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Endometriosis – management after menopause

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Key Points

  • Medical management with either the combined oral contraceptive pill or treatments that create a hypo-oestrogenic state are used in appropriate premenopausal women (i.e. under 50, non-smokers, non-migraineur, low VTE risk).
  • Although endometriosis typically improves after menopause, chronic symptoms may persist.
  • Evidence is sparse but current recommendations favour continuous combined oestrogen- progestogen preparations instead of unopposed oestrogens for women with a history of substantial endometriosis even after hysterectomy.
  • Loss of oestrogen in younger women (<45 years of age) either through medical management or surgery has long-term implications for both bone and cardiovascular health.
Dr James Brown

Leading gynaecologist Dr. James Brown advances women’s health through clinical expertise, policy work, and public education. His clinical focus is on fertility, menopause, and reproductive endocrinology, including the management of conditions like PMDD, PCOS, and heavy bleeding. Based at the Women’s Health & Research Institute of Australia (WHRIA) and Connect IVF, Dr. Brown is known for his accessible, collaborative approach to care. He also co-leads the innovative, virtual Specialist Menopause Service in South-West Sydney. Beyond his clinical work, he is actively involved in policy, research (including a PhD in Health Economics), and teaching at Western Sydney and Sydney Universities. Dr. Brown is a passionate advocate for women’s health education, frequently engaging with the public and peers through media appearances, seminars, and webinars. He translates complex medical information into actionable insights, having been featured on major news outlets like Channel 7 News and Channel 10, sharing his expertise on critical health topics.