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Endometriosis and Estrogen

We often hear that endometriosis is an “estrogen-dependent disease” but this is a bit misleading.

Estrogen-dependent makes it sound like endometriosis depends solely on estrogen and therefore, if we lower estrogen in the body, the endometriosis will just disappear. But this isn’t the case, and people in a low estrogen state (be it natural menopause, medical menopause via hormonal suppression, or surgical menopause) can still have disease progression and pain, and the lesions don’t just disappear. Additionally, endometriosis can make its own local estrogen, even while the body is in menopause. While estrogen is important to endometriosis, it’s not the only hormone that endometriosis is affected by. The interplay of hormones with endometriosis is complex, and progesterone, prostaglandins, and the aromatase enzyme are important too.

Estrogen dominance

Many websites say that estrogen dominance causes endometriosis or that people with endometriosis are estrogen dominant, but neither is true. While estrogen may increase a person’s endometriosis symptoms (and this highly depends on the individual), high estrogen doesn’t cause endometriosis. Additionally, people with endometriosis can have a range of estrogen from low to high – having endometriosis doesn’t mean that you have excess/high estrogen or estrogen dominance.