Lora Liu, M.D., Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon.
City: New York City, NY, USA.
Practice Name: Pelvic Rehabilitation Medicine
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.