Menopause and Endometriosis: Tracing the Entanglements of Hormones, Ageing and Gendered Chronic Illness

Abstract

The article explores menopause as a feminist question through a chronic gynaecological illness: endometriosis. As endometriosis is an oestrogen-associated condition, menopause is expected to alleviate endometriosis symptoms, yet its unfolding effects are unknown. Drawing on interviews with clinicians and people with endometriosis in Finland, as well as ethnographic observation at an endometriosis clinic, we show that endometriosis sheds crucial light on menopause as an embodied process. First, the anticipation of menopause in endometriosis involves uncertainties concerning unique bodily responses and narrowing treatment options that affect how people with endometriosis orientate towards a post-menopausal future. Menopause thus extends in time, becoming entangled with the practices of managing gynaecological illness years before the actual onset of menopause symptoms. Second, radical endometriosis surgery that involves removal of the uterus and ovaries produces an early menopause that raises questions about what constitutes menopause. Post-operative care involves delicate tinkering with hormonal medications to achieve a postponement of menopause symptoms while also responding to slowly unfolding processes of gendered ageing that extend beyond hormonal health. At the same time, ideas about “natural menopause” structure radical surgery and postoperative care as a reference point in relation to which post-operative embodied processes are managed.