Dr. Thaïs Aliabadi

Suppress endometriosis for sure, because endometriosis will go after those egg count and quality.

PCOS will go after your quality.

Yes, it gets better.

The problem is women in their 40s have a lot of adenomyosis, which mimics the symptoms of endometriosis.

So these women actually do extremely well with the progesterone IUD.

We talked about the Mirena IUD because it suppresses their pelvis and their endometriosis.

And once they go through menopause, this is a very important point.

And I'm so glad you brought it up because doctors don't realize this.

For patients with endometriosis,

Menopause will make the pain go away, right?

Because what happens in menopause are ovaries are not functioning and the estrogen levels drop.

However, you come and give these women estrogen.

What happens?

You can stimulate these endometriosis implants all over again.

And this is what happens.

So endometriosis patients in general have a slightly higher increased risk of ovarian cancer, especially the ones with endometriomas or advanced disease.

And postmenopause hormone replacement, the estrogen can still stimulate these implants.

Now, a lot of women in the health care system who have undergo a hysterectomy, meaning they remove their uterus, the doctor says you don't need progesterone because we think we give the progesterone to protect the lining of the uterus from unopposed estrogen causing uterine cancer.

Well, that's not true.

In patients with endometriosis,