Gynecology · Pelvic health
Endometriosis Treatment in Seoul: Diagnosis and Long-Term Care
Endometriosis is a long-term condition in which tissue similar to the lining of the uterus grows outside it, usually on the ovaries and pelvic lining, causing painful periods, pelvic pain and sometimes difficulty getting pregnant. At Hommage Clinic in Gangnam, Seoul, OB/GYN specialist Dr. Park Yuna assesses your symptoms with an ultrasound and builds a medical plan to control pain and protect fertility.
Quick answer
Endometriosis treatment aims to control pain, slow the disease and protect fertility, because the condition cannot be cured permanently. At Hommage Women's Clinic in Gangnam, Seoul, female OB/GYN specialist Dr. Park Yuna diagnoses likely endometriosis from your symptoms, an exam and same-day ultrasound, then starts medical treatment such as a combined pill, dienogest or a hormonal IUD. Surgery is arranged through a hospital when cysts, deep disease or fertility make it worthwhile.
Key takeaways
- Endometriosis affects roughly 1 in 10 women of reproductive age, but diagnosis is often delayed for years.
- Current European guidelines (ESHRE 2022) allow treatment to start without laparoscopy, based on symptoms and imaging.
- A normal ultrasound does not rule endometriosis out; small surface patches are not visible on scans.
- If you hope to conceive, tell your doctor early: hormonal treatment prevents pregnancy, and cyst surgery can lower ovarian reserve.
Infographic
Endometriosis in numbers
Women affected
Of women and girls of reproductive age worldwide (WHO).
Worldwide
Estimated women and girls living with endometriosis.
Diagnostic delay
Average time from first symptoms to diagnosis cited by ESHRE.
Of women with infertility
Have endometriosis, according to the ESHRE guideline.
First assessment
History, exam and ultrasound together at Hommage Women's Clinic.
First review
Then every 6–12 months while treatment continues.
Endometriosis care at a glance
| Key fact | Details |
|---|---|
| What it is | Tissue similar to the uterine lining growing outside the uterus, causing inflammation and scarring |
| Common signs | Severe period pain, pelvic pain between periods, pain during sex, difficulty conceiving |
| How it's diagnosed | Symptom history, pelvic exam and ultrasound; MRI or laparoscopy at a hospital when needed |
| Treatment options | Pain relief, hormonal therapy (pill, dienogest, hormonal IUD), referral for surgery |
| Follow-up | Usually about 3 months after starting treatment, then every 6–12 months |
| Reviewed by | Dr. Park Yuna, OB/GYN specialist |
Book an endometriosis assessment if you have
- Period pain that stops you working, studying or sleeping, even with painkillers
- Pelvic pain between periods, or deep pain during sex
- Painful bowel movements or urination around your period
- An “endometrioma” or “chocolate cyst” found on a previous scan
- Painful periods and difficulty getting pregnant
Seek urgent care instead if you have
- Sudden, severe one-sided pelvic pain with nausea or vomiting
- Pelvic pain with a fever, fainting or feeling faint
- A positive pregnancy test with pain or bleeding
What is endometriosis?
Endometriosis is a chronic inflammatory condition in which tissue similar to the endometrium (the lining of the uterus) grows in places it should not, most often on the ovaries, the ligaments behind the uterus and the lining of the pelvis. The World Health Organization estimates that it affects roughly 10% of women and girls of reproductive age.
Like the uterine lining, this tissue responds to the monthly rise and fall of hormones. It causes inflammation and, over time, scar tissue (adhesions) that can stick pelvic organs together. When it grows inside an ovary it can form a fluid-filled cyst called an endometrioma, often nicknamed a “chocolate cyst” because of its dark contents. Endometriomas are one type of ovarian cyst and need their own follow-up plan.
A related condition, adenomyosis, occurs when this tissue grows into the muscle wall of the uterus. The two often occur together and are managed in similar ways.
What are the symptoms of endometriosis?
The most typical symptom is period pain that is severe, worsens over the years or does not respond well to ordinary painkillers. Other common symptoms include:
- Pelvic or lower back pain between periods
- Deep pain during or after sex
- Pain when passing stool or urine, especially around your period
- Heavy periods or spotting before a period
- Bloating, fatigue and difficulty getting pregnant
The amount of pain does not always match the amount of disease. Some women with small patches have strong pain, while others with large cysts have few symptoms. Because severe cramps are often dismissed as “normal”, diagnosis is frequently delayed by several years. If you are not sure whether your cramps are typical, our page on period pain treatment explains the difference, and our guide to pelvic pain covers other causes.
How is endometriosis diagnosed?
Endometriosis is usually diagnosed from your symptoms together with a pelvic exam and ultrasound, and treatment can often start without surgery. Current international guidelines, including those of the European Society of Human Reproduction and Embryology (ESHRE), no longer require laparoscopy before starting medical treatment.
At your visit, Dr. Park asks about your pain pattern and performs a transvaginal pelvic ultrasound . Ultrasound reliably shows endometriomas and can sometimes show deeper nodules or adenomyosis. Small surface patches are not visible on any scan, so a normal ultrasound does not rule endometriosis out.
If deep disease is suspected, or if symptoms do not improve with treatment, we refer you to a hospital for an MRI or diagnostic laparoscopy, a keyhole operation under general anesthesia that lets a surgeon see and remove lesions directly.
Endometriosis treatment options
There is no permanent cure, but most women can control their symptoms well with medication. The aim is to reduce pain, slow the growth of lesions and protect fertility.
- Pain relief: anti-inflammatory painkillers such as ibuprofen or naproxen are most effective when started at the first sign of a period.
- Combined birth control pills: often taken continuously to reduce or skip bleeds. See our guide tobirth control options.
- Progestin therapy: a daily progestin such as dienogest is a common first-line treatment in Korea and suppresses lesions over time.
- Hormonal IUD: a levonorgestrelIUDreleases hormone directly in the uterus and can ease pain, especially with adenomyosis.
- GnRH medications: used for short courses when other options fail, usually with “add-back” hormone to protect bone health.
Surgery is considered for large or growing endometriomas, deep disease affecting the bowel or bladder, severe pain despite medication, or some fertility situations. Hommage Clinic is an outpatient clinic, so laparoscopic surgery is carried out at a hospital. Dr. Park arranges the referral and can continue hormonal treatment afterwards to lower the chance of recurrence.
Can you get pregnant with endometriosis?
Yes. Many women with endometriosis conceive naturally, although the condition can make it take longer. Inflammation and scarring can affect the tubes and ovaries, and endometriomas or their surgical removal can reduce ovarian reserve.
If you hope to have children, tell us early. Hormonal treatments prevent pregnancy while you take them, so the plan changes when you start trying. An AMH test helps estimate ovarian reserve before decisions about cyst surgery. If you have known endometriosis and have not conceived after about 6 months, we recommend a fertility assessment rather than waiting a full year.
Possible side effects of endometriosis treatment
Every treatment carries possible side effects, and Dr. Park explains them before you start. Anti-inflammatory painkillers can upset the stomach and are not suitable for some people with stomach ulcers, kidney disease or asthma triggered by aspirin. Combined pills can cause nausea, breast tenderness and spotting, and carry a small risk of blood clots, so they are not prescribed if you smoke over age 35, have certain migraines or have a clotting history.
Progestins such as dienogest commonly cause irregular bleeding or spotting in the first months, and some women notice headaches, breast tenderness, acne or low mood. GnRH medications can cause hot flashes and bone thinning, which is why courses are limited. Call the clinic if you have heavy bleeding, worsening pain, severe mood changes, or leg swelling or chest pain on hormonal treatment.
Endometriosis care at Hommage Clinic
Hommage Clinic is a women's clinic in Gangnam, a short walk from Sinnonhyeon Station. Endometriosis care is led by Dr. Park Yuna, a female OB/GYN specialist, and the ultrasound is done during the same visit so you leave with an initial plan. Because endometriosis is long-term, you see the same doctor at follow-up, and your treatment can be adjusted if your pain, side effects or pregnancy plans change.
When surgery or advanced imaging is needed, we refer you to a hospital and share your records. If you are enrolled in Korea's National Health Insurance, many tests and medical treatments for endometriosis are covered; visitors without coverage pay the clinic's fees directly, and we explain costs before any test. You can also explore our other gynecology services .
How it works
Where does endometriosis grow? Types of endometriosis explained
Doctors describe endometriosis by where it is found and how deep it goes, because this shapes both the symptoms and the treatment. The three main types often occur together, and adenomyosis, a related condition inside the muscle wall of the uterus, is frequently found alongside them.
The ESHRE guideline defines deep endometriosis as lesions more than 5 mm below the surface of the pelvic lining. Deep lesions can involve the bowel, bladder or the ligaments behind the uterus, and they are the type most likely to cause pain with sex or bowel movements.
Self-check
Do I have endometriosis? Symptoms worth getting checked
No checklist can diagnose endometriosis, but certain symptoms make it more likely and are the ones the ESHRE guideline asks doctors to take seriously. In studies summarized by ESHRE, women with endometriosis were about eight times more likely than other women to report painful periods. If several of the points below apply to you, especially if they have been getting worse, it is worth booking an assessment rather than waiting.
Bring a pain diary covering two or three cycles if you can. Noting which days hurt, how much, and whether pain comes with sex, bowel movements or urination helps Dr. Park judge how likely endometriosis is and where it may be.
- Period pain that stops your normal day Missing work, school or sleep, even with painkillers.
- Pain that has worsened over the years Or painkillers that used to work no longer help.
- Deep pain during or after sex Felt inside the pelvis rather than at the entrance.
- Painful bowel movements or urination around your period Sometimes with bloating, diarrhea or constipation.
- Pelvic or lower back pain between periods Or spotting in the days before a period.
- Difficulty getting pregnant Especially together with any of the symptoms above.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Severe, worsening period pain is the most typical sign of endometriosis. Illustrative photo.
Diagnosis
Endometriosis diagnosis without surgery: the modern pathway
For many years, endometriosis could only be confirmed by laparoscopy. The 2022 ESHRE guideline changed this: it recommends ultrasound or MRI, and reserves laparoscopy for women whose scans are negative and whose symptoms have not improved with treatment, or for whom treatment was not suitable. Blood tests such as CA-125 are not recommended for diagnosing endometriosis.
This means you can usually start effective treatment within one visit. If the scan shows nothing but your symptoms are typical, hormonal treatment can still be started, and how you respond becomes part of the diagnosis.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Most women start with medical treatment, adjusted at each review. Illustrative photo.
Medical treatment
First-line vs second-line endometriosis medication
Guidelines group endometriosis medicines into first-line options, which most women try first, and second-line options for pain that does not respond. The ESHRE guideline strongly recommends combined hormonal contraceptives and progestogens, including the levonorgestrel IUD, as first-line hormonal treatment. GnRH medicines are second-line, and when GnRH agonists are used, add-back hormone therapy is strongly recommended to protect bone health.
Start here
- NSAID painkillers for pain flares
- Combined pill, often taken continuously
- Progestogens such as dienogest
- Levonorgestrel hormonal IUD
- Usually suitable for long-term use
If pain persists
- GnRH agonists, with add-back hormone
- GnRH antagonists where available
- Aromatase inhibitors for pain that resists other treatment
- Time-limited courses, closer monitoring
- Surgery may be discussed at this stage
Choosing a path
Endometriosis surgery vs medication: which is right for you?
Medication and surgery are not rivals; many women use both at different times. Medication controls symptoms while you take it but does not remove existing lesions. Laparoscopic surgery removes visible disease and can relieve pain, but endometriosis can return, so hormonal treatment is often continued afterwards. For endometriomas, the ESHRE guideline recommends removing the cyst wall (cystectomy) rather than draining it, because this lowers the chance of the cyst coming back.
Surgery on the ovary can also reduce the number of eggs remaining, which is why an AMH test and a conversation about pregnancy plans come before any decision about cyst surgery.
| Compare | Medical treatment | Laparoscopic surgery |
|---|---|---|
| Where | Outpatient, at Hommage Women's Clinic | Hospital, under general anesthesia (referral arranged) |
| Best suited to | Most women, especially when pain is the main problem | Large or growing endometriomas, deep disease, pain despite medication, some fertility situations |
| After treatment | Continue while it helps; review every 6–12 months | Hormones often continued; ESHRE suggests a hormonal IUD or combined pill for at least 18–24 months after surgery if pregnancy is not planned |
| Fertility | Prevents pregnancy while taken; no lasting effect | May help some women conceive; ovarian surgery can lower egg reserve |
Fertility
Endometriosis and fertility: planning ahead
Endometriosis is common among women who have trouble conceiving; the ESHRE guideline notes it is found in up to half of women with infertility. That does not mean most women with endometriosis cannot get pregnant. Many conceive naturally, but planning ahead helps you avoid losing time.
One point surprises many women: hormonal treatment that controls pain does not improve fertility. ESHRE advises against using ovarian suppression to boost pregnancy chances, so when you are ready to try, the usual plan is to stop hormonal treatment and, if needed, move to a fertility assessment rather than more suppression.
Helpful steps
- Tell your doctor early that you may want a pregnancy
- Check ovarian reserve with an AMH test before cyst surgery
- Stop hormonal treatment when you are ready to try
- Seek a fertility assessment after about 6 months of trying
- Keep pain under control between attempts
Things to know
- Hormonal suppression does not improve fertility
- Repeated ovarian surgery can lower egg reserve
- Routine surgery before IVF is not recommended for most women
- IVF does not appear to make endometriosis come back
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
An AMH blood test helps estimate egg reserve before cyst surgery decisions. Illustrative photo.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Endometriosis care is long-term, with the same doctor at each review. Illustrative photo.
Day to day
Living with endometriosis: long-term care and self-management
Endometriosis is a long-term condition, so good care looks more like a partnership than a single treatment. Reviews every 6 to 12 months let you and Dr. Park check whether pain is controlled, whether side effects are acceptable, and whether your plans for contraception or pregnancy have changed. Endometriomas are re-scanned to make sure they are stable.
What you can do between visits
- Keep a simple pain and bleeding diary, so changes are easy to spot.
- Use heat, gentle exercise and well-timed painkillers for flares, alongside your hormonal treatment.
- Mention pain during sex; it is common with endometriosis and treatable. See painful intercourse treatment.
- Be cautious about diets or supplements promoted as cures; evidence for them is limited.
- Ask for support if pain affects your mood, sleep or relationships; this is part of treatment, not a separate problem.
Evidence
Endometriosis treatment: what the research and guidelines say
Endometriosis care at Hommage Women's Clinic follows the 2022 guideline of the European Society of Human Reproduction and Embryology (ESHRE), the most comprehensive international guideline on the condition, together with World Health Organization information. The figures below are taken from those sources.
Women and girls affected
About 10% of those of reproductive age worldwide.
World Health OrganizationAverage diagnostic delay
From first symptoms to diagnosis.
ESHRE guideline, 2022Progressed without treatment
In placebo or sham groups of trials, over 6–12 months.
ESHRE guideline, 2022Hormones after surgery
Hormonal IUD or combined pill suggested to reduce recurrence of painful periods.
ESHRE guideline, 2022Traveling to Seoul
Endometriosis care in Seoul for international patients and expats
An endometriosis assessment at Hommage Women's Clinic usually fits into a single visit: consultation, exam and transvaginal ultrasound happen together, and you leave with a written plan. The clinic is in Gangnam, a short walk from Sinnonhyeon Station (Line 9 and Shinbundang Line).
Before your visit
- Contact the clinic by WhatsApp, KakaoTalk or the contact form to book and ask for language support.
- Bring your passport or alien registration card, a list of current medicines and any previous scan, MRI or surgery reports, translated if possible.
- Bring a pain diary from your last two or three cycles.
- If surgery is a possibility, plan extra time: hospital imaging and operations are arranged separately and take longer.
After you go home
Hormonal treatment is usually reviewed after about three months. If you live abroad, you receive a written summary to share with your local gynecologist, and you can message the clinic with questions. Check that the medicine you are prescribed is available in your home country before you leave.
Hommage · Seoul
Hommage Women's Clinic · Gangnam, Seoul
Gangnam: the clinic is a short walk from Sinnonhyeon Station. Illustrative photo.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Same-visit ultrasound shows endometriomas and other causes of pain. Illustrative photo.
Choosing well
How to choose an endometriosis doctor in Seoul
Because endometriosis is long-term, the relationship with your doctor matters as much as any single test. Use these questions at any clinic, including ours:
- Is the doctor an OB/GYN specialist? Gynecology training is essential for scanning and long-term hormonal care.
- Can they start treatment without surgery? Current guidelines support medical treatment based on symptoms and imaging.
- Do they ask about pregnancy plans? The plan should change when you want to conceive.
- Will you see the same doctor at follow-up? Continuity helps track pain and side effects over years.
- Do they refer to experienced surgeons? Deep endometriosis surgery belongs in specialist hospital teams.
- Are side effects explained before you start? Including bleeding patterns, mood and bone health.
What affects the cost of endometriosis treatment?
Cost depends on whether you are enrolled in Korea's National Health Insurance, which tests you need (ultrasound, blood tests such as AMH), the medicine prescribed and how long you take it, whether a hormonal IUD is fitted, and how often you are reviewed. Hospital MRI and surgery are billed separately by the hospital. Visitors without Korean insurance pay the clinic's fees directly, and we explain costs before any test.
Your visit
What to expect at your endometriosis appointment
01
Consultation
Dr. Park asks about your pain, periods, bowel and bladder symptoms and pregnancy plans. A pain diary from the last few cycles is very helpful.
02
Exam and ultrasound
A pelvic exam and transvaginal ultrasound look for endometriomas, adenomyosis and other causes of pain. A transabdominal scan is available if you prefer.
03
Your treatment plan
We agree on pain relief and, if suitable, a hormonal treatment, and explain its side effects before you start.
04
Follow-up or referral
A review after about 3 months checks how well the plan works. Hospital referral is arranged for MRI or surgery when needed.
Your doctor
Dr. Park Yuna
Medical Director · OB/GYN Specialist
Dr. Park treats endometriosis as a long-term condition that should be managed around your life, not just your scan. She starts with medical treatment where it is safe to do so, tracks your pain over time, and refers for surgery when the findings or your symptoms call for it.
OB/GYN specialist (Korea) and representative director of Hommage Clinic. Leads women's health care, labiaplasty and other cosmetic gynecology procedures.
Endometriosis: frequently asked questions
Can endometriosis be cured?
Endometriosis cannot be cured permanently, but symptoms can usually be controlled well. Hormonal treatment suppresses the disease while you take it, and surgery can remove lesions, although they can return. Symptoms often ease after menopause. Long-term follow-up with the same doctor helps adjust treatment as your needs change.
Do I need surgery to be diagnosed with endometriosis?
Not usually. Doctors can diagnose likely endometriosis from your symptoms, a pelvic exam and an ultrasound, and start treatment without surgery. Laparoscopy is reserved for cases where the diagnosis is unclear, medication does not help, or surgery is needed to treat cysts or deep disease.
Can I get pregnant if I have endometriosis?
Yes, many women with endometriosis become pregnant naturally. It can take longer, so we suggest a fertility assessment after about 6 months of trying. Hormonal treatments prevent pregnancy while you use them, so tell your doctor when you want to conceive. An AMH test can help with planning.
What is the difference between endometriosis and adenomyosis?
Both involve tissue similar to the uterine lining growing where it should not. In endometriosis it grows outside the uterus, on the ovaries or pelvic lining; in adenomyosis it grows into the muscle wall of the uterus, which can cause heavy, painful periods and an enlarged uterus. They often occur together and are treated with similar medications.
Will dienogest stop my periods?
Dienogest often makes periods lighter or stops them altogether, which is part of how it reduces pain. In the first few months, irregular spotting or bleeding is common and usually settles. Periods typically return within a few weeks of stopping. Contact the clinic if bleeding is heavy or does not settle.
Can foreigners get endometriosis treatment in Seoul?
Yes. Foreign residents and visitors can be seen at Hommage Clinic; bring your passport or alien registration card to register. If you are enrolled in National Health Insurance, many tests are covered. Please contact us before your visit to arrange language support, and bring any previous scan or surgery reports.
Can an ultrasound show endometriosis?
A transvaginal ultrasound reliably shows ovarian endometriomas and can show some deep nodules and adenomyosis. Small surface patches on the pelvic lining are not visible on ultrasound or MRI, so a normal scan does not rule endometriosis out. Your symptoms and response to treatment matter as much as the scan.
Is there a blood test for endometriosis?
No. The ESHRE guideline advises against using blood markers such as CA-125 to diagnose endometriosis, because they are not accurate enough. Blood tests may still be used for other reasons, for example an AMH test to estimate egg reserve or a blood count if periods are heavy.
How long does it take to diagnose endometriosis?
Internationally, diagnosis is often delayed for years; the ESHRE guideline cites an average of 8 to 12 years from first symptoms. Because treatment can now start based on symptoms and imaging, most women seen at Hommage Women's Clinic leave their first visit with a working diagnosis and a treatment plan.
Does endometriosis get worse without treatment?
It varies. In the untreated groups of clinical trials summarized by ESHRE, about one in three women had disease that progressed over 6 to 12 months, while others stayed the same or improved. Because the course is hard to predict, regular reviews and treatment of troublesome symptoms are recommended.
Will endometriosis come back after surgery?
It can. Surgery removes visible lesions but does not stop new ones forming. To reduce recurrence, the ESHRE guideline suggests a hormonal IUD or combined pill for at least 18 to 24 months after surgery for women not planning pregnancy soon, and removing endometrioma cyst walls rather than draining them.
Does endometriosis go away after menopause?
Symptoms often ease after menopause, when estrogen levels fall, although some women continue to have pain. If hormone therapy is considered after menopause, your endometriosis history is taken into account when choosing the type of treatment.
Can teenagers have endometriosis?
Yes. Endometriosis can start in the teenage years, and severe period pain that stops a girl going to school deserves assessment. For adolescents, the ESHRE guideline recommends combined pills or progestogens as first-line treatment, with surgery only by experienced surgeons when needed.
References
Sources used for this page, reviewed by Dr. Park Yuna, OB/GYN specialist. Read our editorial and medical review policy.
- Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009. PubMed · Full guideline (PDF)
- World Health Organization. Endometriosis: fact sheet. Geneva: WHO.
- Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;(7):CD001751. Cochrane summary
This page is general information and does not replace a personal consultation. Illustrations are original works of Hommage Women's Clinic, Gangnam, Seoul; photos marked illustrative are not of patients.
Related women's health services
Pelvic Pain Treatment
Assessment of ongoing or new pelvic pain, from cysts and infection to non-gynecological causes.
Period Pain Treatment
When cramps are normal, when they are not, and treatments that help.
Ovarian Cyst Treatment
Monitoring and treatment of ovarian cysts, including endometriomas.
IUD Insertion
Hormonal and copper IUDs fitted in clinic, including for heavy or painful periods.
AMH Test
A blood test that estimates ovarian reserve before fertility or cyst surgery decisions.
Painful Intercourse Treatment
Causes and treatment of pain during sex, including deep pain linked to endometriosis.
Get answers about your pelvic pain
Book an endometriosis assessment with Dr. Park Yuna in Gangnam. The ultrasound is done in the same visit, and hospital referral is arranged when needed.
Hommage Clinic · 4F, Building A, 509 Gangnam-daero, Seoul (near Sinnonhyeon Station) · Mon & Fri 10:00–20:00 · Tue–Thu 10:00–19:00 · Sat 10:00–15:00