I'm just sharing this article with you all, as it never fails to amaze me how many ladies believe this common myth, and think that a hysterectomy is a treatment for endo, it really is NOT!
"Is a hysterectomy with removal of the ovaries really a good treatment for endometriosis?
NO, it is not. Hysterectomy does not treat endometriosis but will resolve any problems caused by the uterus itself. Endometriosis involves areas outside the uterus. If a patient with endometriosis also happens to have problems with her uterus (causing uterine pain) then she may find some pain relief from hysterectomy but this is not because the operation removes or resolves her endometriosis.
Removal of the ovaries can reduce the symptoms associated with endometriosis because the ovaries are the body's main source of estrogen... take away the main source of estrogen and endometriosis may well become less symptomatic or asymptomatic, although it won't make it go away (in 85% of patients removal of the ovaries resolves their endometriosis-related pain)... so you might say "wow that's a great treatment for endometriosis!"... but... removal of the ovaries is generally combined with removal of the uterus (so it's unclear how much of the pain relief is due to the low-estrogen effects on endometriosis and not on concurrent uterine pain), surgical menopause often brings about SEVERE symptoms and can result in long-term health problems (some of which could ultimately significantly shorten your lifespan) and of course robs a woman of her fertility. The toll is therefore high, especially in young patients who still want to have children. Often the option is presented to patients when the doctor is unable to remove their endometriosis [edited to comply with our code of conduct]
Then there are the 15% of women who don't have relief despite hysterectomy and removal of the ovaries... the ovaries are not the only source of estrogen - endometriosis itself can synthesize estrogen and so can body fat... so even without ovaries, endometriosis may continue to be symptomatic. With this in mind, removal of a healthy woman's ovaries and uterus makes little sense in treating endometriosis.... removing the disease not the reproductive organs makes far more sense, brings fewer long-term health concerns and can bring the same, if not better, relief to the patient.
The only instances when the uterus should be removed is when the patient has uterine pain that does not respond to conservative treatments and/or there is something wrong with the uterus that requires its removal (such as severe bleeding or malignancy).
The ovaries should be preserved if at all possible - sometimes if a woman has recurrent or very large endometriomas too much ovarian tissue will be lost to save the ovaries or she may decide that removal is better than having to undergo repeated surgeries. In most cases endometriomas can be removed without removing the ovary and repeated recurrence of ovarian endometriomas following excision only affects an unlucky minority of patients.
If your doctor tells you hysterectomy with removal of the ovaries is your ONLY option... stop and seek a second opinion from an endometriosis specialist. Please never go into this surgery without first being fully informed of your options - while hysterectomy and bilateral oophorectomy (removal of both ovaries) has its place in gynecological surgery it's a treatment option that should not be taken lightly and should only be offered to select patients. "
[edited to comply with our code of conduct]
At this moment in time excision surgery with an endometriosis specialist is the gold standard treatment for endo. This is available to us at the BSGE Endo centres across the UK, if you live in England it's very simple to get referred to a specialist, the rules are different in the other regions but it is still possible. Please note the level of skill does vary with the consultants at the centres, so it's wise to do your research before you decide on which one to be referred to.