Menopause at 16

How Treating my Endometriosis Led to Medically Induced Menopause 

I was sixteen years old when doctors put me into medical menopause.

Not perimenopause. Not an irregular cycle. Not something my body entered naturally.

Medical menopause. At sixteen.

By then, I had already spent years living with stage 3 endometriosis and uterine fibroids. After two years of endless lab tests and medical gaslighting, I had been officially diagnosed at fourteen through laparoscopic excision surgery. Even after having undergone my first surgery, I moved through different forms of hormonal suppression in the form of birth control pills, but was still in enough pain that we were searching for something else to try before attempting a second surgery. I ultimately ended up having that second surgery on July 6th, 2015.

One of those last options prior to the surgery was a nasal spray called Synarel.

Almost nobody I have ever spoken to has even heard of it.

And I mean that literally.

Through years of talking to other women with endometriosis, learning about women’s health, studying herbal medicine, hormone health, anatomy, physiology and pathophysiology, I have mentioned this medication over and over again.

Nothing.

The only person I can specifically remember immediately knowing exactly what I was talking about was the second endometriosis surgeon I eventually went to see at 24, EIGHT years later. 

Yet somehow, at sixteen years old, this was one of the medications handed to me in an attempt to control my endometriosis.

And I certainly did not understand what it was actually about to do to my body.

Synarel Was Not Just Another Birth Control

Hormonal suppression was already part of my life by then.

From the time I was diagnosed at fourteen until I eventually came off hormonal birth control in my early twenties, I spent nearly a decade with some form of hormonal suppression woven through that entire chapter of my life. 

It started with different birth control pills before being prescribed Synarel at sixteen. Then, during my second endometriosis surgery, a Mirena IUD was placed while I was already under anesthesia so everything could be done at once.

I kept the Mirena for five years. When I eventually had it removed, I briefly went back onto Norethindrone, a progestin-based medication, before making the decision about three months later to come off hormonal birth control completely.

I don’t remember the name of every pill I was prescribed over all of those years.

But, what I do remember is a hell of a lot of side effects and what those years felt like inside my body.

And I always remember Synarel.

Because Synarel was different.

Synarel, or nafarelin, is a GnRH agonist administered as a nasal spray. With continued use, it suppresses signaling through the hypothalamic-pituitary-ovarian(HPO) axis and drastically reduces ovarian hormone production. In endometriosis treatment, that creates a profound hypoestrogenic state. The current FDA label recommends only six months of treatment for endometriosis and specifically warns about bone-density loss. 

In simpler words?

It intentionally pushes the reproductive system into a temporary hormonal state resembling menopause.

And I was sixteen.

If you have endometriosis, you’ve probably heard of Orilissa.

That medication is much more commonly talked about now. Orilissa, or elagolix, is a pill used for moderate-to-severe pain associated with endometriosis. It is technically a GnRH antagonist, whereas Synarel is a GnRH agonist, so they do not work identically.

But the treatment philosophy is very similar: suppress signaling to the ovaries, reduce ovarian hormone production, and create a lower-estrogen environment in an attempt to suppress endometriosis-associated pain and activity. Orilissa also carries warnings about dose- and duration-dependent bone loss. 

So no, Synarel was not simply “another birth control.”

And when I say I was put into medical menopause at sixteen, I am not saying every birth control pill I took or the Mirena IUD did the same thing.

They didn’t.

Those were different forms of hormonal manipulation and suppression.

Synarel was the point where that suppression became extreme enough to intentionally mimic the hormonal landscape of menopause.

They Were Treating Estrogen Without Ever Teaching Me About Estrogen

This is the part that pisses me off more now than it did then.

Because back then, I didn’t know enough to be pissed off.

Nobody sat me down and explained why they were trying so desperately to lower my estrogen. Nobody explained what estrogen actually did throughout the rest of my body, or how it was involved in the disease I had been living with since childhood.

They were treating estrogen without ever teaching me about estrogen.

And years later, through my own education, I finally began to understand the physiology behind decisions that had been made about my body when I was still a child.

Yes, estrogen plays a significant role in endometriosis. It is an estrogen-dependent, estrogen-responsive disease, but the relationship between estrogen and endometriosis is far more complicated than simply having elevated estrogen levels.

Endometriosis lesions can create their own locally estrogen-dominant environment through altered estrogen signaling and the activity of enzymes like aromatase, which is involved in estrogen production. Many lesions also demonstrate progesterone resistance, meaning the normal balancing effects of progesterone may be diminished.

And then there’s inflammation.

Estrogen can encourage inflammatory signaling, while inflammation can further support the local production and activity of estrogen.

Mast cells, a type of immune cell involved in inflammatory and allergic responses, add another layer to this relationship. When activated, they can release histamine and other inflammatory mediators that contribute to inflammation and nerve sensitization. Estrogen can also influence mast cell activity, creating another potential connection between hormonal signaling, immune responses, and pain.

Essentially, these pathways can continue feeding into one another.

A complex feedback loop involving estrogen, inflammation, mast cells, and histamine that may help perpetuate the inflammatory environment surrounding endometriotic lesions, therefore helping the disease sustain itself.

But, endometriosis is not simply a hormonal imbalance or a disease confined to the reproductive organs. It involves a complex relationship between hormonal signaling, chronic inflammation, immune dysfunction, and the nervous system, with each influencing the others. And it certainly isn’t just a bad period.

I understand endometriosis as a systemic inflammatory disease with profound neuroimmune involvement. A disease in which hormones, immune cells, inflammatory mediators, nerve growth, and pain pathways are deeply interconnected, creating a cycle that can extend far beyond the reproductive system.

And for nearly a decade, my experience of treatment centered overwhelmingly around suppressing my reproductive hormones.

Stop the bleeding.

Stop ovulation.

Suppress the estrogen.

Manage the pain.

And when one treatment didn’t work, move on to the next.

I understand now why estrogen suppression can help manage endometriosis symptoms. But lowering estrogen does not eliminate every inflammatory, immune, or neurological process involved in this disease, nor does it necessarily remove the lesions themselves.

The body does not divide itself into specialties the way medicine does.

Your reproductive system does not exist independently from your nervous system, immune system, or endocrine system. They are constantly communicating with one another.

And that is precisely why I believe endometriosis deserves to be approached as more than a problem with a woman’s period, hormones, or reproductive organs.

And Then My Bones Started Paying for It

Estrogen does a hell of a lot more inside the female body than regulate menstruation.

It also plays an essential role in maintaining bone density, something especially important during adolescence, when our bodies are still building the bone mass we will depend on throughout adulthood.

And when estrogen is suppressed profoundly enough, our bones can suffer.

I was on Synarel for approximately six months.

Within that time, I went from trying to manage my endometriosis to being told that my bone density had dropped dramatically.

I remember being told that my bone density had decreased by around half, to the point where I had to be taken off the medication immediately and put on calcium, magnesium, and vitamin D to help support my bone health.

And what I remember most clearly is the terminology they used.

Pre-osteoporosis.

At sixteen years old.

I had been given this medication in an attempt to avoid another surgery, and instead, I was left dealing with another consequence of treatment.

And what makes that even harder to look back on is knowing that bone-density loss is a recognized risk of Synarel. The FDA-approved labeling limits treatment for endometriosis to six months because of concerns surrounding bone health.

I was sixteen, still developing, and being treated with a medication capable of interfering with one of the most important periods of bone development in a woman’s life.

I was being treated for one disease, while another part of my body was paying the price.

I Was Taught to Suppress My Body Before I Was Taught to Understand It

Looking back, this is one of the most heartbreaking pieces of my story.

I knew the names of medications before I understood my menstrual cycle.

I knew operating rooms before I understood hormonal physiology.

I knew how to take a pill every day, how to suppress my cycle, and how to use a nasal spray that could temporarily shut down ovarian hormone production.

I knew doctors were already questioning whether I would ever be able to conceive naturally before I had even had the chance to decide what motherhood meant to me.

But I didn’t understand my own body.

For years, everything about being inside a female body felt like something that needed to be controlled.

My ovaries were the problem.

My estrogen was the problem.

My uterus was the problem.

My period was the problem.

And eventually, I began to believe my body itself was the problem.

It wasn’t until years later that I started asking a completely different question.

What if my body wasn’t broken? What if she was asking to be understood?

That question changed the direction of my life.

The Girl I Was at Sixteen

Sometimes I think about that girl.

Sixteen years old, holding a little bottle of Synarel, hoping that maybe this would finally be the thing that made the pain stop.

Maybe it would keep her out of another operating room.

Maybe she could finally experience what it felt like to live without constantly worrying about her own body.

She didn’t understand GnRH agonists, aromatase, neuroinflammation, or the relationship between estrogen and immune signaling.

She certainly didn’t understand what suppressing her estrogen could mean for bones that were still developing.

She just knew she was hurting.

And she trusted the adults treating her to understand everything she didn’t.

That is what stays with me.

Because she shouldn’t have needed to understand all of those things on her own.

She shouldn’t have needed to spend years studying herbal medicine, anatomy, physiology, and hormone health to understand what was being done to her body.

She deserved to be educated.

She deserved to understand the risks, the benefits, and the reasoning behind the decisions being made about her health.

She deserved to be heard.

Not because she was old enough to understand every piece of the science, but because she was young enough to need someone to explain it.

And while I can recognize the role conventional medicine played in my journey, I can also recognize the ways it failed me.

I can be grateful for the surgeries that removed endometriosis lesions from my body while still questioning the treatments I was given and the lack of education surrounding them.

Those things can exist together.

From Suppression to Understanding

After spending nearly a decade on hormonal birth control, I eventually made the decision to come off it in my early twenties.

For the first time in years, I wanted to understand my body without continuously suppressing her natural hormonal rhythms.

I wanted to learn my cycle.

I wanted to understand my hormones.

And I wanted to find out whether the future I had been afraid of since fourteen was truly inevitable.

About two years later, I conceived my daughter naturally.

That part of my story will always mean more to me than I can explain.

But I also know that my experience is not a promise of what another woman’s fertility journey will look like. Endometriosis and infertility are complicated, deeply individual experiences.

What it meant for me was that the future I had been told to fear was not ultimately the future I lived.

My story was not finished at fourteen.

And somewhere along the way, the girl who had been taught to suppress her body became a woman who devoted her life to understanding it.

Today, as a clinical herbalist, aromatherapist, and hormone health practitioner, I approach women’s health differently. Not because I believe plants can replace every medical treatment, but because I believe a woman’s body deserves to be understood as a whole.

Holistic means whole.

Our hormones, immune systems, nervous systems, and reproductive organs are not separate stories. They’re all part of the same body, constantly communicating with one another.

And understanding those relationships has changed everything about the way I view my own health.

I don’t believe healing means pretending disease is sacred or that every illness carries some beautiful hidden lesson.

There is nothing beautiful about watching a child suffer through years of chronic pain.

But there is power in reclaiming the relationship with a body you were once taught to fear.

For years, I thought healing meant finally getting my body to stop fighting me.

Now I understand that part of my journey was learning how to listen to her.

To recognize that my body was never simply a collection of symptoms waiting to be silenced.

To understand that her hormones, her immune system, her nervous system, and her reproductive organs were never separate stories.

They were all part of mine.

At sixteen, I didn’t know how to ask what was happening to me.

Today, I know how to ask. And I know why those questions matter.

And I will spend the rest of my life making sure other women know they have the right to ask those questions, too.

Because the answer to a woman’s pain cannot always be to silence another part of her body.

Sometimes healing begins when we stop asking her to be quiet, and finally learn to listen to everything she has been trying to tell us.