Endometriosis Treatment

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 endometriosis treatment to achieve longer-lasting relief.

Why is endometriosis treatment complex?

Though we now have a better understanding of endometriosis, the exact cause of the disease is still 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 serve to reduce symptoms for a temporary period and do not fully treat the disease. The best treatment involves laparoscopic deep excision surgery and a comprehensive multidisciplinary treatment plan.