Dr. Madhavi Kulkarni received a Grant from the U.S. Army Medical Research- Discovery Award for her proposal titled “A Longitudinal Study of the Epidemiology of Endometriosis After Menopause.”

The research planned in this proposal is an important step toward understanding endometriosis across the full life course, and a continuation of Dr. Kulkarni’s earlier research. Contrary to long held clinical belief, her research has given strong evidence that endometriosis can exist after menopause. Confirmation of endometriosis among postmenopausal women will be paradigm shifting. Women and their health care providers must be made aware of this in order to facilitate proper care.

Multiple case studies have documented endometriotic lesions among symptomatic women in hypoestrogenic environment, with an estimated prevalence of 2-5%. That only case reports exist to date is wholly inadequate to inform physiologic discovery and clinical pedagogy. The overarching goal of this research is to quantify the incidence of endometriosis among postmenopausal women and to identify predictive time-varying factors including inflammatory markers to better understand the pathophysiology of endometriosis after menopause, with a special focus on defining the role of hormone replacement therapy, historically the most prevalent treatment for menopausal symptoms. The proposal also aims to identify whether risk factors might differ from those for premenopausal endometriosis due to different biological processes driving the disease. Identification of the scope of this disease, and high-risk subgroups (e.g. women exposed to exogenous hormones or obese women) will help guide treatment planning and devise effective screening strategies during appropriate time windows. These investigations will provide new and important insights on aims proposed in this funded grant and leap forward our knowledge of postmenopausal endometriosis.