Endometriosis in the postmenopausal female: clinical presentation, imaging features, and management

  • Adela G. CopeEmail author
  • Wendaline M. VanBuren
  • Shannon P. Sheedy
Special Section: Endometriosis


Postmenopausal endometriosis is an important clinical entity which is likely under-recognized and in which the Radiologist can play a valuable role. In this review, we describe the clinical presentation and management of postmenopausal endometriosis, appraising the literature and providing case examples. Persons with postmenopausal endometriosis may present with symptoms including pelvic pain or dyschezia, but endometriosis may also be an asymptomatic, incidental finding. Women may or may not have a prior history of endometriosis or a history of symptoms consistent with it. Therapies and conditions which increase exogenous or endogenous estrogen, respectively, increase the risk. Endometriosis can be found in different locations throughout the body, and the possibility of malignancy should be assessed, especially in the postmenopausal population, where age increases cancer risk. Treatment may involve surgery or medical interventions. Guidelines describing appropriate imaging surveillance in these patients are lacking. In the postmenopausal population, Radiologists need to consider endometriosis as a diagnosis, recommend appropriate exams such as MRI and US, and suggest endometriosis-associated malignancies when appropriate, based on classic morphologic features.


Endometriosis Postmenopause Magnetic resonance imaging Ultrasonography 



The authors wish to thank Sonia Watson, PhD, and Desiree J. Lanzino, PT, PhD, for their help in editing the manuscript.


No sources of funding were utilized to conduct this review.

Compliance with ethical standards

Conflict of interest

No conflicts of interest to disclose.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyMayo ClinicRochesterUSA
  2. 2.Department of RadiologyMayo ClinicRochesterUSA

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