Dr. Thaïs Aliabadi

So that's one.

The other thing is, remember I told you stromal endometriosis that doesn't have the glandular aspect of the tissues missing.

The glandular aspect is mostly the fibrous part of it.

These lesions are almost always missed on laparoscopy.

They tend to cause more inflammation and they tend to be more resistant to progesterone, in my opinion.

So those are the ones that you really need to cut out.

But then if you've never seen stromal endometriosis, you will not remove it during surgery and you will wake your patient up and say you didn't have it.

Absolutely.

Breast cancer.

For endometriosis, yes, because during pregnancy, your endometriosis is at bay.

Patients have no pain, right?

It all starts when the menstrual cycle starts again.

But what I do for these patients, as soon as they deliver, I put a progesterone IUD in them.

When they come postpartum, six weeks postpartum, and they're discussing birth control, I always recommend a progesterone birth control.

Postpartum depression, I think, we see more in patients with anxiety, trauma, or PTSD.

So to answer your question,

endometriosis and PCOS patients have anxiety, have depression, and have PTSD.

When you live their experience in their life and everything they've gone through in their life, they all have PTSD.

So anyone with any history of anxiety, PTSD, or depression, or PMDD, a severe form of PMS,

All of these patients are at a higher risk of postpartum depression.