Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside it, causing inflammation, pain and, in some cases, difficulty getting pregnant. There is no single answer for everyone: treatment is chosen based on your symptoms, your pregnancy plans and how advanced it is.
Treatment with medication (hormonal)
Medical treatment aims to control symptoms — mainly pain and bleeding — by reducing the hormonal stimulation of the lesions (hormonal contraceptives, progestins and other options). It is a good first option when symptoms are manageable and pregnancy is not being sought immediately. Its limit: it does not remove existing lesions, and symptoms often return when it is stopped.
Surgery (minimally invasive excision)
Surgery aims to remove the endometriosis lesions by laparoscopic excision — no open abdomen, small incisions — and also allows a precise diagnosis. It is especially considered when:
- Pain does not respond to medical treatment or affects your quality of life.
- There is an endometrioma (endometriosis cyst in the ovary).
- There is deep endometriosis involving the bowel or bladder.
- You are seeking pregnancy or there is associated infertility.
- The diagnosis needs to be confirmed.
How is it decided?
At your evaluation we review the intensity of your symptoms, your desire for pregnancy, the presence of an endometrioma or deep disease, and your previous response to medication, together with your imaging. Often it is not "one or the other": it is common to operate to remove the lesions and then use hormonal treatment to space out recurrence. The goal is symptom control, fertility when desired, and quality of life.
Frequently asked questions
Does medication cure endometriosis?
It does not remove existing lesions; it controls symptoms while taken, which usually return when stopped.
Does surgery cure endometriosis?
Excision removes visible lesions and can greatly improve pain and, in selected cases, fertility, and confirms the diagnosis. It can recur over time, so we speak of control and quality of life rather than a definitive cure.
When is surgery considered?
When pain does not respond to medication, when there is an endometrioma or deep disease, when seeking pregnancy or with infertility, or to confirm the diagnosis.
Can medication and surgery be combined?
Yes, frequently: surgery to remove lesions, then hormonal treatment to space out recurrence. The plan is individual.