Dr. Jaime Ocampo, M.D., Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
City: Daly City, CA, USA
Philosophy: The most accepted mechanism by which endometriosis occurs is retrograde bleeding. It is certainly possible that most endometriosis happens through this process but the coelomic mutation is also a possible mechanism. Surgical treatment is tailored to the patient’s need and whether they have deep infiltrating endometriosis, ovarian endometriosis, or adenomyosis. Also, fertility is an important factor when deciding on treatment.
Medication: I think the data is better on progesterone treatment. In the United States Aygestin is available but also I use Dienogest. I sometimes use depo lupron but less and less as the side effect profile o progesterone is better.
Approach to Persistent Pain After Surgery: I think persistent symptoms many times point to somatic pelvic floor pain which goes hand in hand with endometriosis. Of course, recurrences occur and I think hormonal treatment is important.