I have had endometriosis removed on two occasions and have also had multiple cysts. I had a hysterectomy in 2014. I recently have been feeling worse and have more consistent pain. My doctor ran my estrogen levels and they are currently 3 times the normal amount. I am not sure what my next steps should be.
Endometriosis
Top Endometriosis Specialist Florida: Your Path to Pain-Free Living
Endometriosis affects approximately 10% of women in Florida, impacting their daily lives and overall well-being. This chronic condition, characterized by the growth of uterine-like tissue
March 17, 2025
Thank you for sharing your history.
From a Western medical perspective, elevated estrogen—especially after a hysterectomy—can still occur if your ovaries were preserved, as they continue to produce hormones. High estrogen levels can stimulate any remaining endometrial tissue or ovarian remnants, which may be contributing to your recent symptoms and pain. It would be worth discussing with your doctor whether further hormonal testing (including progesterone and androgen levels), and pelvic imaging (like an ultrasound or MRI), could give more insight. Depending on the findings, options like hormone-balancing therapies or a referral to a gynecologic endocrinologist might be helpful.
From a Traditional Chinese Medicine (TCM) perspective, your symptoms suggest a combination of Liver Qi stagnation, Blood stasis, and possibly some internal damp-heat or Yin deficiency, especially given the surgical history and hormonal imbalance. These patterns are often associated with pelvic pain, hormone fluctuations, cyst formation, and inflammation.
In TCM, the treatment would focus on:
With acupuncture and herbal medicine, we aim to reduce inflammation, regulate hormone levels naturally, and alleviate pain. Many patients also find their mood, digestion, and sleep improve as we bring the body into better balance.
If ovaries are preserved at the time of a hysterectomy, then you will continue to produce hormones from your ovaries, such as estrogen and progesterone, and you will continue to ovulate. An isolated high level of estrogen is difficult to interpret because the levels can vary depending on the time of month since you are still cycling. For this reason, estrogen levels are best interpreted in the context of other hormones such as FSH. Endometriosis tissue can produce estrogen as well. However, we do not know if these amounts make measurable differences in overall estrogen levels.
Since your ovaries are still producing hormones, these hormones could still stimulate any residual endometriosis tissue. We know that suppressing hormonal production with estrogen-progesterone contraceptives or progestin-only contraceptives reduce the risk of recurrence. The data is most clear in women that have had a cystectomy for an ovarian endometrioma. In this population, the risk of recurrence can be as high as 50-60% without hormonal suppression. This is reduced to approximately 6% with the use of estrogen-progesterone contraceptives as suppression. The data is not as clear as how well progestin-only options prevent recurrence because they do not suppress hormonal cycling and ovulation as efficiently as estrogen-progesterone containing medications. The data is also not as clear regarding the effects of hormonally suppressing patients with Stage 1 or Stage 2 disease to prevent recurrence.
If you are having worsening symptoms, I would recommend seeing an endometriosis specialist to start a work-up to assess for recurrence. They can also review your operative report to help determine whether the endometriosis was adequately addressed at the time of your hysterectomy.
Thank you for your question.