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  • Q&A with Australian Health Practitioners

    Can endometriosis continue post hysterectomy/overies removal/on hrt?

    I had a hysterectomy and overies removal 6 years ago in my mid 30's and was put onto HRT immediately . Gyno said he left some endometriosis in me pelvis as it could not be removed. Could the endometriosis still be in me and could it have spread ? will going off HRT hurt me ? could this kill the endometriosis?
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    Dr Yogesh Nikam

    Gynaecologist, Laparoscopic Surgeon, Obstetrician

    Dr Nikam is a Specialist Gynaecologist, Laparoscopic and Robotic Surgeon who understands that no woman’s body or experiences are the same, which is why he ... View Profile

    Hi There

    Endometriosis is a disease that proliferates in an estrogenic environment. Estrogen is provided naturally by the ovaries before menopause ( average age to achieve menopause is at 51 years). If the ovaries have been removed, HRT supplementation can stimulate endometriosis as it contains estrogen.

    However, in your case the HRT is needed, to prevent symptoms of menopause and bone deterioration. So to answer your questions

    1. Yes, you could have endometriosis. However you require treatment only if you have symptoms of pelvic pain, dyspareunia ( pain during sex) or dyschezia ( pain with opening bowels). Not all women who have endometriosis will have these symptoms.

    2. Stopping HRT - I presume you must be in your early 40's or less. It is still important to continue HRT for symptom relief and bone protection till age 50. Stopping HRT will NOT hurt but may cause you to have menopausal symptoms such as hot flushes, sleeplessness, irritability, etc

    3. Stopping HRT & Endometriosis - As I mentioned above, stopping HRT ( estrogen) will stop endometriosis.

    What can you do?

    1. Seek a discussion with your Gynaecologist regarding your options

    2. Seek a second opinion from an Endometriosis Surgeon / Gynaecologist

    3. If you have symptoms, get a detailed endometriosis ultrasound done

    Hope this helps
    Dr Yogesh A Nikam

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