Send us a text with a question or thought on this episode ( We cannot replay from this link)
Menopause wasn’t supposed to feel like this—so why does pelvic pain persist when periods stop? We sit down with Dr. Megan Wasson, Chair of Medical and Surgical Gynecology at Mayo Clinic, to confront the enduring myth that menopause—or even ovary removal—automatically ends endometriosis. The short answer: endo is a disease of endometrial‑like tissue, not an ovary problem, and those lesions can produce their own estrogen through aromatase.
Across a focused, fast‑paced conversation, we get clear on what actually drives symptoms after 45, 55, and beyond. Dr. Wasson explains how local estrogen production keeps lesions active, why surgical menopause often leads to new risks without solving pain, and what a modern care plan should look like when cycles fade but symptoms don’t. We explore smarter hormone therapy for hot flashes, sleep issues, and brain fog—when combined estrogen and progesterone makes sense, when estrogen‑only can be safe, and how to avoid common pitfalls with testosterone supplementation that can inadvertently fuel endo.
You’ll hear practical guidance on assessing disease burden, deciding if and when excision is warranted, and building a supportive team that addresses pelvic floor dysfunction, pain processing, and long‑term health. The goal is clarity: understand the biology, personalize hormone choices, and focus on the lesions—not just the labs. If you’ve felt dismissed or confused about treatment after menopause, this conversation brings both validation and a roadmap.
If this helped you rethink endometriosis after menopause, follow the show, share it with someone who needs it, and leave a quick review so others can find these expert insights. Got a question for our next Quick Connect? Send it in—we’re listening.
Website endobattery.com
Setting The Stage: Endo At Any Age
SPEAKER_00
0:00
Endometriosis
doesn't
care
how
old
you
are.
Maybe
you're
in
menopause
thinking,
wait,
why
am
I
still
in
pain?
In
this
episode,
Dr.
Megan
Wasson,
Chair
of
Medical
and
Surgical
Gynecology
at
the
Mayo
Clinic,
walks
us
through
what
endo
can
look
like,
not
just
in
your
reproductive
years,
but
beyond.
Yes,
we
even
go
there.
Endo
after
menopause.
Dr.
Wasson
brings
clarity,
passion,
and
real
insight
into
the
care
we
all
deserve.
So
grab
your
favorite
drink,
take
a
deep
breath,
and
join
us
because
you
are
not
alone
in
this
fight.
Life
moves
fast,
and
so
should
the
answers
to
your
biggest
questions.
Quick Connect Format And Disclaimer
SPEAKER_00
0:36
Welcome
to
Indo
Batteries
Quick
Connect,
your
direct
line
to
expert
insights.
Short,
powerful,
and
right
to
the
point.
You
send
in
the
questions,
I
bring
in
the
experts,
and
in
just
five
minutes,
you
get
the
knowledge
you
need.
No
long
episodes,
no
extra
time
needed.
And
just
remember,
expert
opinions
shared
here
are
for
general
information
and
not
for
personalized
medical
advice.
Always
consult
your
provider
for
your
case-specific
guidance.
Got
a
question?
Send
it
in,
and
let's
quickly
get
you
the
answers.
I'm
your
host,
Alana,
and
it's
time
to
connect.
Introducing Dr. Megan Wasson
SPEAKER_00
1:14
Today's
guest
is
someone
who
brings
a
deep
expertise,
compassion,
and
innovation
to
the
field
of
gynecology.
Dr.
Megan
Wasson
is
the
chair
of
the
Department
of
Medical
and
Surgical
Gynecology
at
the
Mayo
Clinic
in
Arizona
and
a
professor
of
obstetrics
and
gynecology
at
the
Mayo
Clinic
College
of
Medicine
and
Science.
Her
clinical
focus
includes
endometriosis,
chronic
pelvic
pain,
and
advanced
surgical
techniques.
Dr.
Wasson
is
helping
redefine
what
care
can
look
like
for
patients
around
the
world.
Please
help
me
in
welcoming
Dr.
Megan
Wasson.
Busting The Menopause Cure Myth
SPEAKER_00
1:46
Let's
talk
about
the
myth
of
menopause
cures
endometriosis.
Why
isn't
that
always
true?
SPEAKER_01
1:52
Or
so
number
one,
um,
one
of
my
biggest
pet
peeves
with
endometriosis
in
general
is
when
individuals
have
their
uterus
removed,
their
ovaries
removed,
and
nothing
is
done
for
endometriosis,
but
I
cured
your
endometriosis.
Nothing
could
be
further
from
the
truth.
So
endometriosis,
yes,
it
responds
to
the
hormones
that
the
ovaries
release,
but
it's
not
an
issue
with
the
ovaries.
It's
an
issue
with
how
that
tissue
is
responding.
So
we
need
to
focus
on
fixing
that
tissue
rather
than
just
castrating
everyone
and
removing
ovaries.
So
I
very,
very
rarely
am
removing
ovaries
for
treatment
of
pelvic
pain
for
treatment
of
endometriosis.
And
the
reason
for
that
is
if
we
really
understand
endometriosis,
it
truly
is
endometrial-like
tissue.
It
is
not
the
endometrium.
So
endometriosis
has
a
chemical
in
it
called
aromatase,
and
aromatase
converts
testosterone
into
estrogen.
So
even
if
the
ovaries
are
gone,
the
endometriosis
is
going
to
continue
to
feed
itself.
And
so
whether
that's
surgical
menopause,
natural
menopause,
medical
menopause,
using
those
various
medications
that
I
previously
mentioned,
symptoms
can
continue.
Symptoms
can't
progress.
And
we
shouldn't
just
ignore
them
and
say,
well,
I
guess
you're
menopausal
and
there's
nothing
else
we
can
do.
So
now
you
really
have
to
Aromatase And Ovaries: What Matters
SPEAKER_01
3:16
just
suck
it
up
and
deal
with.
SPEAKER_00
3:17
I
think
there's
a
lot
of
fear
as
well
when
you
get
into
this
stage
and
you
want
to
do
hormone
replacement
therapy.
And
I
think
that
a
lot
of
people
are
leery
of
doing
that
because
they
have
endometriosis
and
they
don't
want
to
make
it
worse.
Can
you
touch
on
that
just
a
little
bit?
Because
I
think
that
is
a
fear
of
a
lot
of
these
people
walking
through
the
stage
of
life.
SPEAKER_01
3:36
Yeah,
and
that's
where
you
really
need
to
understand
how
these
hormones
interplay
and
what
affects
endometriosis.
I
recently
just
saw
a
patient,
she
came
in,
was
getting
testosterone
supplementation,
and
was
completely
asymptomatic.
Endometriosis
had
never
even
entered
the
conversation
until
she
was
getting
that
testosterone,
and
all
of
a
sudden
she
developed
severe
pelvic
pain
and
no
one
could
understand
why.
Well,
endometriosis
converts
that
testosterone
into
estrogen.
And
so
it
just
caused
that
vicious
cycle
to
really
ramp
Smarter Hormone Therapy After Menopause
SPEAKER_01
4:06
up.
So
that
being
said,
hormone
replacement
therapy
is
not
the
enemy.
We
just
need
to
be
very
mindful
and
very
cognizant
about
what
we're
doing
with
hormone
replacement
therapy
and
balancing
those
risks
and
benefits.
So
just
another
plug
for
why
removing
the
ovaries
doesn't
really
make
sense.
So
if
you
have
someone
who
is
very
young
and
you
remove
the
ovaries,
you
induce
menopause,
the
immediate
next
thing
is
going
to
be,
well,
now
you're
at
risk
for
osteoporosis,
heart
disease.
I
need
to
give
you
hormones
now
to
reduce
that
risk.
So
we've
taken
the
hormones
away,
but
now
I'm
gonna
give
you
hormones
because
you
need
the
hormones
in
your
body.
It
just
doesn't
logically
line
up.
Right.
So
that's
another
point
for
why
we
just
really
shouldn't
be
doing
that.
But
after
menopause,
in
that
perimenopausal
transition,
there's
a
lot
of
other
symptoms
that
can
arise.
Hot
flashes,
difficulty
sleeping,
that
brain
fog
is
very
common
and
hormones
can
help
with
that.
And
so
if
you
need
hormones
to
help
to
support
your
body
during
that
transition,
absolutely
we
can
do
that.
If
someone
still
has
a
large
amount
of
disease
burden
with
endometriosis,
so
that
patient
who
we've
been
following
with
endometriomas
hasn't
wanted
to
do
surgery,
I
do
recommend
estrogen
and
progesterone
together
in
that
patient,
even
if
they've
had
a
hysterectomy.
So
for
some
individuals,
after
hysterectomy,
we
say
only
estrogen,
you
don't
need
any
progesterone.
But
on
the
flip
side
of
that,
if
it's
someone
who's
had
a
very
thorough
excision
of
endometriosis
or
not
suspicious
of
significant
disease
burden
remaining,
that's
where
someone
can
use
estrogen
alone,
and
that's
completely
fine.
If
they
need
estrogen
to
help
with
those
menopausal
symptoms,
absolutely
endometriosis
is
not
a
contraindication
to
hormone
replacement
Closing And How To Send Questions
SPEAKER_01
5:50
therapy.
SPEAKER_00
5:50
That's
a
wrap
for
this
quick
connect.
I
hope
today's
insights
helped
you
move
forward
with
more
clarity
and
confidence.
Do
you
have
more
questions?
Keep
them
coming.
Send
them
in,
and
I'll
bring
you
the
expert
answers.
You
can
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in
by
using
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link
in
the
top
of
the
description
of
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podcast
episode
or
by
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contact
at
indobattery.com
or
visiting
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Indobattery.com
contact
page.
Until
next
time,
keep
feeling
empowered
through
knowledge.