What Determines the Right Treatment for Me?
The right starting point depends on the severity of your symptoms, the extent of the disease, and whether you are hoping to fall pregnant in the near future. When pain is the main concern, medication is usually tried first, with surgery kept as an option if symptoms do not settle.
A detailed mapping scan shows how extensive the disease actually is, which makes this decision far more precise than one based on symptoms alone.
What Medications Are Used?
Pain relievers such as nonsteroidal anti-inflammatory drugs are often the first step, alongside hormonal options including the contraceptive pill, progestin-only medication, or gonadotropin-releasing hormone agonists. These hormonal treatments work by slowing the growth of endometrial tissue and limiting new adhesions, though they do not remove tissue that has already formed. Read more about managing symptoms with these options.
When Is Surgery Recommended?
Surgery is considered when medication has not brought enough relief, when endometriomas or significant adhesions are present, or when fertility is a priority.
It is also recommended when mapping shows deep endometriosis affecting the bowel or urinary tract. Dr Groenewald performs both laparoscopic and robotic-assisted excision surgery, and removing endometriosis in this way can relieve pain and, in many cases, improve the chances of falling pregnant.
Can Endometriosis Be Cured?
Surgery brings relief from pain for most women, though it is not always permanent. Roughly 40 to 80 percent of women experience some return of pain within two years, with more severe disease more likely to recur. Continuing hormonal treatment after surgery can help extend how long that relief lasts.
In cases of severe pain that does not settle despite treatment, a hysterectomy is sometimes discussed as a last resort. This is not a step taken lightly, and it is one that Dr Groenewald would only raise once other options have genuinely been exhausted, with a full explanation of what it would and would not resolve for you.
