When is hysterectomy recommended for endometriosis?

Endometriosis is tissue similar to the womb lining growing outside the uterus. It can affect the pelvis, bowel, bladder, or other areas. Removing the uterus prevents pregnancy and usually stops menstrual bleeding, but endometriosis outside the uterus can remain. The ovaries may be kept or removed, and that choice affects hormones and menopause timing.

Review pain patterns, previous medicines, hormonal treatment, and any surgery with an endometriosis-trained gynaecologist. Discuss whether visible endometriosis would also be treated, the effect on fertility, and what happens if the ovaries remain. Read about [Endometriosis](/conditions/endometriosis/) and [Hysterectomy](/treatments/gynaecological-surgery/hysterectomy/) as preparation for that conversation.

Seek medical review for new severe pelvic pain, pain with fever or vomiting, difficulty passing urine or stool, blood in urine or stool, or unexpected heavy bleeding. Sudden intense pain, faintness, or heavy bleeding needs urgent assessment rather than waiting for a planned surgical appointment.

Ask which symptoms surgery is expected to improve, whether lesions outside the uterus will be treated, and what pain could persist. Ask about ovarian conservation, fertility alternatives, the surgical route, recovery, and a plan for symptoms after the operation.