A new global study from the University of Queensland has found that women with endometriosis are significantly more likely to experience premature or early menopause—especially if brought on by surgery—posing long-term risks to their health. Drawing on data from nearly 280,000 women across Australia, the UK, Sweden, and Japan, the research provides the most extensive evidence to date that endometriosis can influence not only fertility but also the timing and type of menopause.
Published in the journal Human Reproduction, the study was led by Dr. Hsin-Fang Chung and overseen by senior author Professor Gita Mishra. It analyzed long-term population health data gathered between 1996 and 2022 as part of the InterLACE (International collaboration for a Life course Approach to reproductive health and Chronic disease Events) project—a major international effort aimed at improving women’s health outcomes.
Endometriosis, which affects around one in ten women of reproductive age, occurs when tissue similar to the uterine lining grows outside the uterus. While often associated with chronic pelvic pain and infertility, the condition’s effects beyond reproductive health have been less well understood. This study, however, sheds new light on how endometriosis may accelerate the end of a woman’s reproductive years, with serious implications for long-term health.
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The researchers examined menopause timing and whether it occurred naturally or due to surgery such as hysterectomy or oophorectomy (removal of one or both ovaries). Menopause was categorized as premature if it occurred before age 40, early between 40 and 44, and normal or late after age 45. The study adjusted for a range of influencing factors including smoking, BMI, education level, and age of first menstruation.
Key findings show that women with endometriosis are seven times more likely to undergo surgical menopause than those without the condition. On average, surgical menopause occurred 19 months earlier in women with endometriosis, while natural menopause came 5 months earlier. Women with the condition were more than twice as likely to undergo surgical menopause before age 40, and 36% more likely to experience premature natural menopause.
“These findings suggest that endometriosis has a meaningful impact on ovarian function and longevity,” said Dr. Chung. “The risk isn’t limited to fertility concerns—it extends to earlier reproductive aging and all the health risks that come with it.”
Premature and early menopause are linked to a range of health issues, including increased risks of cardiovascular disease, osteoporosis, cognitive decline, and all-cause mortality. Surgical menopause, particularly when it involves bilateral oophorectomy, tends to heighten these risks because of the abrupt loss of estrogen.
Professor Mishra, founding director of the Australian Women’s and Girls’ Health Research Centre, emphasized the clinical relevance of the results. “Preventing or managing early or medically induced menopause requires a comprehensive understanding of its underlying causes and proactive measures to address the long-term health risks associated with it,” she said.
The need for early, individualized reproductive planning is a central takeaway from the study. Women with endometriosis may benefit from discussing fertility preservation options earlier in life and should have regular screenings for chronic disease risk factors. The researchers hope that healthcare professionals will use these insights to better guide patients with endometriosis in navigating surgical decisions and long-term health planning.
Although the study is broad in scope, one limitation is the absence of data on specific endometriosis subtypes and stages, which might influence the timing of menopause differently. It also did not fully explore how certain treatments—such as surgery to remove ovarian endometriomas—may alter the trajectory toward menopause.
“Future studies incorporating data on the subtype, stage, and treatment of endometriosis are needed to better understand the biological mechanisms and evolutionary origins of the condition,” the authors concluded. Understanding how disease severity and specific interventions affect reproductive aging could enable even more targeted prevention strategies.
Until such data is available, the current findings represent a critical step forward. They not only validate prior smaller-scale observations but also underscore the need to view endometriosis as a condition with wide-reaching consequences beyond fertility. By identifying premature and early menopause as part of the broader health impact of endometriosis, this research calls for more comprehensive management strategies for affected women.
