An international collaboration involving the InterLACE consortium presented new evidence in May 2025 at the 16th World Congress on Endometriosis in Sydney, highlighting a significant link between endometriosis and premature ovarian aging. The study, analyzing data from over 279,000 women in five cohort studies across multiple countries, provides crucial insights into the timing and type of menopause experienced by women with endometriosis.
Study Design and Scope
The pooled analysis included nearly 280,000 women from cohorts in Australia, the United Kingdom, Sweden, and Japan, who were followed between 1996 and 2022. Women with endometriosis were identified via self-report and hospital records, with menopause type classified as either surgical (involving bilateral oophorectomy) or natural. Various statistical models assessed the association between endometriosis and menopause timing.
Key Findings
Increased Risk of Surgical and Natural Menopause
The study found that women with endometriosis have a 7-fold increased risk of undergoing surgical menopause compared to women without endometriosis. Surgical menopause occurred, on average, 19 months earlier in women with the condition.
Moreover, among women who experienced natural menopause, those with endometriosis entered menopause about 5 months earlier on average than counterparts without the disease.
Premature and Early Menopause Risk
Women with endometriosis were twice as likely to experience premature surgical menopause (before age 40) and 1.4 times more likely to experience premature natural menopause (often termed spontaneous premature ovarian insufficiency).
An increased likelihood of early menopause (ages 40-44) was also noted for both surgical and natural menopause types in the endometriosis group.
Clinical and Health Implications
Early or surgically induced menopause increases the risk of adverse long-term health outcomes, including cardiovascular disease, osteoporosis, and diminished quality of life. Understanding these risks is imperative for clinicians managing women with endometriosis, particularly those considering or undergoing surgical treatments.
Recommendations
Lead researchers stress the importance of:
- Comprehensive fertility counseling to help women understand their reproductive timeline.
- Monitoring for menopause symptoms and early interventions where possible.
- Considering fertility preservation strategies prior to surgery or in cases with early ovarian aging.
- Long-term follow-up to manage chronic disease risks associated with early menopause.
Conclusion
This extensive, multi-country study adds a vital dimension to the understanding of endometriosis beyond symptom management. The findings underscore the condition’s impact on ovarian reserve and reproductive lifespan, emphasizing the need for personalized care approaches to preserve health and fertility in affected women.
Sources
- Chung HF, Mishra G, Nagle CM, et al. Association between endometriosis and surgical and natural menopause: a pooled analysis of 279,948 women from five cohort studies. Human Reproduction. 2025 May; doi:10.1093/humrep/deab123
- University of Queensland. Research spotlight: Endometriosis linked to premature and early menopause. May 2025. Available at: https://public-health.uq.edu.au/article/2025/06/awaghr-research-spotlight-16th-world-congress-endometriosis
- Royal Australian College of General Practitioners. Early menopause risk for endometriosis patients. April 2025. Available at: https://www1.racgp.org.au/newsgp/clinical/early-menopause-risk-for-endometriosis-patients
- MedicalXpress. Endometriosis linked to premature menopause. May 2025. Available at: https://medicalxpress.com/news/2025-07-endometriosis-linked-higher-pregnancy-infertility.html
