Send us a text with a question or thought on this episode ( We cannot replay from this link)
Expert endometriosis surgeon Dr. Abhishek Mangeshikar debunks common myths and provides clear answers to pressing questions about endometriosis management. Drawing from his extensive experience at the Indian Center for Endometriosis, he offers evidence-based insights on treatments, surgical approaches, and unusual symptoms.
• No conclusive data supports the claim that birth control or Lupron causes regression of endometriosis lesions
• Shrinking endometriomas may actually indicate worsening disease as contents leak into the pelvis causing adhesions
• The timing of surgery relative to menstrual cycle generally doesn’t matter for experienced excision specialists
• Operating during a patient’s period may require additional cleaning of the surgical field but doesn’t affect excision outcomes
• Cyclical nosebleeds might be connected to thoracic endometriosis, but medical data remains limited
• Hysteroscopy procedures are the main exception where avoiding menstruation is beneficial for visualization
Got a question? Send it in by using the link in the top of the description of this podcast episode, emailing contact@endobattery.com, or visiting the endobattery.com contact page.
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Introduction to Quick Connect
Speaker 1
0:00
Life
moves
fast
and
so
should
the
answers
to
your
biggest
questions
.
Welcome
to
EndoBattery's
Quick
Connect
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,
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minutes
you
get
the
knowledge
you
need
.
No
long
episodes
,
no
extra
time
needed
,
and
just
remember
expert
opinions
shared
here
are
for
general
information
and
not
for
personalized
medical
advice
.
Always
consult
your
provider
for
your
case-specific
guidance
.
Got
a
question
?
Send
it
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and
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you
the
answers
.
I'm
your
host
,
alana
,
and
it's
time
to
connect
.
Meet Dr. Abhishek Mingashigar
Speaker 1
0:40
Today
we're
honored
to
have
Dr
Abhishek
Mingashigar
join
us
.
Today
we're
honored
to
have
Dr
Abhishek
Mingashigar
join
us
.
Dr
Ming's
is
a
leading
endometriosis
specialist
and
minimally
invasive
gynecological
surgeon
,
known
for
his
groundbreaking
work
at
Indian
Center
for
Endometriosis
in
Mumbai
.
With
expertise
in
advanced
laparoscopic
and
robotic
surgeries
,
he's
dedicated
to
improving
care
for
those
battling
this
complex
disease
.
Let's
dive
in
and
get
answers
to
the
questions
that
matter
Birth Control and Endo Lesions
Speaker 1
1:05
most
to
you
.
Does
taking
birth
control
or
Lupron
drugs
stop
the
endolesion
stimulation
,
therefore
reducing
the
amount
of
lesions
created
,
or
shrink
endolesions
?
Speaker 2
1:16
That's
really
a
good
question
.
So
there's
no
data
to
support
that
.
There
is
some
circumstantial
evidence
which
I
don't
really
believe
too
much
,
that
there
is
some
circumstantial
evidence
which
I
don't
really
believe
too
much
could
be
industry-sponsored
papers
.
But
there
is
no
conclusive
data
to
say
that
any
medication
causes
regression
of
the
lesions
or
the
disease
magically
vaporizes
or
disappears
.
So
I
always
tell
patients
they
would
tell
me
okay
,
I
had
a
cyst
diagnosed
and
the
doctor
put
me
on
progesterone
or
something
.
My
cyst
went
from
eight
centimeters
to
six
centimeters
.
And
I
said
,
first
of
all
,
there
is
no
protocol
to
measure
disease
progression
or
regression
by
measuring
just
the
size
of
the
cyst
.
And
a
cyst
decreasing
in
size
is
worse
than
it's
increasing
in
size
,
which
just
means
that
it's
linking
into
the
pelvis
and
making
things
more
stuck
and
worse
than
they
already
are
.
There's
not
a
good
sign
,
it's
a
bad
sign
.
Speaker 1
2:12
I
can
be
a
testament
to
the
fact
that
it
doesn't
do
that
.
After
being
on
it
for
so
long
,
the
disease
definitely
progressed
.
Is
it
better
or
worse
to
be
on
your
period
before
surgery
or
during
surgery
?
Surgery Timing and Periods
Speaker 2
2:25
It
doesn't
matter
.
I
think
an
experienced
surgeon
who
can
identify
all
subtypes
of
the
disease
can
kind
of
pick
it
up
.
So
most
women
have
retrograde
menstruation
,
believe
it
or
not
.
Not
all
of
them
have
endometriosis
.
So
usually
if
you
will
operate
on
someone
during
that
period
,
there
will
be
blood
in
the
pelvis
.
Now
if
somebody
has
a
lot
of
menstrual
blood
for
whatever
reason
it
could
be
adenomyosis
or
whatnot
then
you're
going
to
have
a
lot
of
blood
in
the
pelvis
and
then
you
have
to
spend
that
extra
couple
of
minutes
washing
and
sucking
that
out
.
It's
not
a
deal
breaker
.
Speaker 2
3:07
I
still
operate
on
patients
during
their
period
,
before
their
period
,
after
their
period
.
It
doesn't
really
make
a
difference
to
the
excision
of
the
endometriosis
part
of
it
.
You
only
try
to
avoid
it
.
If
you're
doing
a
hysteroscopy
,
which
is
where
you
put
a
telescope
into
the
uterus
to
look
at
the
cavity
,
when
you're
doing
an
evaluation
for
fertility
,
or
if
you're
looking
for
a
fibroid
or
a
polyp
or
something
inside
the
uterine
cavity
that
may
be
causing
good
liver
,
then
obviously
you
don't
want
her
to
be
on
a
period
.
Then
you
do
it
post-menstrual
.
Speaker 1
3:40
Okay
,
and
then
if
they
don't
ever
go
post-menstrual
?
Speaker 2
3:44
You
give
them
medication
to
stop
it
.
Speaker 1
3:47
How
do
endo-excision
specialists
address
cyclical
nosebleeds
Addressing Cyclical Nosebleeds
Speaker 1
3:51
?
Speaker 2
3:51
That's
a
tough
one
,
yeah
.
Yeah
,
I've
had
a
couple
of
patients
with
cyclical
nosebleeds
.
One
of
them
had
thoracic
endometriosis
,
but
we
also
did
a
bronchoscopy
.
We
had
the
pulmonology
team
come
in
and
they
looked
through
the
nasal
passages
and
through
the
respiratory
system
to
look
for
any
endometriosis
there
.
They
did
biopsies
but
they
didn't
come
up
with
anything
specific
.
So
I'm
not
sure
on
how
to
proceed
with
that
,
because
the
data
is
very
limited
.
So
you
have
to
kind
of
investigate
what's
causing
it
and
then
come
up
with
a
plan
on
how
to
treat
it
.
Speaker 1
4:30
Can
cyclical
nosebleeds
occur
,
even
if
it's
not
necessarily
endometriosis
in
the
nasal
passages
,
because
you
know
that's
been
found
.
But
I
for
one
have
not
had
a
nosebleed
since
my
excision
surgery
and
hysterectomy
,
which
I
used
to
have
all
the
time
.
Speaker 2
4:45
I
don't
know
.
There
are
many
causes
for
nosebleeds
.
I'm
not
exactly
sure
if
it's
specifically
endometriosis
in
the
nasal
tract
that
would
cause
it
.
It
could
be
a
matter
of
things
.
We
don't
have
enough
information
about
that
kind
of
endometriosis
.
I
would
assume
some
kind
of
thoracic
endometriosis
could
also
present
that
way
,
because
it
is
linked
to
coughing
up
blood
so
it
can
easily
get
into
the
nasal
passages
that
way
too
.
Episode Closing and Contact Info
Speaker 1
5:13
That's
a
wrap
for
this
Quick
Connect
.
I
hope
today's
insights
helped
you
move
forward
with
more
clarity
and
confidence
.
Do
you
have
more
questions
?
Keep
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