⚕️ The content of this website is for informational and educational purposes only and does not replace professional medical advice, diagnosis or treatment. Always consult a doctor if you have health concerns.

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 definitively cure it. The goal of care is therefore not only the removal of lesions, but long-term relief of symptoms, slowing disease progression, preserving or improving fertility and above all improving quality of life.

This principle is also emphasised by the consensus of the World Endometriosis Society published in the journal Human Reproduction in 2013. The authors stress the need for individualised, long-term treatment strategies that take into account not only medical findings but also the preferences, life situation and priorities of the individual woman. Significantly, in this international consensus process, representatives of 16 patient and support organisations participated alongside professional societies, reinforcing the emphasis on the patient perspective.

Three core approaches

1. Hormonal treatment

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

Options include hormonal contraception, the hormonal intrauterine device, progestins or GnRH analogues. For some women, however, pain relief may be only temporary. Hormonal treatment does not completely remove lesions and symptoms may return after stopping. It is appropriate for women who do not plan pregnancy in the near future and whose symptoms can be managed in this way.

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 all lesions causing pain or reducing the chance of conception during a single procedure.

Surgical treatment provides longer-lasting pain relief and significantly increases the chances of conception in women with fertility problems. 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.

Supportive care complements both hormonal and surgical treatment and helps manage the condition long-term.

How is treatment decided?

The WES consensus emphasises that women may differ in how they perceive surgical risks, possible side effects of medications and the goals of treatment itself. Therefore, even in seemingly identical clinical situations, different treatment approaches may be chosen. Treatment of endometriosis should therefore always be individualised and arise as a shared decision between doctor and patient. When selecting the most appropriate approach, 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 treatment options are not suitable if you are currently trying to conceive
  • side effect tolerance - each woman may respond differently to hormonal and other treatment
  • age and general health
  • previous treatment - what you have already tried and what effect it had
  • your personal preferences and priorities - for example pain relief, preserving fertility, improving quality of life or 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

It is important to have realistic expectations:

  • 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 Frydek-Mistek 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.