Dr. Amanda Chu, Endometriosis Specialist
City: New York, USA
Philosophy of Endometriosis Care: No single theory adequately explains all presentations of endometriosis, but I believe that certain theories play more of a role in individual patients. Older theories have merit, e.g., retrograde menstruation and coelomic metaplasia, but we are constantly increasing our knowledge of endometriosis, & I think that epigenetics and immune dysregulation will become increasingly important.
What type of surgery do you perform for endometriosis?: Excision
Medication: Currently, hormonal medications are a useful and, at times, necessary adjunctive for cyclic symptoms and ovarian cyst prevention. Typically, I utilize continuous progesterone-only medications with the goal of amenorrhea/anovulation. I prefer to avoid GnRH agonists/antagonists for long-term use given their severe side effect profile.
Approach to Persistent Pain After Surgery: Postoperatively, I prefer to focus on finding less invasive ways to decrease inflammatory, musculoskeletal, & neuropathic pain rather than repetitive procedures. I believe in treating all etiologies of pain, including often coexisting comorbidities, and well as being receptive to approaches that expand beyond traditional Western medicine. Finally, the mental & social impact of endometriosis cannot be overstated, and a multidisciplinary team is essential.