The Link Between Endometriosis and Early Menopause

Endometriosis is often recognized for its painful periods, pelvic discomfort, and link to infertility—but new research suggests it may also quietly impact something many women don’t often consider until it’s too late: ovarian reserve and the timing of menopause.

A new study published using data from the Nurses’ Health Study II, one of the largest and longest-running women’s health studies in the U.S., has shown that women with laparoscopically confirmed endometriosis have significantly lower levels of anti-Müllerian hormone (AMH)—a marker commonly used to estimate ovarian reserve.

What Is Anti-Müllerian Hormone (AMH), and Why Does It Matter?

AMH is a hormone secreted by ovarian follicles and is used to estimate how many eggs a woman has left. While AMH doesn’t predict natural pregnancy success directly, it is widely used to:

• Assess ovarian reserve
• Evaluate fertility potential
• Predict onset of menopause
• Guide fertility treatment decisions like IVF

In general, AMH declines as a woman ages, and lower levels are associated with a shorter time to menopause.

Key Findings: Endometriosis and Lower AMH Levels

In the study, researchers analyzed data from 1,961 premenopausal women who provided blood samples for AMH testing. Of these, 119 had a history of laparoscopically confirmed endometriosis. The results showed:

• Women with endometriosis had nearly 30% lower AMH levels compared to women without the condition.
• This difference was even greater in women with a BMI over 25 kg/m², where the AMH levels were 44% lower.
• The link between endometriosis and low AMH held strong even after accounting for infertility history, parity, and hormonal medication use.

Why Should You Care?

This matters because low AMH may indicate an earlier onset of menopause, which has implications far beyond fertility. Early menopause is associated with increased risks for:

• Cardiovascular disease
• Osteoporosis
• Cognitive decline
• Mood disorders

If you’re a woman living with endometriosis—especially if you’re in your 30s or early 40s—this research offers critical insight: your ovarian aging may be progressing faster than you realize, even if you’re not currently trying to get pregnant.

Can Endometriosis Itself Cause Low AMH?

Previous studies have linked ovarian endometriomas and surgical treatment to reduced AMH. However, this new study broadens the scope by including women who may not have had ovarian involvement or fertility treatment. The findings suggest that endometriosis may impact AMH regardless of surgery or lesion location.

Inflammation, oxidative stress, and immune dysregulation caused by endometriosis could contribute to damage within the ovaries and accelerate follicular loss—reducing AMH levels and shortening the reproductive window.

What Should You Do?

Here are a few proactive steps you can take:

• Talk to your doctor about AMH testing, especially if you’ve been diagnosed with endometriosis.
• Consider fertility preservation options if you plan to delay childbearing.
• Ask about lifestyle interventions and treatments to support hormonal and cardiovascular health.
• Stay informed and monitor changes in your cycle that might indicate ovarian aging.