Menopause is an interesting point in time. Besides the fact that it is generally under-researched like most things around women’s health, in the context of endometriosis, menopause is seen as a good thing. The hormones will finally stop. The pituitary will take a chill. LH and FSH will take some rest and most importantly, estrogen will no longer be a problem. But you can rarely use menopause as a way to wait the disease out. The perimenopausal phase—a period of about 4 to 8 years before menopause—isn’t simply a time when hormones start to wind down. It’s a time when they go erratic. For many women, perimenopause becomes not an epilogue but a plot twist in their battle against endometriosis. As hormones go haywire and the body’s rhythms misfire, endometriosis finds new ways to persist, morph, and mislead. This week, we bring you a clinical intelligence file: five rogue forms endometriosis can take in the perimenopausal and postmenopausal phases. From bladder pain mistaken for UTIs to hormone-hijacking lesions that produce their own estrogen, this is essential knowledge for both surgeons and patients. Because for women reading this who thought menopause would finally bring relief: understanding these patterns means you can advocate for proper diagnosis instead of being dismissed as “just menopausal symptoms.” Read more