Early Hysterectomy in Patients with Endometriosis

Introduction: Endometriosis affects between 5% and 10% of women of reproductive age. Despite its high prevalence, diagnosis is often delayed, leading to radical surgical interventions such as early hysterectomy. This approach, frequently avoidable, results in definitive loss of fertility and significantly impacts the physical, emotional, and social health of affected patients. Objective: To investigate the early indication of hysterectomy in patients with endometriosis. Methods: A systematic review was conducted using the PubMed and ScienceDirect databases, applying the descriptors “early hysterectomy,” “endometriosis,” and “late diagnosis.” Full-text articles published between 2020 and 2025 were included. Results: Studies indicate that between 12% and 18% of women undergoing hysterectomy before the age of 40 had endometriosis as a primary or secondary indication. Additionally, it is estimated that approximately 30% to 50% of these cases could have been initially managed with clinical or conservative surgical alternatives. Discussion: Although radical hysterectomy remains effective in oncological contexts, its early indication for endometriosis raises significant ethical, reproductive, and psychosocial concerns. Beyond the irreversible loss of fertility, affected patients face increased risks of anxiety, depression, low self-esteem, and impaired interpersonal relationships. Evidence suggests that personalized management and timely detection of endometriosis could substantially reduce these consequences, preserving patients’ quality of life and personal life plans. Conclusion: Strengthening health education policies, training healthcare professionals for early recognition of endometriosis, and investing in research are essential to reduce unnecessary radical interventions. Prioritizing early diagnosis and less invasive approaches contributes to a more humanized, patient-centered care model focused on quality of life.