Andrea Wood, PT, DPT
Visit types: Office/Hospital
Spoken languages: English
Interpreting services for other languages: Yes
Philosophy of care and typical treatment strategies:
My philosophy includes helping individuals with endometriosis learn tools to help live a better quality of life throughout the course of treatments and lifespan. I also integrate nervous system down training through breathing techniques and manual therapy, while promoting healthy movement for overall wellness. I believe in a team relationship with my patients in working together to improve their function.
Justine Roper, PT, DPT
Visit types: Office/Hospital
Spoken languages: English
Interpreting services for other languages: Yes
Philosophy of care and typical treatment strategies:
Our lead therapist, Dr. Justine Roper PT, DPT is a certified women’s pelvic specialist & pelvic floor therapist. She has dedicated her life to offering innovative ways to heal her patients’ bodies of pain and other dysfunction through alternative methods. From sexual dysfunction to pelvic pain, many of her patients are impacted by both physical ailments as well as mental health issues. We focus heavily on functional goals established by our patients in order to endow them with autonomy over their treatment plans. Some specific techniques that we use for our patient population affected by endometriosis include visceral mobilization, myofascial release,”breathwork”/breathing techniques, & functional training.
Justine Payne, PT, DPT
Justine Payne, PT, DPT
Justine Payne – Endometriosis Physical Therapist
Summary: Justine Payne is a compassionate and highly skilled pelvic physical therapist with a deep commitment to supporting individuals living with endometriosis and adenomyosis. Fluent in both English and Spanish and offering interpreting services for other languages, Justine provides inclusive care in office, hospital, and even home settings. As a dedicated clinician, Justine Payne, pelvic physical therapist, combines evidence-based treatment with a holistic, patient-centered approach to restore function and reduce pain.
With a strong foundation in neurorehabilitation and training as a yoga instructor, Justine uses techniques like myofascial release, soft tissue mobilization, dry needling, and functional mobility work. She incorporates Pilates, yoga, meditation, and breathwork to address both the body and nervous system. Justine Payne, a pelvic physical therapist, empowers patients through trauma-informed care, education, and shared decision-making, ensuring every person feels heard, safe, and in control of their healing journey.
Visit types: Office/Hospital, At home
Spoken languages: English, Español
Interpreting services for other languages: Yes
Philosophy of care and typical treatment strategies:
The appropriate care and management of individuals with endometriosis and/or adenomyosis have been a passion of mine since I first began working in pelvic health, and through all the experiences I have been so fortunate to have had patients I have learned the importance of a holistic, evidence-based, patient-centered, team approach to the management of these horrendous and all too often misunderstood disorders.
Coming from a strong neurorehabilitation background and having been trained as a yoga teacher as well, I prioritize the treatment not only of the musculoskeletal system via flexibility training, strength training (mainly via pilates and yoga), manual therapies (including myofascial release, soft tissue mobilization, and dry needling, externally and internally if needed) and functional mobility but also the nervous system as a whole. I am a firm believer that the autonomic nervous system plays an intimate role in the management of chronic pain and functional gastrointestinal disorders and use meditation, pranayama, yoga, dry needling, grounding techniques, myofascial release, and aerobic conditioning to improve the functioning of the ANS. I also utilize visceral mobilization in my practice but have not undergone the advanced trainings as of this date (i.e. Barral Institute, Herman & Wallace, etc.).
Above all, providing each and every patient with the education that they need regarding these diseases to make informed decisions, along with providing trauma-informed care, are the two most important cornerstones of my practice. As I say to all of my patients, although you are in my clinic, you are the boss of your own body, and I will always be respectful of your wishes.
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Spanish
Primero en aclarar todos esos acrónimos que denotan mis credenciales: Doctor en Terapia Física, Especialista Clínico Neurológico Certificado (APTA), Especialista Certificado en Rehabilitación Pélvica (Herman & Wallace), Profesor de Yoga Registrado (Yoga Alliance 200 horas), Certificado de Punción Seca (Master Punción Seca).
La atención y el manejo adecuados de las personas con endometriosis y/o adenomiosis ha sido una de mis pasiones desde que comencé a trabajar en salud pélvica. A través de todas las experiencias que he tenido la suerte de haber tenido con los pacientes, he aprendido la importancia de un enfoque de equipo holístico, basado en la evidencia y centrado en el paciente para el tratamiento de estos trastornos horrendos y, con demasiada frecuencia, incomprendidos.
Con una sólida formación en la rehabilitación neurológica y con una formación como profesora de yoga, priorizo el tratamiento no solo del sistema musculoesquelético a través del entrenamiento de flexibilidad, entrenamiento de fuerza (principalmente a través de pilates y yoga), terapias manuales (incluida la liberación miofascial, masaje y punción seca, externalmente o internalmente si es necesario) y movilidad funcional, pero también el sistema nervioso en su conjunto. Creo firmemente que el sistema nervioso autónomo juega un papel íntimo en el manejo del dolor crónico y los trastornos gastrointestinales funcionales y utilizo la meditación, pranayama, yoga, punción seca, técnicas de conexión a tierra, liberación miofascial y acondicionamiento aeróbico para mejorar el funcionamiento del ANS. También utilizo la movilización visceral en mi práctica, pero no he recibido entrenamientos avanzados a esta fecha (es decir, Barral Institute, Herman & Wallace, etc.).
Sobre todo, brindar a todos y cada uno de los pacientes la educación que necesitan con respecto a estas enfermedades para tomar decisiones informadas junto con brindar atención informada sobre el trauma son los dos pilares más importantes de mi práctica. Como digo a todos mis pacientes – aunque esta en mi oficina, siempre Usted es la jefa (o jefe, dependiendo en su idendidad de género) y siempre respecto sus deseos.
Dr. Steven Vasilev
Dr. Steven Vasilev MD, MBA FACOG FACS FACN ABIHM ABOIM
Dr Steven Vasilev – Endometriosis Specialist, Oncology & Minimally Invasive Robotic Surgery| Medical Director, GO Institute.
Summary: Dr Steven Vasilev is a highly respected endometriosis specialist serving patients in Santa Monica, Beverly Hills, and San Luis Obispo. With over 30 years of experience, Dr Vasilev is known for his expertise in complex gynecologic surgery, including minimally invasive and robotic techniques. Steven Vasilev MD is the only physician in the U.S. triple board-certified in OB-GYN, oncology, and integrative medicine—bringing a comprehensive, personalized approach to each patient’s care.
Patients who choose Dr Steven Vasilev benefit from a philosophy that combines precision excision surgery with holistic healing strategies. From preoperative imaging to pelvic floor therapy and integrative recovery plans, Dr Vasilev offers thoughtful, multidisciplinary care tailored to long-term wellness. Steven Vasilev MD is not only a skilled surgeon but also a compassionate listener dedicated to improving outcomes for those living with endometriosis.
City: Santa Monica, Beverly Hills & San Luis Obispo, CA, USA.
Please watch the short informative video in the upper left corner of this profile.
Philosophy:
In addition to being a doctor and surgeon, I am a clinical researcher and translational scientist. We are studying the molecular behavior of endometriosis in our laboratories. Endometriosis theories suggest multiple causes, and each thesis
contributes to factors likely tied together at the molecular genetic level. Identification of endometriosis molecular and immunomodulatory pathway biomarkers will soon lead to better non-invasive diagnostics, accurate monitoring, and effective therapies beyond the baseline of expert excisional surgery and hormonal manipulation. I focus on this and the uncommon but clear overlap with malignancy in older endo patients or those with a family history.
Surgical excision is a critical cornerstone for endo diagnosis, initial treatment, and re-excision of recurrence or pain-producing fibrosis. My philosophy is to be fully informed and prepared, no matter the findings, through optimal preoperative imaging and testing. Fortunately, my unique training and board certifications permit surgery on all abdominal or pelvic organs, including small and large bowel, ureters, bladder, liver, and diaphragm. If disease is suspected beyond these organs, such as the chest, we have expert cardiothoracic and neurosurgeons ready to join a multidisciplinary surgery. Having used both laparoscopy and robotics in thousands of surgeries over three decades, including the hardest of the complicated surgeries, I firmly believe that the far superior 3-D camera optics and articulating or wristed “tiny hands” instruments used in robotics are better than traditional laparoscopy for all but the simplest of cases. When complicated anatomy or scarring from endo and fibrosis is unexpectedly found, which is not uncommon because endo is intensely inflammatory, the ability to see better and use finesse instruments makes all the difference, especially in highly experienced hands.
Medication:
During the perioperative period, we use holistic ERAS-modified care, combined with integrative modalities such as acupuncture and acupressure, to allow faster recovery with lower narcotic use. We individually construct and coordinate a multidisciplinary consulting team of experts to manage pain, intestinal manifestations such as SIBO and pelvic floor dysfunction. We work with referring gynecologists regarding hormonal support but discourage using GnRH-based therapies. My board certification in Integrative Medicine uniquely injects additional options involving holistic care. An example is proactive estrobolome management to lower systemic estrogen levels naturally.
Approach to Persistent Pain:
Both pre- and post-operatively, I strongly encourage pelvic floor therapy and pain specialist consultation and follow-up. The genesis of endo-induced pain can be due to endometriosis implants and peripheral visceral and parietal peritoneal nociception, fibrosis, direct nerve impingement, pelvic floor dysesthesia, or central sensitization. A very individual approach is vital to the best management plan. In primary and persistent pain situations, each of these “medicalese” terms is discussed in detail to craft the best possible personalized plan. Finally, as noted above, I am a board-certified integrative medicine practitioner and thus apply Eastern thought such as acupuncture, mind-body strategies, and personal nutritional counseling and interventions.
Dr. Steve’s Articles:
Dr. Nadim Hawa
Dr. Nadim Hawa, M.D.
Dr Nadim Hawa – Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon
Summary: Dr Nadim Hawa is an experienced endometriosis specialist and minimally invasive gynecologic surgeon based in Leesburg, VA. Known for his compassionate and individualized care, Dr. Hawa is committed to helping patients find lasting relief from endometriosis. Whether you’re searching for Dr Hawa OBGYN or learning more about Dr Hawa endometriosis expertise, his approach combines surgical precision with long-term support.
Dr Hawa believes endometriosis has diverse origins, which is why he tailors treatment plans to each patient’s specific condition. While medications may ease symptoms, he emphasizes that they don’t address the root of the disease. Instead, he focuses on complete excision surgery and often integrates pelvic floor therapy to improve outcomes. As both a skilled surgeon and dedicated partner in care, Dr Nadim Hawa offers a comprehensive approach to managing endometriosis with the goal of restoring quality of life.
City: Leesburg, VA, USA
Philosophy: Multiple factors. Combination of in Sito development and endometrial transplantation. I do not believe there is only one type of endometriosis. Different origins hence different differentiation, behavior, and clinical impact. Same as fibroid. Why you have one solitary fibroid vs the bag of marbles of a uterus. Different gene expression and different behavior.
Medication: Medication and hormonal suppression serve only to relieve symptoms but not treat the disease. By stopping the dynamic motion of the uterus with suppression, you limit the superficial peritoneal inflammation and cause symptomatic relief, but you will not affect the deep lesions. since they produce their own estrogen and pro-inflammatory mediators. .I use IUD and usually insert intraoperatively after the excision surgery if the patient e desires birth control. GnRH agonist/antagonist are harmful and I do not use them
Approach to Persistent Pain: Surgery alone is not enough. Pelvic floor therapy is as important as surgery, for long term recovery.
A second excision is usually advised.
Dr. Lora Liu
Dr. Lora Liu, M.D.
Dr Lora Liu – Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon.
Summary: Dr Lora Liu, a highly respected endometriosis specialist and minimally invasive gynecologic surgeon, is based in New York City. Known for her skill and compassionate care, Dr Liu NYC is a trusted name among patients seeking expert treatment for complex pelvic pain. At the core of Dr Liu Endometriosis care is a comprehensive understanding of the disease’s multifactorial origins, including inflammation, immune dysfunction, and hormonal influences. Patients turn to Lora Liu MD for individualized care that blends evidence-based medicine with a human-centered approach.
Dr Lora Liu believes in treating each patient uniquely. She often combines advanced excision surgery with hormonal therapy, non-opioid pain relief, and pelvic floor rehabilitation. At Dr Liu NYC, her multidisciplinary team supports long-term healing, even for those with persistent symptoms. Dr Liu Endometriosis care reflects a deep commitment to improving quality of life, and Lora Liu MD remains a leading voice in delivering compassionate, specialized care for women with endometriosis.
City: New York, NY, USA.
Philosophy: I believe that the etiology of endometriosis is complex and multifactorial. I support the Mullerianosis theory. However, there are other contributing factors such as oxidative stress and inflammation, impaired immune response, genetics, and hormones – both endogenous and exogenous that play a role in the pathogenesis and proliferation of endometriosis.
Medication: I incorporate medications into my practice for the management of symptoms. For hormonal suppression, I incorporate combined OCPs, progesterone-only pills, or progesterone IUD. I do not prescribe GnRH agonists or antagonists. Depending on the patient’s pain generators, I may also recommend non-opioid pain medication, such as NSAIDs, gabapentin, SNRIs, and compounded suppositories.
Approach to Persistent Pain: I am committed to closely following my post-operative patients to ensure that their persistent pain is managed and overall quality of life is improved. Patients with a long history of pelvic pain due to endometriosis will often require additional support following surgery. I am fortunate to work in a multi-disciplinary practice with Physical Medicine and Rehabilitation physicians who specialize in pelvic pain, as well as with pelvic floor physical therapists and pain management physicians. However, my approach depends on the individual patient and her history and current symptoms. Some patients may find that their symptoms are adequately managed with hormonal suppression alone, whereas others may need a second look if symptoms start to recur after their initial surgery. By integrating a multifaceted approach, I find that patient outcomes are overwhelmingly more positive.
Dr. Nicholas Fogelson
Nicholas Fogelson, M.D., FACOG,
Dr Nicholas Fogelson – Endometriosis Specialist, Advanced Pelvic Surgeon, Minimally Invasive Gynecologic Surgeon.
Summary: Dr Fogelson is a leading endometriosis specialist and advanced pelvic surgeon based in Portland, Oregon. Patients from across the country trust Dr Nicholas Fogelson and his clinic, Northwest Endometriosis, also known as NW Endometriosis, for expert, compassionate care. With a strong foundation in the latest research, Dr Fogelson approaches each case with precision and empathy, offering tailored treatments that prioritize long-term relief. Thanks to his reputation for surgical excellence and individualized care, NW Endometriosis has become a top destination for patients seeking advanced support for this complex condition.
At Northwest Endometriosis, Dr Nicholas Fogelson provides excision surgery backed by a deep understanding of the varied presentations of endometriosis. His treatment plans often include pelvic floor therapy, lifestyle guidance, and selective use of hormonal therapy. Whether patients are local or traveling for care, Dr Fogelson and the NW Endometriosis team are committed to delivering ongoing support and expertise every step of the way.
City: Portland, Oregon.
Philosophy: I strongly believe that endometriosis is not one disease, but rather are a constellation of states of similar but not identical disease states. This concept is strongly supported by the very large number of genes that are tightly bound to the disease state, which is more characteristic of a multifactorial and multiorigin disease than a single disease entity. Ie. calling endometriosis one thing is like calling cancer one thing.
Right now the predominant theory is that of mullerianosis, suggesting that endometriosis is a defect of embryogenesis. This theory is supported by a variety of data. At the same time, we also have evidence of environmental factors that seem to promote endometriosis, either through actual genesis of disease or through worsening of the already existent disease and therefore making diagnosis more likely.
The variable response to various therapies among different patients is also suggestive that there is more than one underlying disease state. Ie some patients respond completely to surgical excision and have very little benefit from medical therapies, while some other patients have near-complete cessation of symptoms while on progesterone suppression. Some patients have severe pain, others have no pain, and may only present with infertility. Furthermore, the variability of the appearance of endo surgically also suggests more than one underlying origin. For example, there is a clearly a subtype of endometriosis that presents with high grade rectovaginal deep infiltrating endometriosis, while sparing the ovaries and other peritoneal surfaces. Other patients may have endometriotic implants studded throughout their pelvis, many superficial with perhaps some small deeper areas, without advanced deep disease in any particular area. Again, this suggests a different origin of disease rather than a clinical variation of an identical disease state.
At this point, our understanding of the disease is incomplete. My approach is to individualize care to each particular patient in efforts to improve her quality of life to the maximum. Most patients seek me out for excision surgery, which I do a great deal of. And at this point, excision surgery is the optimal treatment we have available. At the same time, it is critical that we keep an eye out to a better future understanding of the underlying disease that may open up other effective treatment modalities.
Medication: Most of my patients have already been on medical therapies with other physicians and have not found relief, leading them to seek out endometriosis surgery. My primary treatment modality is excisional therapy, but we may augment that with hormonal suppression postoperatively in some cases. Usually, this is only for 3-6 months postoperatively, but in some cases, patients may choose to be on suppression for longer. While in theory, a patient who has had full excision of disease should not benefit from medical therapy, there are some data that do suggest a decreased frequency of recurrent pain in patients who do use progesterone suppression after surgery. These data may be biased by the inclusion of surgery that is not as complete as what is typical in my practice and other expert-level surgeons’ practices, and this may explain this result.
I typically do not use GnRH modulators such as Lupron or Orilissa, as their side effect profile is often worse than the benefit gained, and a minority of women may experience long term harm from their use.
Approach to Persistent Pain: Every case is different, so there can be no one specific approach. Most patients have thorough excision of endometriosis as part of their treatment. Most experience substantial relief from this, but over time some may have recurrent pain.
All patients should be evaluated by a skilled pelvic PT and get support for pelvic floor pains. When this is severe pelvic floor botox may be appropriate. We also have to consider urinary tract sources of pain such as interstitial cystitis. When appropriate, some patients may have repeat laparoscopy if we believe there may be recurrent or residual disease (particularly if a patient comes in after surgery from an outside surgeon. We also must evaluate other neurologic sources of pain, such as vascular or ligamentous entrapment of pelvic nerves (ie nerve roots, sciatic, femoral, obturator, pudendal, etc.). In limited cases, direct neurolysis of affected nerves may lead to relief. When a persistent pain can be neurologically localized but is not addressable surgically, or surgery has failed to relieve the pain, direct neurostimulation of affected nerves can have substantial efficacy in decreasing or even eliminating pain. We also encourage all patients to eat a healthy anti-inflammatory diet and to get regular exercise.
While some patients travel to see us, many patients come from our local area and continue to work with our practice ongoing for their routine care as well as any issues of recurrent pain. We are committed to continuing to care for all of our patients, as long as it is practical for them. While many patients do travel for surgery, we think that the best care comes with an ongoing relationship with a physician who not only can operate but has a wide base of knowledge in pelvic pain, and can help manage care actively.
Dr. Antonio Rosario Gargiulo
Dr Antonio Gargiulo MD
Dr Antonio Gargiulo – Endometriosis Specialist, Gynecologist
Summary: Dr Antonio Gargiulo is a leading endometriosis specialist Boston patients trust for expert, compassionate care. As a highly respected gynecologic surgeon based in Boston, MA, Dr Antonio Gargiulo is known for his advanced techniques and individualized approach to treatment. Patients from across the U.S. seek Antonio Gargiulo MD endometriosis care for its innovation, depth, and dedication to whole-person health. Whether you’re searching for a highly experienced endometriosis specialist in Boston or have been referred to Doctor Gargiulo by another provider, his reputation for excellence and holistic, evidence-based care sets him apart.
While the exact causes of endometriosis are still under investigation, Dr Antonio Gargiulo supports the theory of a polypotential germ-cell origin. In clinical settings, Doctor Gargiulo often begins treatment with FDA-approved progestins and NSAIDs, reserving GnRHa primarily for patients with adenomyosis preparing for IVF. His thoughtful, personalized strategies help patients manage symptoms while minimizing unnecessary interventions.
When facing chronic or complex pelvic pain, Antonio Gargiulo MD endometriosis care expands well beyond standard gynecological evaluations. Doctor Gargiulo integrates comprehensive assessments across specialties, including urology, gastrointestinal, neuro-orthopedic, rheumatology, and mental health domains. His approach ensures coexisting or overlooked conditions are addressed, and that issues such as adhesions or hernias are not missed. Physical therapy and regular follow-ups are also central to his long-term treatment plans.
With unmatched expertise and a commitment to multidisciplinary, compassionate care, Dr Antonio Gargiulo remains a leading name in the field. As a trusted endometriosis specialist Boston patients rely on, Doctor Gargiulo continues to provide clarity, relief, and lasting solutions in the often misunderstood world of endometriosis.
City: Boston, MA, USA
Philosophy: Etiology is yet unclear. Polypotential germ-cell origin is a promising hypothesis.
Medication: My first line is FDA-approved progestins and NSAIDs. I use GnRHa exclusively for adenomyosis patients in the setting of IVF.
Approach to Persistent Pain: Expanding diagnostic approach (uro, GI, neuro/ortho, rheumatology, psyche). Expanding physical therapy approach. Clinical reevaluation for possible residual disease or iatrogenic disease (hernia, adhesions). Pain service.
Dr. Jeff Arrington
Jeff Arrington MD, FACOG, ACGE Endometriosis Specialist
Summary: Dr Jeffrey Arrington, MD, FACOG, ACGE is a renowned endometriosis specialist in Riverton, Utah, recognized for his advanced surgical expertise and patient-first approach. Often referred to as Dr Jeff Arrington, he is sought after by patients across the region searching for a trusted expert like Jeffrey Arrington MD. As one of the leading gynecologic surgeons in the area, Dr Arrington Utah is known for combining cutting-edge techniques with compassionate, individualized care.
A firm believer in the Mullerianosis theory, which suggests that endometriosis develops from embryologic tissue, Dr. Jeff Arrington offers a wide range of treatment options tailored to each patient’s condition. These include hormonal therapies such as OCPs, POPs, and LNG-IUDs, as well as advanced laparoscopic excision surgery. Patients working with Dr Arrington Utah appreciate his clear communication and commitment to empowering them through every step of the treatment process.
For those struggling with ongoing pain after surgery, Jeffrey Arrington MD takes a comprehensive, multidisciplinary approach. This can include physical therapy, targeted medications, or second-look surgery when necessary. He also collaborates with other specialists for concerns like nerve impingement or neuro-compromise, ensuring that patients receive thorough, whole-person care.
City: Riverton, Utah, USA.
Philosophy: Mullerianosis. This doesn’t explain all the presentations, but I believe is the most dominant one with the highest degree of evidence.
Medication: OCP, POPs, LNG-IUD. I typically only use these if the patient chooses palliation. I do present all options with the appropriate explanation of the goal and risks of therapy. The patient is then allowed to choose the most appropriate management for her.
Approach to Persistent Pain: It depends on the symptoms and the other potential pain generators discovered in the pre-op work up. Some patients benefit from PT, some from simple hormones, and some from compounded muscle relaxers and inflammatory mediators. When appropriate I perform a second look with liberal biopsies of anything suspicious. If there is residual endo, I want to find it. I have also been looking into help with neurogastroenterology for some of the more difficult patients after endo is confirmed absent. I am also cognizant if potential nerve impingement and neuro-compromise and use appropriate referrals or personal surgical management for these.
Dr. Ken Sinervo
Dr Ken Sinervo, M.D., M.Sc, F.R.C.S.C., A.C.G.E.
Medical Director, Center for Endometriosis Care
Gynecology & Minimal Invasive Surgery
Endometriosis Specialist.
Summary: Dr Ken Sinervo, M.D., M.Sc., F.R.C.S.C., A.C.G.E., is a globally recognized leader in the treatment of endometriosis and the Medical Director of the Center for Endometriosis Care in Atlanta GA. With decades of experience, Dr. Ken Sinervo is renowned for his expertise in minimally invasive excision surgery and his compassionate, patient-focused approach. Patients from around the world travel to see Dr Ken Sinervo Atlanta GA for advanced care that addresses the full complexity of this challenging condition. As a leading expert in the field, Ken Sinervo gynecology services are known for combining surgical precision with a deep understanding of chronic pelvic pain and reproductive health. Whether patients are newly diagnosed or have struggled with endometriosis for years, Dr Ken Sinervo offers hope through highly individualized treatment. His reputation for excellence continues to make Dr Ken Sinervo Atlanta GA a trusted destination for those seeking specialized care. With a strong foundation in evidence-based medicine, Ken Sinervo gynecology expertise reflects a commitment to both innovative treatment and long-term patient support.
City: Atlanta, GA, USA.
Dr. Ken Sinervo is a world-renowned expert in the excision of endometriosis and multidisciplinary care of the disease. A humble, compassionate surgeon who truly cares for his patients, he has won countless awards for his dedicated service and is known to always go above and beyond for those in his care.
Philosophy: Endometriosis can likely be ascribed to embryologic origins as upheld by Redwine’s Mülleriosis theory, which suggests that the disease is created following abnormal differentiation of the Müllerian duct system during embryogenesis and later triggered by varied mechanisms.
Medication: When patient has chosen the option based on their specific circumstances and indications; LNR-IUS for adenomyosis, short-term ovulation suppression (3-6 immediately post-operatively) with either continuous low dose contraceptives or progestins such as norethindrone. Narcotics/pain medication as needed/appropriate.
Approach to Persistent Pain: Re-assessment of potential causes of pain. Pelvic floor PT where needed. Pain management where needed – trigger point injections, nerve blocks, medication. If need for narcotics, and have had appropriate referrals to other specialists where necessary, then we would consider another laparoscopy. Happens less than 10-15% of the time.
Dr. Andrea Vidali MD
Dr. Andrea Vidali, M.D
Endometriosis Specialist, Obstetrics & Gynecology / General Obstetrics & Gynecology, Reproductive Endocrinology
Summary: Dr Andrea Vidali MD is a highly regarded endometriosis specialist and reproductive endocrinologist based in New York, NY, USA. Known for his expertise and compassionate approach, Dr Vidali offers comprehensive care for patients dealing with complex endometriosis cases. His practice attracts individuals from both the New York City area and beyond, especially those searching for a trusted expert like Andrea Vidali NYC. What makes Dr Andrea Vidali endometriosis treatment unique is his focus on combining excision surgery with targeted medical therapies, such as progestins and IUDs. This approach not only helps control bleeding but also addresses related conditions that often go untreated. His methods are especially effective for patients who haven’t responded well to hormonal therapy alone.
In addition to his surgical skill, Dr Vidali emphasizes the importance of personalized, long-term care. Every patient receives a tailored recovery plan that may include physical therapy and collaboration with physiatrists to help manage persistent pelvic pain. This ongoing support is a key part of the experience with Dr Andrea Vidali MD, who believes that successful treatment doesn’t end in the operating room.
Many patients turn to Dr Andrea Vidali MD not just for his medical knowledge, but for his commitment to improving their overall quality of life. Whether you’re local to New York or researching providers like Andrea Vidali NYC from across the country, his integrative approach to endometriosis makes him a leading choice in the field. It’s no surprise that Dr Andrea Vidali endometriosis care is so highly sought after by those navigating this challenging condition.
City: New York, NY, USA
Philosophy: Current scientific evidence points to the coelomic theory of endometriosis
Medication: The approach to endometriosis has to be holistic and address not only the disease itself but also potentially associated conditions. At this time, since we do not have medical candidates for curing endometriosis, the first essential step in the treatment of endometriosis is excision surgery. Additionally, Dr. Vidali rely on hormonal contraception, preferably progestins either orally or in the form of IUD to control bleeding or adenomyosis-related factors, if present. He does not rely on GnRH agonists or antagonists as in my experience the risk profile and efficacy profile not better than progestins make them undesirable.
Approach to Persistent Pain: I would like to affirm that I follow all the patients I operate on until they are well. I see the patients periodically as long as necessary. I always have a plan post-operatively especially if history, lab work, and initial examination have highlighted the possibility of the coexistence of additional pain generators. I do recommend physical therapy to most if not all patients and rely on a network of physiatrists.
Dr. Cindy Mosbrucker
Dr. Cindy Mosbrucker, M.D.
Dr Cindy Mosbrucker – Endometriosis Specialist, Urogynecologist
Summary: Dr Cindy Mosbrucker MD is a highly respected endometriosis specialist and urogynecologist based in Gig Harbor, Washington. Dr. Mosbrucker brings a compassionate, evidence-based approach to endometriosis care, guided by the belief that peritoneal metaplasia, influenced by genetics, plays a key role in the disease. With a focus on thorough evaluation and individualized treatment, Dr Mosbrucker prioritizes conservative hormone therapy and advanced excision surgery. She avoids GnRH therapies, favoring progestins and multimodal postoperative pain management to enhance patient recovery.
Dr Mosbrucker’s approach to persistent pelvic pain is holistic and thoughtful. Recognizing that most postoperative pain stems from myofascial or pelvic floor dysfunction, she frequently partners with physical therapists and employs non-opioid treatments. Patients searching for expert care from Dr Cindy Mosbrucker MD can trust in her meticulous, patient-centered philosophy focused on long-term relief and improved quality of life.
City: Gig Harbor, Washington, USA
Philosophy: Peritoneal metaplasia, which is genetically influenced
Medication: I do not use any GnRH agonists or antagonists. I will use progestins (either norethindrone or Prometrium) for suppression when necessary, either while waiting for surgery or for those recurrent pains typically from ovarian cysts. I am not opposed to OCPs or progestin-containing IUDs s however, their utility is not as good as progestins alone. I use multimodal pain management postop with TAP blocks, an On-Q pump, gabapentin, tramadol, Sprix (ketorolac nasal spray), antiemetics, and minimal narcotics.
Approach to Persistent Pain: Figure out what is causing their pain. At least 75% of the time, it is myofascial, usually related to pelvic floor spasm. Most of my patients are referred to PT post-op. IC patients are taught installations usually before surgery, but sometimes postop. Those prone to adhesion formation are referred to as visceral mob PTs around 6-8 weeks postop. For those with pain after these interventions, we consider repeat surgery, and my reoperation rate is somewhere between 5% and 10%.
