Treatment options overview

Endometriosis cannot be cured, but symptoms can be significantly reduced. Hormonal treatment, surgery or supportive care - find out how treatment is chosen, what to expect from it, and why a personalised approach is key.

Treatment options for endometriosis

Endometriosis is a chronic condition and currently no method exists that can fully cure it. The goal of treatment is to relieve symptoms, slow disease progression, preserve or improve fertility and maximise quality of life.

The World Endometriosis Society (WES) in its landmark first-ever consensus on endometriosis management, published in Human Reproduction (2013), emphasises that the aim is to define "personalised, long-term treatment strategies that take into consideration the individual woman's point of view, as well as her priority for different outcomes." For the first time in history, 16 patient organisations participated in this consensus as full partners.

Three core approaches

1. Hormonal treatment

Endometriosis is oestrogen-dependent - the hormone stimulates lesion growth. Hormonal treatment suppresses menstruation and reduces oestrogen levels, preventing lesion growth and relieving pain.

Options include hormonal contraception, the hormonal intrauterine device (Mirena), progestins or GnRH analogues. As endometriosis.org honestly states: "Hormonal therapies have varying degrees of side effects and, unfortunately, whatever pain relief that is achieved may, for many, be only temporary." Hormonal treatment does not remove lesions and symptoms may return after it is stopped.

2. Surgical treatment

Surgery is the only method that physically removes endometriosis lesions. It is performed laparoscopically - minimally invasively, without a large incision. An experienced surgeon removes or destroys lesions, drains ovarian endometriomas and releases adhesions during a single procedure.

The outcome depends fundamentally on the surgeon's experience - making the choice of a specialist centre critical.

3. Pain management and supportive care

Chronic pain associated with endometriosis requires a comprehensive approach. NSAIDs help with acute menstrual pain. Pelvic floor physiotherapy, psychological support and lifestyle modifications can significantly improve daily functioning.

How is treatment decided?

The WES consensus emphasises that "women may have varying degrees of acceptance towards surgical risks or side effects of drugs, and may choose diverse therapeutic options" even in seemingly identical clinical situations. When choosing treatment, the doctor considers together with you:

  • Symptom intensity - how much pain and other problems disrupt your daily life
  • Disease extent - type and stage of endometriosis, presence of endometriomas or deep infiltrating endometriosis
  • Pregnancy planning - some methods are unsuitable for women who wish to conceive
  • Side effect tolerance - each woman responds to medications differently
  • Age and general health
  • Previous treatment - what you have already tried and how it worked
  • Your preferences and priorities - quality of life, fertility, avoiding surgery

Combining methods

In practice, treatment methods are often combined. For example, after surgical removal of lesions, hormonal treatment is started to delay potential recurrence. Or physiotherapy is combined with hormonal treatment for better pain management.

Endometriosis is a long-term condition and treatment changes throughout life - what works now may not be optimal in five years. Regular follow-up with a specialist is therefore an important part of care.

What treatment cannot guarantee

  • No treatment guarantees that endometriosis will not return
  • Hormonal treatment only works while you are taking it - symptoms may return after stopping
  • Even surgery may not be a definitive solution - lesions may reappear in some women over time
  • Treating one symptom may not resolve all problems - pain, fertility and quality of life are separate areas requiring their own approach

Where to seek help?

Endometriosis treatment should be led by a gynaecologist experienced with this condition, ideally at a specialist centre. Our centre in Frýdek-Místek is accredited by the Czech Ministry of Health as a centre of highly specialised care for the treatment of advanced forms of endometriosis.

If you are unsure which treatment is right for you, or would like a second opinion, book a consultation with us. We respond within 24 hours.

Global recommendations for endometriosis management: World Endometriosis Society - Management.