The Role of Hysterectomy in the Management of Endometriosis

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This review explores current knowledge and uncertainties in endometriosis management, focusing on the potential implications of hysterectomy as a treatment option.

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This paper reviews the management of endometriosis, emphasizing that, because there is no cure, treatment is best approached longitudinally with attention to disease features and sequelae, typically combining conservative measures and hormone suppression therapy, with surgery tailored to the patient and provider. It specifically explores what is known and unknown about hysterectomy’s potential implications, positioning hysterectomy as a key surgical topic within broader endometriosis management. A limitation is that the article is a narrative-type overview focused on updating considerations rather than presenting new empirical comparative outcomes or a systematic evidence synthesis. This paper is centrally about endometriosis — it focuses on the role and implications of hysterectomy in endometriosis management.

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Abstract

Endometriosis is a complex, chronic disorder that has the potential to produce long-term negative impact on the life and function of patients who carry this diagnosis. Endometriosis is thought to impact up to 10 to 15% of women across the globe and up to 90% of patients with pelvic pain. Yet, many questions remain regarding the true pathogenesis of this disease, as well as the best approach to surveillance and treatment. What we do know is that, as there remains no cure for endometriosis, management of this disease is best achieved with a longitudinal approach, with consideration of immediate disease features and other potential sequelae. The ideal treatment approach typically involves more conservative lifestyle changes, including dietary modifications, and incorporation of medication therapy, typically at the very least involving some form of hormone suppression therapy. The role of surgery remains dependent on both the patient's clinical course and the provider. Here, we explore both the known and the unknown in endometriosis management, with key updates on the potential implications of hysterectomy.
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Abstract

Endometriosis is a complex, chronic disorder that has the potential to produce long-term negative impact on the life and function of patients who carry this diagnosis. Endometriosis is thought to impact up to 10 to 15% of women across the globe and up to 90% of patients with pelvic pain. Yet, many questions remain regarding the true pathogenesis of this disease, as well as the best approach to surveillance and treatment. What we do know is that, as there remains no cure for endometriosis, management of this disease is best achieved with a longitudinal approach, with consideration of immediate disease features and other potential sequelae. The ideal treatment approach typically involves more conservative lifestyle changes, including dietary modifications, and incorporation of medication therapy, typically at the very least involving some form of hormone suppression therapy. The role of surgery remains dependent on both the patient's clinical course and the provider. Here, we explore both the known and the unknown in endometriosis management, with key updates on the potential implications of hysterectomy. Publication History Article published online: 09 December 2025 © 2025. Thieme. All rights reserved. Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA -

References

- 1 Tomassetti C, Johnson NP, Petrozza J. et al; International working group of AAGL, ESGE, ESHRE, and WES. An international terminology for endometriosis, 2021. J Minim Invasive Gynecol 2021; 28 (11) 1849-1859 - 2 Falcone T, Flyckt R. Clinical management of endometriosis. Obstet Gynecol 2018; 131 (03) 557-571 - 3 Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril 2014; 101 (04) 927-935 - 4 De Corte P, Klinghardt M, von Stockum S, Heinemann K. Time to diagnose endometriosis: current status, challenges and regional characteristics-a systematic literature review. BJOG 2025; 132 (02) 118-130 - 5 Agarwal SK, Chapron C, Giudice LC. et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019; 220 (04) 354.e1-354.e12 - 6 Parasar P, Ozcan P, Terry KL. Endometriosis: epidemiology, diagnosis and clinical management. Curr Obstet Gynecol Rep 2017; 6 (01) 34-41 - 7 Frankel LRA. A 10-year journey to diagnosis with endometriosis: an autobiographical case report. Cureus 2022; 14 (01) e21329 - 8 Ballard K, Lowton K, Wright J. What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis. Fertil Steril 2006; 86 (05) 1296-1301 - 9 Saunders PTK, Horne AW. Endometriosis: etiology, pathobiology, and therapeutic prospects. Cell 2021; 184 (11) 2807-2824 - 10 Chauhan S, More A, Chauhan V, Kathane A. Endometriosis: a review of clinical diagnosis, treatment, and pathogenesis. Cureus 2022; 14 (09) e28864 - 11 Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, Becker CM. The management of menopause in women with a history of endometriosis: a systematic review. Hum Reprod Update 2017; 23 (04) 481-500 - 12 Kitawaki J, Kado N, Ishihara H, Koshiba H, Kitaoka Y, Honjo H. Endometriosis: the pathophysiology as an estrogen-dependent disease. J Steroid Biochem Mol Biol 2002; 83 (1–5): 149-155 - 13 Bulun SE, Monsavais D, Pavone ME. et al. Role of estrogen receptor-β in endometriosis. Semin Reprod Med 2012; 30 (01) 39-45 - 14 Kvaskoff M, Mu F, Terry KL. et al. Endometriosis: a high-risk population for major chronic diseases?. Hum Reprod Update 2015; 21 (04) 500-516 - 15 Andres MP, Arcoverde FVL, Souza CCC, Fernandes LFC, Abrão MS, Kho RM. Extrapelvic endometriosis: a systematic review. J Minim Invasive Gynecol 2020; 27 (02) 373-389 - 16 Abrao MS, Andres MP, Miller CE. et al. AAGL 2021 endometriosis classification: an anatomy-based surgical complexity score. J Minim Invasive Gynecol 2021; 28 (11) 1941-1950.e1 - 17 Barnard ND, Holtz DN, Schmidt N. et al. Nutrition in the prevention and treatment of endometriosis: a review. Front Nutr 2023; 10: 1089891 - 18 Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain 2009; 10 (09) 895-926 - 19 Endometriosis: Diagnosis and Management NICE Guideline. 2017. Accessed October 24, 2025 at: www.nice.org.uk/guidance/ng73 - 20 Duffy JMN, Arambage K, Correa FJS. et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2014; 2014 (04) CD011031 - 21 Bafort C, Beebeejaun Y, Tomassetti C, Bosteels J, Duffy JMN. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2020; 10 (10) CD011031 - 22 Pundir J, Omanwa K, Kovoor E, Pundir V, Lancaster G, Barton-Smith P. Laparoscopic excision versus ablation for endometriosis-associated pain: an updated systematic review and meta-analysis. J Minim Invasive Gynecol 2017; 24 (05) 747-756 - 23 Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstet Gynecol 2008; 111 (06) 1285-1292 - 24 Zafrakas M, Grimbizis G, Timologou A, Tarlatzis BC. Endometriosis and ovarian cancer risk: a systematic review of epidemiological studies. Front Surg 2014; 1: 14 - 25 Saraswat L, Ayansina D, Cooper KG, Bhattacharya S, Horne AW, Bhattacharya S. Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study. BJOG 2018; 125 (01) 64-72 - 26 Kvaskoff M, Mahamat-Saleh Y, Farland LV. et al. Endometriosis and cancer: a systematic review and meta-analysis. Hum Reprod Update 2021; 27 (02) 393-420 - 27 Barnard ME, Farland LV, Yan B. et al. Endometriosis typology and ovarian cancer risk. JAMA 2024; 332 (06) 482-489 - 28 Moawad G, Youssef Y, Fruscalzo A. et al. The present and the future of medical therapies for adenomyosis: a narrative review. J Clin Med 2023; 12 (19) 6130 - 29 Adelman MR, Sharp HT. Ovarian conservation vs removal at the time of benign hysterectomy. Am J Obstet Gynecol 2018; 218 (03) 269-279 - 30 Casiano ER, Trabuco EC, Bharucha AE. et al. Risk of oophorectomy after hysterectomy. Obstet Gynecol 2013; 121 (05) 1069-1074 - 31 Madueke-Laveaux OS, Elsharoud A, Al-Hendy A. What we know about the long-term risks of hysterectomy for benign indication—a systematic review. J Clin Med 2021; 10 (22) 5335 - 32 Wilson LF, Pandeya N, Byles J, Mishra GD. Hysterectomy status and all-cause mortality in a 21-year Australian population-based cohort study. Am J Obstet Gynecol 2019; 220 (01) 83.e1-83.e11 - 33 Moorman PG, Myers ER, Schildkraut JM, Iversen ES, Wang F, Warren N. Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol 2011; 118 (06) 1271-1279 - 34 Choi HG, Jung YJ, Lee SW. Increased risk of osteoporosis with hysterectomy: A longitudinal follow-up study using a national sample cohort. Am J Obstet Gynecol 2019; 220 (06) 573.e1-573.e13 - 35 Li PC, Huang HK, Ding DC. Hysterectomy associated with de novo lower urinary tract symptoms in a Taiwanese population: a nationwide, population-based study. Int Urogynecol J 2019; 30 (10) 1711-1717 - 36 Laughlin-Tommaso SK, Satish A, Khan Z, Smith CY, Rocca WA, Stewart EA. Long-term risk of de novo mental health conditions after hysterectomy with ovarian conservation: a cohort study. Menopause 2020; 27 (01) 33-42 - 37 Georgakis MK, Beskou-Kontou T, Theodoridis I, Skalkidou A, Petridou ET. Surgical menopause in association with cognitive function and risk of dementia: a systematic review and meta-analysis. Psychoneuroendocrinology 2019; 106: 9-19 - 38 Dobson AJ, Xu Z, Wilson LF. et al. Menopause age and type and dementia risk: a pooled analysis of 233 802 women. Age Ageing 2024; 53 (11) afae254 - 39 Wedatilake Y, Myrstad C, Tom SE, Strand BH, Bergh S, Selbæk G. Female reproductive factors and risk of mild cognitive impairment and dementia: the HUNT study. J Prev Alzheimers Dis 2024; 11 (04) 1063-1072 - 40 Koebele SV, Bernaud VE, Northup-Smith SN. et al. Gynecological surgery in adulthood imparts cognitive and brain changes in rats: a focus on hysterectomy at short-, moderate-, and long-term intervals after surgery. Horm Behav 2023; 155: 105411 - 41 Koebele SV, Palmer JM, Hadder B. et al. Hysterectomy uniquely impacts spatial memory in a rat model: a role for the nonpregnant uterus in cognitive processes. Endocrinology 2019; 160 (01) 1-19 - 42 Wilson LF, Pandeya N, Byles J, Mishra GD. Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: the role of hysterectomy with ovarian conservation. Maturitas 2016; 91: 1-7

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (37)

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