Why Does Endometriosis Come Back After Surgery? The Gut, Estrobolome, and Bioenergetic Mechanism — Frequently asked questions about endometriosis recurrence and the gut-endometriosis connection

Is endometriosis curable? Cure is not the right framing. The clinically useful framing is durable remission, where the disease is quiescent, the symptoms are manageable, and progression is halted or substantially slowed. Bioenergetic and estrobolome restoration extends the durability of remission and reduces the rate of recurrence. The underlying genetic susceptibility, where present, is not eliminated by any current approach. Can I avoid surgery if I do the upstream work? This is a decision made with your gynecologist and excision specialist, not with Biomelogic. The Host Capacity Model framework is not a strategy for avoiding indicated surgery. Some patients with mild disease and predominant gut-driven mechanisms experience symptom improvement substantial enough that surgery is deferred or avoided. Other patients have anatomical disease (deep infiltrating endometriosis, endometriomas, structural issues) that requires surgical intervention regardless of upstream work. The surgical decision is medical care and belongs with the medical team. Does the framework apply to all stages of endometriosis? The framework is most directly applicable to cases dominated by inflammatory, hormonal, and bioenergetic drivers. Mild and moderate disease, recurrent disease after surgery, and disease with prominent systemic features (fatigue, gut symptoms, MCAS overlap) are the strongest fits. Sever