Dr. José Eugenio Colon
Dr. Alejandro González
Dr. Alejandro González, an expert in endometriosis specializing in gynecology and minimally invasive surgery. Gain insights into pelvic endometriosis, fertility, and treatment options.
Dr. Ana Gabriela Sierra Brozon
Dr. Ana Gabriela Sierra Brozon
Dr Ana Sierra – Minimally Invasive Gynecological Surgery
Summary: Dr Ana Sierra is a skilled minimally invasive gynecologic surgeon based in Mexico City, specializing in endometriosis care. With a deep understanding of the condition’s complexity, Dr Ana Sierra embraces a unique approach grounded in the mesodermal origin theory, viewing endometriosis as a congenital condition rather than one solely caused by retrograde menstruation. This insight shapes her commitment to early diagnosis and precision excision surgery, making Dr Ana Sierra a trusted choice for patients seeking expert, evidence-based care.
She creates personalized treatment plans that may include hormonal therapy, anti-inflammatory supplements, and pelvic floor physiotherapy. When persistent pain remains after surgery, Dr Ana Sierra conducts a thorough neuropelviology evaluation and collaborates closely with pain management specialists. Patients benefit from her thoughtful, multidisciplinary approach and dedication to long-term relief. With Dr Ana Sierra, endometriosis care is comprehensive, compassionate, and rooted in the latest medical understanding.
City: Mexico City, Mexico
Philosophy of Endometriosis Care: Our approach to the treatment of endometriosis is based on the mesodermal origin theory, which suggests that individuals are born with endometriotic-like cells due to embryological misdifferentiation of the mesoderm. This theory posits that endometriosis is not solely a retrograde menstruation phenomenon but rather a condition that originates during fetal development, where misplaced Müllerian or mesothelial cells retain their potential to differentiate into endometrial-like tissue later in life.
This perspective explains why endometriosis can be diagnosed in prepubertal patients, postmenopausal women, and even in cases without functional menstruation. It also underscores the importance of a comprehensive excision-based surgical approach, as the disease is not merely a result of refluxed endometrial tissue but rather a condition embedded in the developmental blueprint of the pelvic structures. Understanding endometriosis from a congenital standpoint allows us to refine treatment strategies, emphasizing early diagnosis, precision excision surgery, and a multidisciplinary approach to improve patient outcomes.
What type of surgery do you perform for endometriosis: Excision
Medication: Hormonal treatment, primarily progestins, only when necessary; anti-inflammatory diet; pelvic floor physiotherapy; anti-
Approach to Persistent Pain After Surgery: If the patient persists with neurological alterations, I perform an extensive neuropelviology evaluation and interconsultation with pain management specialists.
Dr. Abdala Karame
Dr. Abdala Karame, Endometriosis Specialist
City: Maracaibo, Venezuela
Dr. Paul Tyan
Dr. Paul Tyan, M.D.
Dr Paul Tyan – Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
Summary: Dr Paul Tyan is a leading endometriosis specialist and minimally invasive gynecologic surgeon based in Arlington, VA. Known for his patient-centered approach and deep expertise, Dr. Tyan brings clarity and compassion to those navigating the complexities of endometriosis. Patients searching for experienced care often turn to Paul Tyan, or Dr Paul Tyan, for his commitment to evidence-based, individualized treatment plans. With a strong foundation in the latest research, including genetic and epigenetic insights, Dr Tyan endometriosis care emphasizes early intervention and holistic pain management.
He specializes in excision surgery and integrates hormonal therapies, physical therapy, and medication tailored to each patient’s needs. Whether you’re exploring treatment for deeply infiltrative endometriosis or managing persistent pain after surgery, Dr. Paul Tyan offers thoughtful, comprehensive support. With Dr Tyan endometriosis care, patients receive both advanced clinical knowledge and the compassionate guidance they deserve.
City: Arlington, VA, USA
Philosophy: In its most basic definition, endometriosis is the presence of endometrial cells (that form the inner lining of the uterus) outside the uterus. In some patients, those ectopic cells can produce an inflammatory response that is at the origin of various cascades that can lead to pain or scarring. There are multiple proposed theories about the origin of endometriosis. The only certainty is that the origin of endometriosis is multifactorial.
The retrograde menstruation or implantation theory is one of the initial principles of the pathogenesis of endometriosis;however, it has been challenged as the single cause for several years, as evidenced by the occurrence of symptomatic endometriosis in premenarchal and postmenopausal women. Also, by the fact that nearly all patients will have retrograde menstruation, but not everyone has endometriosis.
Most recently, we have had significant advances in the genetic and epigenetic theory of endometriosis. The clonality of endometriosis lesions and the cancer-driver genes that have been identified in deeply infiltrative endometriosis lesions shed light on the genetic component of the disease. Recent work on the epigenetic factors linked to external conditions affecting pluripotent cell behavior in the setting of endometriosis is a promising field set to unveil exciting information.
Keeping up to date with the intricacies of the pathogenesis of endometriosis is crucial to my clinical practice. Many patients will be counseled over the years that surgery is unnecessary at that blocking the menstrual cycle or hormonal suppression is sufficient for “curing” endometriosis. Explaining to patients the complex nature of the disease and the necessity of early intervention, especially in the deeply infiltrative endometriosis subtype, could be a crucial factor in decreasing morbidity and improving the quality of life of my patients.
What type of surgery do you perform for endometriosis?:
Excision
Medication: I recommend a combination hormonal contraceptive (birth control) for post-surgical suppression. In cases where a combination option is contraindicated, I recommend a progesterone-only option.
I recommend treatment with an SSRI, SNRI, or GABA-Analog for patients with central sensitization due to chronic pain secondary to endometriosis.
For patients with pelvic floor tension myalgia, I recommend physical therapy, various muscle relaxers, and trigger point injections or nerve blocks in warranted conditions.
Treatment plans tend to be individualized based on the patients’ presenting symptoms, surgical management, and postoperative course.
Approach to Persistent Pain After Surgery: For some patients, endometriosis excision is sufficient for complete symptomatic relief. However, some patients will still have symptoms after surgery. It is crucial to counsel patients before surgery that endometriosis excision is only one aspect of a comprehensive management plan that should involve central and peripheral pain management, pelvic floor physical therapy, and dietary modification.
Dr. Miguel Luna Russo
Dr. Miguel Luna Russo, Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
City: Cleveland, Ohio, United States
Dr. Elvira Bratila
Prof. Dr. Elvira Bratila, MD, Ph.D., Endometriosis Specialist, Gynecologist
City: Bucharest, Romania
Dr. Lawrence Sullivan
Dr. Lawrence Sullivan, Endometriosis Specialist, Gynecologist
City: Enosburg Falls, Vermont, USA
Dr. Benjamin Beran
Dr. Benjamin Beran, Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
City: Milwaukee, Wisconsin, USA
Dr. Stephanie Delgado
Dr. Stephanie Delgado, Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
City: Miami, Florida, USA
Dr. Nicholas Hazen
Dr. Nicholas Hazen, M.D.
Dr Nicholas Hazen – Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
Summary: Dr Nicholas Hazen MD, a renowned endometriosis specialist and gynecologist based in Washington DC, USA, is dedicated to providing personalized care for women dealing with endometriosis. Dr Hazen understands that the disease process is still not fully understood, and he combines scientific evidence with personal experience to tailor treatment for each patient. When surgery is required, he favors an excisional approach with wide margins to ensure the best possible outcomes.
In managing endometriosis, Dr Nicholas Hazen MD uses a range of treatments, including progestational agents, GnRH antagonists, NSAIDs, and gabapentinoids. He emphasizes a holistic approach, recognizing the importance of diet and mental health in managing pain. For patients experiencing persistent pain after surgery, Dr. Hazen customizes treatment plans to meet each individual’s needs, working closely with them to extend pain relief and improve quality of life.
City: Washington DC, USA
Philosophy: I believe there is still more that is unknown than known about the disease process of endometriosis. Quality scientific evidence supports multiple current etiologies, suggesting that endometriosis is not a simple process with a simple solution. My approach to surgical treatment is based on my most up to date understanding of the disease process, in combination with my personal experience caring for patients along their unique health journeys. When surgery is warranted, I favor an excisional approach with wide margins to include both visible and surrounding microscopic disease. In my experience, this leads to the best outcomes for patients.
Medication: The choice of medication for the management of endometriosis is an extremely individual one. Finding the best fit for a patient requires reviewing both their current status and past history very thoroughly, including their previous experiences, the evolution of their symptoms, and their individual management goals. In my practice, I most commonly prescribe progestational agents but often recommend GnRH antagonists. The current literature shows that suppression results in decreased return of pain and symptoms following endometriosis surgery, and I often recommend and manage post-surgical resection hormonal suppression. I use non-narcotic medications such as NSAIDS for the treatment of pain and gabapentinoids and SNRI/SSRIs for central sensitization. I believe that diet and mental health also play an important role in the body’s pain response to endometriosis.
Approach to Persistent Pain After Surgery: I believe there is no single “right” approach to addressing continued pain after surgery. Every patient is different, and so is each surgery, so it is critical to individualize treatment plans based on a patient’s unique needs. It has been widely shown that for the majority of patients, the pain relief experienced from surgery is unfortunately only temporary. In the continued care of my patients, my goal is always to work together to extend pain relief as long as possible and minimize impacts and disruptions to the patient’s life going forward.
Dr. Ulises Armando Menocal Tavernier
Dr Ulises Armando Menocal Tavernier
Dr Ulises Armando Menocal Tavernier – Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
Summary: Dr Menocal is a highly skilled endometriosis specialist and gynecologist based in Morelia, Michoacán, Mexico. As a minimally invasive gynecologic surgeon, Dr Menocal provides personalized and compassionate care to women suffering from endometriosis. His approach to the condition is grounded in the coelomic metaplasia theory and the endometrial stem cell recruitment theory, which helps inform his treatment strategy.
Dr Ulises Armando Menocal Tavernier utilizes a range of treatments, including combined oral contraceptives for young women and Dienogest following surgery, to manage symptoms and improve quality of life. For patients with persistent pain after surgery, Dr. Menocal follows a multidisciplinary approach, collaborating with nutritionists, psychologists, and pelvic rehabilitation specialists. In some cases, he may recommend a second-look laparoscopy to assess the effectiveness of treatment.
City: Morelia, Michoacan, Mexico
Philosophy: Coelomic metaplasia
Medication: Combined oral contraceptives in young women for a period of 6 months up to 5 years
Approach to Persistent Pain After Surgery: Patients will remain in a multidisciplinary approach with a nutritionist, psychologist, and pelvic rehabilitation. And in some patients, we will perform a second-look laparoscopy.
