August 8, 2022 | by Tamer Seckin, MD
Endometriosis treatment focuses on relieving pain, controlling the progression of the condition, and improving quality of life. The approach depends on factors such as the severity of symptoms, age, and reproductive goals. Medications are often the first step, with options like hormonal therapies to suppress the menstrual cycle and reduce the activity of endometrial-like tissue. Pain management, typically with anti-inflammatory drugs, can also help ease daily discomfort.
For individuals who do not respond well to medication, surgical options may be considered. Laparoscopic surgery is commonly used to remove or destroy endometrial lesions while preserving healthy tissue. In more advanced cases, surgery may be combined with medical treatment for endometriosis to achieve longer-lasting relief.
Summary
Endometriosis treatment aims to alleviate pain, manage disease progression, and enhance quality of life. Treatment options vary based on symptom severity, age, and reproductive goals, often starting with medications like hormonal therapies and anti-inflammatory drugs for pain relief.
Surgical interventions, including laparoscopic deep excision surgery, may be necessary for those unresponsive to medication. This minimally invasive approach allows for the removal of endometrial lesions while preserving healthy tissue and fertility.
Why is endometriosis treatment complex?
Although we now have a better understanding of endometriosis, the exact cause remains unclear. Due to the fact that endometriosis symptoms often overlap with those of other diseases, the diagnosis itself is quite complex. Currently, there is no simple blood or imaging test that definitely diagnoses this disease. This often leads to numerous treatments or unwarranted surgical interventions. Moreover, this disease can progress to eventually involve other organ systems, such as the gastrointestinal, urinary, and/or pulmonary systems.
Surgical methods for endometriosis treatment
Laparoscopic deep excision surgery
Laparoscopic deep excision surgery is currently the preferred method for endometriosis diagnosis and treatment. It involves visualization and complete removal of endometriosis lesions. It is a type of minimally invasive surgery that doctors can do via small incisions in the abdomen / pelvic region.
Dr. Seckin’s team at the Seckin Endometriosis Center has years of experience in laparoscopic deep excision surgery and has adapted the procedure with their own techniques. They include manual cold excision of the lesion from its root, enhanced visualization using a patented Aqua Blue Contrast dye, and reconstructive techniques. This allows for full recovery while preserving the patient’s fertility.
We do not advocate for hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries) unless necessary or by patient choice in endometriosis treatment. Removal of the uterus and ovaries does not guarantee that symptoms will not recur; therefore, patients must receive complete counseling on the risks and benefits of such procedures.
Myomectomy
Myomectomy is the removal of uterine fibroids with the goal of fertility preservation. Though myomectomy preserves the uterus, it is a more invasive procedure and requires larger incisions than hysterectomy, as fibroids often penetrate deep into the uterine wall. A myomectomy can be performed in many different ways, depending on the technique that the doctor uses and the location of the fibroids.
Oophorectomy
Oophorectomy is the removal of one or both ovaries. The procedure may be performed alone or in combination with a hysterectomy. Oophorectomy can help treat extremely severe forms of ovarian endometrioma, non-cancerous cysts, cancer, or necrotic ovaries. Oophorectomy, if bilateral, leads to surgical menopause. Unilateral oophorectomy does not result in surgical menopause provided that healthy tissue remains. In the treatment of endometriosis, cystectomy is preferred over oophorectomy to preserve fertility.
Hysterectomy
Hysterectomy refers to the surgical removal of the uterus. It can be a total hysterectomy (uterus and cervix) or supracervical/partial (uterus alone) with or without preservation of the ovaries. Often, the doctors also remove the fallopian tubes in all types of hysterectomy as this decreases the future risk of ovarian cancer. They can perform a hysterectomy via the abdomen or the vagina. Dr. Harry Reich pioneered the first laparoscopic hysterectomy in 1988. The procedure results in complete cessation of menstruation and causes surgical infertility.
Goals of endometriosis treatment
The goals of endometriosis treatment are to manage pain, slow disease progression, and improve daily functioning. Since endometriosis can cause chronic discomfort, the first aim is to reduce pain so that everyday activities become easier and less physically draining. Pain relief also supports emotional well-being, as living with persistent discomfort can significantly affect mood and quality of life.
Another important goal is to limit the growth and spread of endometrial-like tissue. By controlling the activity of these lesions, treatment can help prevent further organ damage and reduce the risk of worsening symptoms over time. In some cases, preserving or improving fertility is also a key objective, especially for individuals who wish to conceive in the future.
Choosing the right treatment plan for you
Choosing the right treatment plan for endometriosis starts with understanding the severity of your symptoms, your medical history, and your future goals, such as preserving fertility. A thorough medical evaluation, including imaging tests and a detailed discussion of symptoms, helps determine the most suitable options. Treatment can range from medication to control pain and hormone levels, to surgical procedures aimed at removing endometrial lesions.
The choice also depends on how the condition affects daily life. For those with mild symptoms, lifestyle changes combined with pain relief may be enough to maintain comfort. In more advanced cases, a combination of medical therapy and surgery may provide better results.
What is the most effective treatment for endometriosis?
The most effective treatment for endometriosis depends on the severity of symptoms, the extent of the disease, and personal health goals. For many, a combination of hormonal therapy and pain management offers significant relief by reducing the activity of endometrial-like tissue and controlling inflammation. Hormonal options such as birth control pills, progestins, or gonadotropin-releasing hormone (GnRH) agonists can help suppress the menstrual cycle and slow lesion growth.
In cases where medication alone is not enough, laparoscopic surgery is often considered. This minimally invasive procedure allows for the removal or destruction of endometrial implants while preserving healthy tissue. Surgery can be particularly beneficial for those with severe pain, organ involvement, or fertility concerns.
Non-surgical methods for endometriosis treatment
Non-surgical treatment methods such as nonsteroidal anti-inflammatory drugs (NSAIDs), progestin-only contraceptive pills, and GnRH analogs may help manage some of the symptoms of endometriosis. However, these may only reduce symptoms temporarily and do not fully treat the disease. The best treatment involves laparoscopic deep excision surgery and a comprehensive multidisciplinary treatment plan.
FAQ
What is the best treatment for endometriosis?
The most effective treatment for endometriosis is laparoscopic deep excision surgery, which involves the complete removal of endometrial lesions from their root. Unlike ablation, which only burns the surface of lesions, excision addresses the disease at its origin and significantly reduces recurrence rates. For patients with mild symptoms, hormonal therapy may provide temporary relief, but it does not eliminate the disease. At Seckin Endometriosis Center, deep excision surgery is the cornerstone of our approach to achieving long-term remission.
Can endometriosis be treated without surgery?
Non-surgical options such as NSAIDs, hormonal contraceptives, progestins, and GnRH agonists can help manage pain and slow the progression of endometriosis. However, these treatments suppress symptoms rather than eliminate the disease. They may be appropriate for patients with mild symptoms or those who are not yet ready for surgery, but they do not remove existing lesions. For moderate to severe endometriosis, surgery remains the most effective long-term solution.
Does a hysterectomy cure endometriosis?
A hysterectomy does not guarantee a cure for endometriosis. Endometrial-like tissue can exist outside the uterus — on the ovaries, bowel, bladder, diaphragm, and other organs — and removing the uterus does not address these implants. Symptoms can persist or recur even after hysterectomy if residual lesions are left behind. At Seckin Endometriosis Center, we recommend complete excision of all visible disease rather than hysterectomy as a primary treatment, except in select cases where the patient’s condition warrants it.
How long is the recovery after endometriosis excision surgery?
Recovery after laparoscopic excision surgery typically ranges from two to six weeks, depending on the extent of the disease and the organs involved. Most patients return to light activities within one to two weeks. Cases involving bowel, bladder, or diaphragmatic involvement may require a longer recovery period. Our surgical team provides individualized post-operative guidance to support a safe and complete recovery.
Will endometriosis treatment improve my fertility?
For many patients, excision surgery can improve fertility outcomes by removing lesions that interfere with ovarian function, tubal patency, and the pelvic environment. Studies show that surgical treatment of endometriosis can increase natural conception rates and improve IVF success when the procedure is performed by an experienced specialist. However, the impact on fertility depends on the severity of the disease and individual factors. We work closely with reproductive specialists to develop a fertility-preserving treatment plan when needed.
Is endometriosis treatment covered by insurance?
In many cases, endometriosis treatment — including diagnostic laparoscopy and excision surgery — is covered by health insurance, as it is a medically necessary procedure. However, coverage varies by plan, provider, and the specific procedures performed. We recommend contacting your insurance provider directly and reviewing your policy for details on coverage, deductibles, and out-of-pocket costs. Our patient services team can assist with insurance-related questions during your consultation.
Get a Second Opinion
Our endometriosis specialists are dedicated to providing patients with expert care. Whether you have been diagnosed or are looking to find a doctor, they are ready to help.Our office is located on 872 Fifth Avenue New York, NY 10065.
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