A hysterectomy is the surgical removal of all or part of the uterus. It may help treat severe endometriosis, but endometrial changes and symptoms may still occur after the procedure.

Endometriosis is a condition that occurs when the endometrial tissue that ordinarily lines the uterus grows outside the uterus, causing pain and other symptoms.

A hysterectomy may relieve endometriosis symptoms, but it is not a cure for endometriosis. In some cases, endometriosis symptoms may persist or recur following the procedure.

This article outlines the causes of endometriosis after hysterectomy. It lists some of the symptoms and complications of the condition, outlines other treatment options, and offers advice on when to see a doctor.

Finally, it discusses the outlook for people living with endometriosis symptoms following a hysterectomy.

Learn more about hysterectomy and when it is needed here.

A doctor talking to a person about endometriosis developing or persisting after a hysterectomy.Share on Pinterest
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There is no cure for endometriosis, though treatments can help alleviate symptoms of the condition. Conservative treatment options include pain medication and hormone treatments. If these prove ineffective, a doctor may recommend surgical options, such as a hysterectomy.

A hysterectomy involves the removal of some or all of the uterus. In some cases, a hysterectomy may also involve removing other tissues and organs, such as the cervix, ovaries, and fallopian tubes.

While a hysterectomy can provide symptom relief in some cases, it may be ineffective in others. Below are some potential explanations for endometriosis following hysterectomy.

Learn more about endometriosis at MNT’s dedicated hub.

Spread of endometrial tissue

A 2017 case report discusses how one individual developed endometriosis following a hysterectomy for an unrelated condition. The researchers hypothesize that the procedure may have spread endometrial tissue outside the uterus.

Despite this report, it remains extremely rare for endometriosis symptoms to begin after hysterectomy.

Ovarian preservation

Some researchers recommend that people with severe endometriosis receive a total hysterectomy with bilateral salpingo-oophorectomy, which is the removal of the uterus and both ovaries and fallopian tubes.

These researchers state that leaving the ovaries intact enables the continued production of hormones that may stimulate microscopic endometrial lesions. This may lead to persistent or recurrent endometriosis symptoms.

However, some people with endometriosis choose to conserve their ovaries and fallopian tubes so they can have children. Doctors can perform different surgeries to preserve the reproductive organs. A person can talk with a doctor for advice on individual treatment options.

Ovarian remnant syndrome

Some people may choose to undergo an oophorectomy, which is the surgical removal of one or both ovaries.

A person may experience ovarian remnant syndrome following an oophorectomy, but this is rare. This is where some ovarian tissue — potentially even microscopic amounts — remains after the oophorectomy. The residual ovarian tissue could worsen endometriosis or cause endometriosis-like symptoms.

Anyone who experiences pain or unusual urinary or bowel symptoms following an oophorectomy should notify a doctor right away.

Hormone replacement therapy

Depending on the type of hysterectomy a person undergoes, they may experience surgical menopause, in which the body stops producing estrogen. Hormone replacement therapy (HRT) helps restore hormone levels and can reduce uncomfortable menopause symptoms.

On rare occasions, HRT can re-trigger endometriosis, even in people who have undergone a hysterectomy. Anyone considering HRT should speak with their doctor about the potential risks.

The symptoms of endometriosis can vary according to the location and extent of the endometrial tissue. Some of the more common symptoms include:

A person who experiences severe period pain combined with one or more of the above symptoms should visit a doctor for a checkup.

In some cases, endometriosis can cause complications ranging from mild to severe. Some examples include:

  • damage to affected organs
  • ongoing pelvic pain that interferes with daily activities
  • fertility issues

Endometriosis is different for everyone. Complications that may arise vary according to:

  • the person’s age
  • the severity of the condition
  • the point at which the person received a diagnosis and began treatment
  • whether the person wants to have children

There is no cure for endometriosis. However, treatments are available to help manage the symptoms.

The most common treatments are:

Hormone therapy

Endometrial tissue responds to hormones within the body and may bleed during a person’s menstrual cycle.

Certain types of hormone therapy prevent the ovaries from producing hormones, such as estrogen. This may help slow the growth of existing endometrial lesions, though it will not remove them.

Some of the more common hormone therapy medications for endometriosis include:

Pain management medication

Effective pain management is an important aspect of endometriosis treatment. Anyone experiencing endometriosis should consult a doctor about pain management.

In some cases, over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) can help to reduce pain and inflammation. If these treatments are ineffective, a doctor may prescribe stronger pain relief.


Doctors may recommend surgery to treat severe endometriosis pain that does not respond to more conservative treatments, such as pain relief medication or hormone therapy.

A surgeon can perform a laparoscopy to remove endometrial lesions and scar tissue. This procedure can help reduce pain for individuals who have deep endometrial lesions.

Sometimes, a surgeon may recommend a hysterectomy to remove the uterus and the cervix. If necessary, a surgeon may also remove the ovaries and fallopian tubes.

According to research, as many as 8 in 10 people will experience pain within 2 years of surgery for endometriosis. Surgery is an invasive and painful procedure that will not suit everyone. Anyone considering surgical options for endometriosis should talk with their doctor for further advice.

A person should see a doctor if they experience symptoms of endometriosis. Anyone who has had a hysterectomy to help treat endometriosis symptoms should visit a specialist to explore further treatment options.

Endometriosis affects around 10% of females of reproductive age.

There are currently no simple blood tests or imaging studies widely available to detect endometriosis, so doctors will either use a presumptive diagnosis based on a patient’s history or a definitive diagnosis based on surgery. A delayed diagnosis can lead to unnecessary pain and discomfort.

Many people experience relief from endometriosis symptoms after a hysterectomy. However, endometriosis returns in up to 15% of people who undergo a bilateral salpingo-oophorectomy.

Anyone experiencing endometriosis symptoms following a hysterectomy should visit a doctor as soon as possible. The doctor will assess a person’s medical history and current symptoms to determine whether the endometriosis has recurred.

Further research is necessary to improve diagnostic tools for recognizing endometriosis. A better understanding of the disease will improve treatment methods moving forward. For now, early diagnosis and treatment are the best options for minimizing the effects of endometriosis.

Endometriosis is a medical condition in which the endometrial tissue that ordinarily lines the uterus grows outside the uterus. Depending on the location and extent of endometrial lesions, this can result in pain and other symptoms. Doctors may recommend a hysterectomy to help treat severe endometriosis symptoms that have not responded to conservative treatment.

However, endometriosis can recur following a hysterectomy. Factors that may affect recurrence include the type of hysterectomy a person has, whether there were surgical complications, and whether the person used HRT following the surgery.

People who continue to experience endometriosis symptoms following a hysterectomy should consult with a doctor. A doctor can recommend the most effective treatment strategies to help manage pain and other symptoms going forward.