Combination. Depending on symptoms endometriosis is treated with a combination of medications and surgery. The only sure way to diagnose endometriosis is to see the lesions during surgery. If seen the lesions are usually removed.
We usually start w/ Medical management. Nsaids and continuous birth control pills are usually a first place to start however if pregnancy is desired this might be conflicting and its important to talk to your doctor about this. More aggressive hormonal medications are available for those that don't respond to initial therapy. Surgey is reserved for those with adnexal masses and pain and to confirm diagnosis.