EP.380/ Why people with endo are at higher risk of early Menopause and premature ovarian insufficiency
I wanted to do this episode on perimenopause and menopause because so many clients are in perimenopause or are approaching the age when it begins, and often when they come to me, they have no idea what’s going on and how all these worsened or new symptoms could all be connected to one thing.
And based on this show’s demographics, I think many of you will also be going through or about to go through the same, and so I wanted to do a little episode on what to expect in these first years of perimenopause, so you know what to look our for.
Now, when I started writing this episode, I wanted to deliver all the information in one go, but the more that wrote, the more I felt it would be better delivered in bitesize chunks, because even though in total, it won’t make for a long episode at all, it is a lot of information to take in.
So, today, we’re starting with the basics of what menopause is and how it’s different for those of us with endo, and it is going to be a very, very short episode, so be prepared!
Menopause is when we stop ovulating, and our ovarian production of testosterone, oestrogen and progesterone significantly declines, and we lose our periods. We are in menopause when we haven’t had a period in a full year.
Menopause typically occurs between 45 and 55, however, people with endo are at higher risk of earlier menopause. Perimenopause can begin between ages 35-45 and typically begins in the two to ten years leading up to menopause and commonly starts around 40-45. However, it’s reasonable to assume that if some of us with endo are more likely to go through menopause earlier, then perimenopause may occur earlier too, so we may well fall into the mid-30s age range, which is what happened for me and what I tend to see for a number of my clients.
A recent 2025 study looked 279,948 women between 1996 and 2022, and found that women with endo were significantly more likely to experience early surgical or natural menopause between the ages of 40 and 44. They were also 1.4 times more likely to experience premature ovarian insufficiency, which is when ovaries stop functioning before the age of 40.(1)
A previous 2022 found that people with endo were at a 50% higher risk of going through early natural menopause, which is menopause before 45.(2)
Menopause may also occur earlier in people who have had a hysterectomy but the ovaries were left remaining, with research showing that menopause can happen up to four years earlier and menopause symptoms can also be more severe. (3) This is thought to be, at least in part, due to decreased blood flow to the ovaries, with studies showing that a hysterectomy can cause a 50%-70% reduction in blood flow to the ovaries.(4)
So, aside from surgery, why does earlier menopause happen in endo patients? Research has shown that oxidative stress levels are linked to earlier ovarian decline and disease development, including premature ovarian insufficiency.(5)
We know that people with endo have higher levels of oxidative stress in the blood, but also in the pelvic area and even in the ovaries, with fewer antioxidant defences.(6) This oxidative stress creates a pro-inflammatory state, that can further damage ovaries and follicles.(7) In fact, research has shown that higher levels of pro inflammatory markers like interleukin-6, which plays a key role in endometriosis and is elevated in both the blood stream and pelvic fluid of endo patients, also contributes to the onset of premature ovarian insufficiency.(8)
Additionally, studies have shown that the ovaries of people with endo have more oxidative damage, including the granulosa cells (which nurture developing eggs) and the outer layer of the ovary, called the ovarian cortex.(9)
Okay, so now we know why it happens, next time we’ll be looking at what happens. And don’t worry, I am going to give you a number of tools for reducing oxidative stress and inflammation to the ovaries, and for improving this transitional time.
Affiliate Partnerships
DITTO - DITTO is a clinically studied PMS and PMDD supplement with 10 ingredients that target both the mental and physical challenges that come along with the menstrual cycle, developed by a PhD Nutrition Scientist. You can use the code: ENDOBELLY (all caps) for 20% off any and all orders, now and in the future.
Mira - Mira is an at-home hormone testing device for every day use. Use this link and code 2DJESS20 to get 20% off the device and any future wand orders.
Tempdrop - Track fertility effortlessly with Tempdrop’s Wearable Sensor. Get 15% off with code: ENDOLIFE
Need more help or want to learn how to work with me?
Ways to work with me:
One to one coaching info and application
Live and Thrive with Endo 2.0 DIY online course
Endo Sessions: Single and mini-package one to one endo coaching
SIBO Sessions: Single and mini-package one to one SIBO coaching
Masterclasses in endo nutrition, surgery prep and recovery and pain relief
This EndoLife, It Starts with Breakfast digital cookbook
Free resources:
This podcast!
References
1) https://pubmed.ncbi.nlm.nih.gov/40304605/
2) https://pubmed.ncbi.nlm.nih.gov/35061039/
3) https://www.sciencedirect.com/science/article/pii/S0015028216499425, https://pmc.ncbi.nlm.nih.gov/articles/PMC3223258/, https://pmc.ncbi.nlm.nih.gov/articles/PMC9912518/
4) https://pmc.ncbi.nlm.nih.gov/articles/PMC9912518/
5) https://pmc.ncbi.nlm.nih.gov/articles/PMC3952404/
6) https://pmc.ncbi.nlm.nih.gov/articles/PMC5625949/
7) https://pmc.ncbi.nlm.nih.gov/articles/PMC6334348/
8) https://pmc.ncbi.nlm.nih.gov/articles/PMC6334348/
9) https://pmc.ncbi.nlm.nih.gov/articles/PMC5625949/
Produced by Chris Robson