Does A Hysterectomy Get Rid Of Endometriosis and Fibroids: What to Know

Does A Hysterectomy Get Rid Of Endometriosis and Fibroids: What to Know

A hysterectomy—the surgical removal of the uterus—is one of the most common gynecologic surgeries. But does it cure endometriosis or fibroids? The short answer: it reliably eliminates uterine fibroids by removing the organ where they grow, but it does not necessarily cure endometriosis, which can exist and continue outside the uterus. Here is what to know, based on guidance from leading medical organizations and U.S. health agencies.

Quick answer

  • Fibroids: Because fibroids grow in the uterus, removing the uterus removes the fibroids and prevents them from coming back. Symptoms tied to the uterus—like heavy bleeding—typically resolve. (ACOG; NIH/NICHD)
  • Endometriosis: Hysterectomy is not a guaranteed cure. Endometriosis lesions can occur outside the uterus (e.g., on ovaries, peritoneum, bowel). Symptoms may persist or recur unless endometriosis lesions are thoroughly treated, and hormonal factors addressed. (ACOG; NIH MedlinePlus)

Understanding fibroids vs. endometriosis

Uterine fibroids (leiomyomas) are noncancerous muscle tumors that form in the wall of the uterus. They can cause heavy menstrual bleeding, pelvic pressure, anemia, and fertility challenges. They are confined to the uterus. (NIH/NICHD)

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, most often in the pelvis. It can cause pelvic pain, painful periods, pain with sex, and infertility. Because it’s often outside the uterus, simply removing the uterus does not remove all endometriosis. (ACOG)

Will a hysterectomy get rid of fibroids?

Yes—if the uterus is removed, fibroids go with it, and new fibroids cannot grow. Hysterectomy is considered a definitive solution for fibroid-related heavy bleeding and bulk symptoms in those who do not desire future fertility. If the cervix is retained (supracervical hysterectomy), rare fibroids in cervical tissue could persist, but this is uncommon. Decisions about removing the cervix are individualized. (ACOG)

Does a hysterectomy cure endometriosis?

Not necessarily. Endometriosis can be present on the ovaries, fallopian tubes, peritoneum, and other pelvic or abdominal organs. A standard hysterectomy removes the uterus (and sometimes cervix) but not the ovaries or endometriosis lesions elsewhere. Even when the ovaries are removed (oophorectomy), lesions can remain or recur. Hormonal suppression after surgery may help reduce symptoms for some, but the key to symptom relief is meticulous identification and treatment (often excision) of endometriosis lesions at the time of surgery. (ACOG; NIH MedlinePlus)

Types of hysterectomy and what they mean for symptoms

  • Total hysterectomy: Removes the uterus and cervix.
  • Supracervical (subtotal) hysterectomy: Removes the uterus but leaves the cervix.
  • Hysterectomy with salpingo-oophorectomy: May also remove one or both fallopian tubes and ovaries. Removal of fallopian tubes is sometimes performed to reduce the future risk of ovarian cancer; ovary removal causes immediate menopause if both are removed. (ACOG)

For endometriosis, surgeons may combine hysterectomy with excision of visible endometriosis lesions and, in select cases, removal of ovaries to reduce estrogen stimulation. However, this must be balanced against the risks of surgical menopause (e.g., bone density loss, cardiovascular changes, vasomotor symptoms). Decisions should be individualized based on age, symptom severity, response to prior therapies, and fertility goals. (ACOG)

Risks, recovery, and long-term considerations

  • Surgical risks: Bleeding, infection, anesthesia risks, injury to surrounding organs, blood clots. (NIH MedlinePlus)
  • Recovery: Most people need several weeks to resume normal activity (varies by surgical approach—vaginal, laparoscopic, or abdominal). Pain is usually manageable with standard regimens. (ACOG)
  • Menopause considerations: If both ovaries are removed, menopause occurs immediately. This can affect bone, heart, and sexual health; hormone therapy may be considered when appropriate. (ACOG)
  • Fertility: Hysterectomy ends the ability to carry a pregnancy. If future genetic parenthood is desired, discuss options such as egg or embryo freezing prior to surgery.

Alternatives to hysterectomy

For fibroids

  • Medication: Options include hormonal IUDs, combined hormonal contraceptives, tranexamic acid for heavy bleeding, and GnRH modulators. The FDA has approved oral GnRH antagonist combinations for heavy menstrual bleeding due to fibroids, such as relugolix combination therapy (Myfembree). (FDA)
  • Uterus-sparing procedures: Myomectomy (surgical removal of fibroids), uterine artery embolization, radiofrequency ablation, or MRI-guided focused ultrasound can reduce symptoms while preserving the uterus. (ACOG; ACOG on UAE)

For endometriosis

  • Medication: First-line therapies often include hormonal suppression (combined oral contraceptives, progestins, levonorgestrel IUD). GnRH analogs and antagonists can reduce pain by lowering estrogen levels; the FDA has approved elagolix (Orilissa) for moderate-to-severe endometriosis pain and extended indications for relugolix combination (Myfembree) for endometriosis-associated pain. (FDA on elagolix; FDA on Myfembree for endometriosis)
  • Conservative surgery: Laparoscopic excision or ablation of endometriosis lesions can improve pain and fertility for many patients while preserving reproductive organs. Outcomes are best when lesions are thoroughly identified and treated. (ACOG)
  • Multidisciplinary care: Pelvic floor physical therapy, targeted pain management, and treatment of overlapping conditions (e.g., bladder pain syndrome, IBS) may be valuable.

When is hysterectomy considered?

Hysterectomy is typically reserved for individuals who are done with childbearing and have persistent, significant symptoms that do not respond to medical or less invasive surgical treatments. For fibroids, it is a definitive option. For endometriosis, it may be considered when pain is severe and refractory, ideally combined with excision of endometriosis and individualized decisions about the ovaries. Shared decision-making with a gynecologist experienced in complex pelvic pain is essential. (ACOG)

Questions to ask your clinician

  • Are my symptoms more consistent with fibroids, endometriosis, or both?
  • What imaging or diagnostic steps can clarify the diagnosis?
  • What are my uterus-sparing options and how do their outcomes compare?
  • If considering hysterectomy, will you also remove visible endometriosis? What is the plan regarding my ovaries and fallopian tubes?
  • How will surgery affect my fertility, hormones, bone health, and cardiovascular risk?
  • What should I expect for recovery time and pain control?

Bottom line

Hysterectomy reliably eliminates fibroids by removing the uterus, and it can be life-changing for those with debilitating bleeding and bulk symptoms. For endometriosis, hysterectomy alone is not a cure because lesions often exist outside the uterus. The best outcomes come from a tailored plan—accurate diagnosis, expert lesion treatment, thoughtful decisions about the ovaries, and consideration of medical therapies. Work with a trusted gynecologic specialist to choose the safest, most effective path for your goals and life stage.

Sources and further reading

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