Dr. Thaïs Aliabadi

They could be in the ovary called endometrioma, or they can be deep infiltrating, where they go deep.

And as I told you, they make their own nerve fibers.

And what happens eventually, these nerve fibers start shooting

And our central nervous system starts going in overdrive and exaggerating those pains.

That's why the pain is so real and so debilitating because their body, they get sensitization to this new nerve pains that are forming in their pelvis.

The gold standard way of treating this is a laparoscopic resection of endometriosis.

So let's talk about that.

So you don't have to jump to surgery, but surgery is the gold standard way of diagnosing A, to be 100% if you're not confident, and B,

cutting these, excising these lesions.

We used to burn them, but as of like for the past 15 years, we've learned that you really need to cut them.

You don't want to burn them, right?

Because burning them is just a bandaid and the pain comes back.

They stubborn and they're painful.

Here's the problem, Andrew.

Surgery is not first-line therapy, but it's gold standard if you have a patient in severe pain who's not responding to hormonal suppression, which we're going to talk about.

But here's the problem with surgery.

Do you know that out of 100 gynecologists, one is trained to do laparoscopic endometriosis surgery?

And then it gets better.

If you give 100 laparoscopes,

to 100 gynecologists, half of them will wake the patient up and say you didn't have it.