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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.

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