Myths & Misunderstandings

Go in with a one-page snapshot of your story so the limited time is spent on decision-making, not backtracking. The most helpful snapshot includes: your top 2–3 symptoms, the pattern (cyclical vs daily, triggers, where pain starts and spreads), what you’ve already tried and what happened, and what your symptoms keep you from doing (work, school, intimacy, exercise). If you have a history of “normal” scans, bring that too—because imaging can miss endometriosis, and the pattern of symptoms and prior response to treatment still matters.

Bring the right records if you have them—especially operative reports, pathology, and imaging reports (and ideally the actual images). Then decide your goal for the visit: diagnostic clarity, a plan to evaluate look-alike or coexisting conditions, or a clear surgical discussion (whether surgery is likely to help, anticipated scope, and what recovery may involve). If you want to make the appointment count even more, reach out to our team ahead of time so we can review what you’ve already done and tell you exactly what information would be most useful for a focused, productive conversation.

It depends on what kind of “treatment” you mean—because treating endometriosis itself and managing endometriosis pain don’t always improve on the same timeline. Symptom-focused plans (like pain management strategies) can change how you feel relatively quickly, while disease-directed approaches may take longer to translate into steady, day-to-day relief. And even after technically successful treatment, pain can persist if the nervous system has become sensitized, so we look at the full picture rather than using one symptom as the only yardstick.

In general, we recommend judging progress using patterns over time—your flare frequency, intensity, function (sleep, work, activity), and how predictable your cycles and triggers feel—rather than one “good” or “bad” week. Tracking symptoms helps us see whether you’re trending in the right direction or whether we’re simply masking pain while the underlying drivers remain. If you’ve been cycling through treatments without durable improvement, our team can review your records and symptoms, clarify what the treatment is truly targeting, and map out what a reasonable trial period and next step should look like for your specific situation.

Dr. Vasilev is in full-time practice helping patients with endometriosis. He also happens to be a fellowship-trained gynecologic oncologist who is an expert in MIGS surgery. So that training background doesn’t mean his current practice is focused on cancer care. It reflects very advanced surgical training in complex pelvic anatomy and challenging operative situations, including scar tissue and recurrent disease. In addition, beyond the training that average gynecologic oncologists go through he has additional training and experience derived from mentors in urologic oncology and general surgery, as well as a ten-year extensive experience in collaborative multi-disciplinary surgeries as Director at the City of Hope.

That expertise translates directly to endometriosis and adenomyosis surgery, where it’s often critical to operate safely around the ureters, bowel, bladder, nerves, and major blood vessels, and to make sound decisions in densely scarred tissue. Today, our team’s work is dedicated entirely to endometriosis and adenomyosis care, and we welcome you to reach out if you’d like to discuss your symptoms and surgical options.

No—out-of-network care doesn’t automatically mean you’ll pay 100% of the cost. Many plans still offer out-of-network benefits, and what you owe depends on your specific coverage details and the type of care you receive.

Our team can help you understand the financial side of moving forward, including what information to request from your insurer and what documentation may be needed. If you’d like, reach out to schedule a consultation and we’ll walk you through the process based on your situation.

Before we schedule your consultation, our team completes a brief preliminary review to understand what you’re experiencing and what information is already available. This typically includes reviewing your symptoms and any medical records you’ve shared, so we can route you to the right next steps.

If your history and goals appear to be a good fit for the care we provide, we’ll move forward with scheduling and outline what to expect from the consultation process. If we need anything else to make that decision—such as additional records or clarification—our team will let you know so we can keep things moving efficiently.

Endometriosis isn’t one uniform condition, so study results can vary depending on which lesion types and locations are included, how advanced disease is, and whether participants have had prior hormonal treatment or surgery. Many studies also rely on small or highly selected groups, which can make findings look stronger (or weaker) than they are in real-world patients.

On top of that, research teams may use different diagnostic standards, define outcomes differently (pain scores vs quality of life vs fertility), and follow patients for different lengths of time—so they’re not always measuring the same thing. When we interpret research with patients, we look for results that hold up across larger, more diverse groups and, when possible, well-designed randomized trials, because that’s more likely to reflect what you can expect in care.

Some people with pelvic pain, bloating, or bowel symptoms notice improvement when they reduce gluten and/or dairy—especially if those foods consistently trigger discomfort for them. Others don’t see a meaningful change, so there isn’t one universal “endometriosis diet” that fits everyone.

We typically encourage an individualized approach: paying attention to symptom patterns, making one change at a time, and choosing changes you can maintain without feeling restricted or under-fueled. If your symptoms are significant or you’re unsure whether food is a trigger versus an underlying endometriosis or adenomyosis issue, our team can help you sort that out and discuss next steps.

Patient stories can be incredibly helpful for naming symptoms, spotting patterns, and feeling less alone—but they’re not a forecast of what will happen in your body. The most reliable way to use them is to focus on the “why” behind someone’s experience (what symptoms led them to seek care, what was found, what choices they made), rather than assuming the same diagnosis or outcome applies to you.

Expert opinions are useful, but they’re still interpretation based on the information available and the clinician’s experience. We encourage you to treat expert commentary as a way to generate precise questions about your own situation—what diagnoses are being considered, what evaluations actually clarify them, what risks and tradeoffs matter for you, and what a reasonable plan looks like if symptoms persist. If you’re sorting through conflicting stories or advice, our team can help you translate what you’re reading into an individualized next-step plan and decide what’s most relevant for your case.