Endometriosis

Multidisciplinary Endometriosis Care at Hoag

Hoag provides comprehensive, multidisciplinary care for individuals living with endometriosis — a chronic inflammatory disease that can affect far more than the reproductive organs. As a designated Center of Excellence in Multidisciplinary Endometriosis Care by the Surgical Review Corporation (SRC), Hoag brings together experts across gynecology, colorectal surgery, fertility, imaging, pain management, pelvic floor therapy, gastroenterology, urology, and other specialties to deliver coordinated, patient-centered care tailored to each individual.

Led by Dr. Marc Winter, Medical Director of Minimally Invasive Gynecology, and Dr. Elizabeth Raskin, Chief of Colorectal Surgery and Co-Chairs of the Endometriosis Advisory Council, Hoag's multidisciplinary program is designed to accurately diagnose and comprehensively treat even the most complex cases of endometriosis.

What is Endometriosis?

Endometriosis is a chronic, systemic inflammatory disease in which tissue similar to the lining of the uterus grows outside the uterus. These growths, called lesions, can develop throughout the pelvis and, in some cases, beyond the reproductive organs, affecting the bowel, bladder, diaphragm, nerves, and other areas of the body.

Although endometriosis is often associated with painful periods, it is not simply a “menstrual condition.” The disease can cause ongoing inflammation, pain, fertility challenges, gastrointestinal and urinary symptoms, fatigue, and significant impacts on quality of life.

Endometriosis affects approximately 1 in 10 women and individuals assigned female at birth during their reproductive years, though it can also occur in adolescents, postmenopausal individuals, and, in rare cases, those without menstruation.

Symptoms of Endometriosis

Symptoms vary widely from person to person, and severity of symptoms does not always correlate with the extent of disease. Common symptoms may include:

• Chronic pelvic pain

• Painful periods (dysmenorrhea)

• Heavy or irregular menstrual bleeding

• Pain during or after intercourse

• Pain with ovulation

• Lower back, hip, groin, or abdominal pain

• Painful bowel movements or urination

• Bloating or abdominal pressure (“endo belly”)

• Constipation or diarrhea

• Nausea or vomiting

• Bladder pressure or urinary dysfunction

• Fatigue and exhaustion

• Infertility or difficulty becoming pregnant

• Pain that extends beyond menstrual cycles

In more advanced or complex cases, endometriosis may also contribute to bowel, bladder, nerve, or diaphragmatic symptoms.

Important to Know

Endometriosis is frequently underdiagnosed or misdiagnosed. Many patients are told their symptoms are “normal” or “just bad periods,” leading to delays in diagnosis that can span years.

How Endometriosis is Diagnosed

Diagnosing endometriosis begins with a detailed medical history, symptom review, physical examination, and advanced imaging when appropriate.

While imaging studies such as ultrasound or MRI may help identify certain forms of endometriosis, imaging alone cannot rule out the disease. In many cases, minimally invasive laparoscopy with tissue biopsy remains the gold standard for definitive diagnosis.

At Hoag, patients benefit from coordinated evaluation by specialists experienced in recognizing both common and complex presentations of endometriosis.

Hoag's Multidisciplinary Approach to Endometriosis Care

Because endometriosis can affect multiple body systems, effective treatment often requires care from more than one specialty.

Hoag’s Multidisciplinary Endometriosis Care Program brings together experts across:

• Minimally invasive gynecologic surgery

• Colorectal surgery

• Fertility and reproductive endocrinology

• Gastroenterology

• Urology and urogynecology

• Pelvic floor physical therapy

• Pain management

• Nutrition and lifestyle support

• Mental health and wellness support

• Advanced imaging

This collaborative model allows Hoag physicians to develop individualized treatment plans that address the full scope of symptoms and long-term health goals.

Treatment Options for Endometriosis

Although there is currently no cure for endometriosis, comprehensive treatment can significantly improve quality of life and reduce symptoms.

Treatment plans may include:

Minimally Invasive Surgery

Laparoscopic or robotic-assisted excision surgery removes visible endometriosis lesions while preserving healthy tissue whenever possible. At Hoag, we offer the most advanced surgical options available for treating endometriosis, including minimally invasive options such as laparoscopic and GYN robotic surgery.

Hoag’s GYN robotic team is recognized as a Center of Excellence in Robotic Surgery (COERS) by the Surgical Review Corporation for demonstrating unparalleled commitment and ability to consistently deliver safe, effective, evidenced-based care. Hoag is committed to providing the highest-quality care to its patients through expert use of the da Vinci® Surgical System.

The combination of technological advancements provided by robotic-assisted surgery ensures the surgery is much easier to perform.

Additional benefits to GYN robotic-assisted surgery include:

• Less post-operative pain and scarring

• Decreased blood loss and lower risk of blood transfusion

• Lower risk of infection

• Shorter hospital stay

• Faster return to normal activities

Medical Management

Hormonal therapies and other medications may help reduce inflammation and manage symptoms for some patients.

Pelvic Floor Physical Therapy

Pelvic floor dysfunction commonly occurs alongside endometriosis. Specialized therapy can help reduce pain, improve mobility, and restore function.

Fertility Evaluation and Support

Endometriosis can affect fertility. Hoag offers coordinated reproductive endocrinology and fertility services for patients planning future pregnancies.

Nutrition and Lifestyle Support

Inflammation management, nutrition counseling, exercise guidance, and stress reduction strategies may support overall well-being.

Understanding Endometriosis Stages

Endometriosis may be classified into stages based on the location, depth, and extent of disease. However, staging does not reliably predict symptom severity.

Some individuals with minimal disease may experience severe pain, while others with extensive disease may have fewer symptoms.

At Hoag, treatment decisions are based on each patient’s symptoms, goals, imaging findings, and overall health — not staging alone.

Why Choose Hoag for Endometriosis Care?

Designated Center of Excellence

Hoag has been designated a Center of Excellence in Multidisciplinary Endometriosis Care by the Surgical Review Corporation (SRC), recognizing the program’s expertise, quality standards, and collaborative approach to care.

Personalized Treatment Plans

Every patient’s experience with endometriosis is unique. Hoag develops individualized care plans aligned with each patient’s symptoms, reproductive goals, and quality-of-life priorities.

Leading Women’s Health Care

Hoag is nationally recognized for excellence in women’s health and minimally invasive gynecologic surgery.

Coordinated Multidisciplinary Care and Advanced Surgical Expertise

Hoag’s minimally invasive gynecologic surgeons and colorectal surgeons work together to treat complex and deeply infiltrating endometriosis. Patients have access to a comprehensive team of specialists across multiple disciplines in one integrated program.

Meet our Endometriosis Advisory Council Co-Chairs:

• Dr. Marc Winter, Medical Director of Minimally Invasive Gynecology

• Dr. Elizabeth Raskin, Chief of Colorectal Surgery

Meet our Gynecologic Health team

Meet our Pelvic & Sexual Health team