptoms.
More than just pelvic pain
Not all period pain is a cause for concern. Mild cramping in the lower abdomen or back that occurs just before or during menstruation and responds to simple pain relief is generally considered normal. Endometriosis, however, is different.
The pain is often described as severe, burning or throbbing, lasting for several days and sometimes radiating into the legs. It may not improve with over-the-counter painkillers and can interfere with work, relationships and everyday life.
Pain may also occur during ovulation, between periods or during sexual intercourse.
Because endometriosis tissue can grow outside the uterus and affect surrounding organs, symptoms frequently extend well beyond the reproductive system. Women may experience bloating, constipation, diarrhoea and abdominal discomfort that closely resembles IBS. Others develop bladder symptoms, including urgency, frequent urination or pain when passing urine.
Fatigue, headaches, irregular bleeding and fertility difficulties are also commonly associated with the condition.
Why diagnosis still takes so long
Despite increasing awareness, endometriosis remains one of the most underdiagnosed conditions affecting women.
A major reason is that generations of women have been taught to minimise their symptoms. Many grow up believing that debilitating period pain is simply part of being female, while others feel uncomfortable discussing menstrual health altogether.
There is still a tendency to normalise women’s pain, as many women equate pushing through pain with being resilient, when in reality it can delay them from receiving the care they need.
Diagnosis itself also presents challenges. Currently, the gold standard for diagnosing endometriosis is laparoscopic surgery, as pelvic ultrasound scans often cannot detect the characteristic endometriosis lesions. Combined with lengthy NHS waiting lists, this can add years to an already delayed diagnosis.
Emerging research into blood and saliva biomarkers offers hope for less invasive testing in the future, but these methods are not yet widely available.
For women who suspect they may have endometriosis, keeping a detailed diary of symptoms can be invaluable. Recording pain levels, digestive issues, bladder symptoms and how they affect daily life provides objective information that can help guide conversations with healthcare professionals.
Menopause isn’t always the end of the story
Many women assume that menopause marks the end of endometriosis because oestrogen levels naturally decline.
While reduced oestrogen may lessen symptoms for some, it doesn’t guarantee the condition disappears. Existing endometriosis lesions can continue to cause inflammation, scar tissue and chronic pain even after periods have stopped.
This means women experiencing ongoing pelvic pain, digestive problems or bladder symptoms in midlife should not automatically assume these issues are simply part of ageing or menopause itself.
Supporting the body beyond medication
Although medical treatment remains an important part of managing endometriosis, lifestyle measures can also play a valuable role in reducing inflammation and improving overall wellbeing. Because endometriosis is influenced by both hormonal balance and immune function, adopting an anti-inflammatory approach wherever possible is recommended.
Eating a diet rich in healthy fats, including oily fish, olive oil, avocados and nuts, can help support hormone health, while plenty of fibre assists the body’s natural processing of oestrogen. Magnesium-rich foods may also help regulate inflammatory responses.
Some women find reducing dairy and gluten improves symptoms, while limiting alcohol and caffeine and staying well hydrated may further support hormone metabolism.
Stress management is another often overlooked factor. Chronic stress can amplify inflammation and disrupt immune function, making symptoms harder to control.
Finding small moments of joy every day can also have a meaningful impact. Whether that’s returning to a hobby you loved as a child or simply creating more space to relax, supporting your nervous system is an important part of managing long-term health.
Regular movement also offers natural anti-inflammatory benefits, while prioritising good quality sleep helps the body recover and regulate inflammation.
A more personalised approach to treatment
Conventional treatment options have traditionally focused on hormonal contraception, medications that temporarily switch off ovarian function or surgery. However, treatment is becoming increasingly personalised.
For some women, lower-dose progestin therapies may offer symptom relief without completely suppressing ovulation. Bioidentical progesterone can also be considered in carefully selected cases as part of an individualised treatment plan, particularly where hormonal imbalance is contributing to symptoms.
The most appropriate treatment will always depend on the individual, their stage of life, symptom severity and future health goals.
Listening to women
Perhaps the biggest change still needed is not medical but cultural.
Too many women continue to live with chronic pain because they have been told their symptoms are normal or because they have learnt to ignore them. Whether you’re 25 or 55, severe pelvic pain, persistent digestive symptoms or ongoing fatigue deserve investigation.
Endometriosis is far more than a painful period. It’s a complex inflammatory condition that can affect every aspect of a woman’s health and wellbeing. Greater awareness, earlier diagnosis and more personalised care could dramatically improve the lives of thousands of women who have spent years suffering in silence.
About The Marion Gluck Clinic
The Marion Gluck Clinic is the UK’s leading medical clinic that pioneered the use of bioidentical hormones to treat menopause, perimenopause and other hormone related issues. Founded by Dr. Marion Gluck herself, the clinic uses her method of bioidentical hormonal treatment to rebalance hormones to improve wellbeing, quality of life and to slow down ageing.
[1] https://www.endometriosis-uk.org/endometriosis-uk-release-new-report-highlighting-alarming-increase-endometriosis-diagnosis-times