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Guides / Treatment

Treatment

In short

There is no cure. Treatment aims to control symptoms. Which option fits depends on the person, the side effects, whether pregnancy is wanted, and what is available. This is a map of the options guidelines name, not a prescription.

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No cure — symptom control

WHO says there is currently no cure, and no treatment that definitively cures the disease. Treatment aims to control symptoms and limit long-term impacts. The choice depends on severity, individual preferences, side effects, long-term safety, cost, availability, and whether pregnancy is desired.

WHO says symptoms can continue or return after treatment starts.

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Medicines for pain

WHO says NSAIDs such as ibuprofen and naproxen, and other painkillers, are often used for pain.

NICE says to discuss the benefits and risks of analgesics, and to consider a short trial — for example three months — of paracetamol or an NSAID, alone or together, as first-line management of endometriosis-related pain. If that trial does not give adequate relief, consider other pain management and referral.

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Hormonal treatment

WHO says hormonal medicines may reduce how severe pain is, or how often it happens, for some people. The methods it names are combined hormonal contraceptives (pill, patch, ring), progestins (hormonal IUD, DMPA), and GnRH analogues. It also mentions aromatase inhibitors as other hormonal modulators. Some of these are not suitable for people who want to become pregnant.

NICE says to offer hormonal treatment, for example the combined oral contraceptive pill or a progestogen, to people with suspected, confirmed, or recurrent endometriosis, and to explain that hormonal treatment can reduce pain and has no permanent negative effect on later fertility.

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Surgery, including hysterectomy

WHO says surgery can remove endometriosis lesions, adhesions, and scar tissue. How much it reduces pain, and how much it changes pregnancy rates, often depends on the extent of disease. Lesions may come back after they have been removed. Pelvic floor muscle problems can also contribute to chronic pelvic pain.

WHO says hysterectomy, usually with removal of the ovaries, may be considered for people who do not respond to other treatments and are not planning to have a child. It also says hysterectomy is not a cure, and some people still have symptoms afterwards.

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Fertility care

WHO says fertility treatments — ovulation induction, intrauterine insemination, or IVF — may be recommended for people who are having difficulty conceiving because of endometriosis. Among people with infertility, WHO says as many as 25–50% have endometriosis. That figure is about people already being seen for infertility. It is not the chance that any one person with endometriosis cannot conceive.

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Physiotherapy, psychology, and support

WHO says that alongside medical care, local patient groups can help, and that multidisciplinary pain care — including physiotherapy and cognitive behavioural therapy — can reduce endometriosis-associated pain for some people.

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  1. Fact sheetWHO fact sheet, endometriosis (15 October 2025)
  2. GuidelineNICE NG73 recommendations