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. The exact cause is unknown, but estrogen likely plays a role.
Can hormone replacement therapy (HRT) trigger the development or worsening of endometriosis? There is some evidence that HRT containing estrogen may exacerbate endometriosis in some women:
- Several studies have found that women taking unopposed estrogen (estrogen without progesterone) as part of HRT are more likely to develop new endometriosis lesions or have worsening of existing disease. The added estrogen provides fuel for any endometrial tissue outside the uterus.
- However, other studies show no increase in endometriosis risk or symptoms in women taking combination estrogen-progestin HRT. The progesterone helps counteract the estrogen's effects on endometrial tissue.
- So unopposed estrogen appears to pose more risk, while combination HRT with both estrogen and progesterone may be safer with respect to endometriosis.
Some key points about HRT and endometriosis:
- The effect likely depends on the dose and formulation - higher doses of estrogen and unopposed estrogen regimens seem more likely to exacerbate endometriosis
- Not every woman on HRT will experience worsening endometriosis
- For those with severe endometriosis, the risks of HRT may outweigh potential benefits
- More research is still needed on this question
In summary, unopposed estrogen HRT poses a higher risk of developing or worsening endometriosis compared to combination estrogen-progestin regimens. Any woman with known or suspected endometriosis should carefully consider these risks vs. benefits when discussing HRT options with their healthcare provider.
If you are struggling with
menopause symptoms and unsure of your best HRT options given a history of endometriosis, consider scheduling a consultation with Rejuvenate Hormone Clinic. Our physicians and nurse practitioners specialize in tailored bioidentical
hormone therapy to help women achieve hormone balance and relieve troubling menopause concerns. Let our experts design an individualized plan just for you.
