The Endometriosis Podcast

In this special episode of The Endometriosis Podcast, Dr. Nicholas Fogelson travels to Kerugoya, Kenya, for the Healing Mama Africa Bootcamp and Conference, where surgeons, advocates, and educators from around the world come together to expand access to endometriosis care in Africa. Through a series of on-the-ground conversations, the episode explores what it means to deliver complex surgical care in a low-resource setting, why patient advocacy and education matter so deeply, and how collaboration across borders is helping change the future of endometriosis treatment. Highlights: Dr. Joe Njagi shares the vision behind Healing Mama Africa and how one ambitious idea grew into a groundbreaking conference bringing expert training, complex surgery, and long-overdue care to patients across the continent. Endometriosis advocate Arti Shah reflects on her decades-long journey with endometriosis in Kenya and explains why patient empowerment, better information, and tools like her educational game Endo Quest are essential for changing the landscape. Dr. Myriam En Nosse discusses her highly specialized work in female genital mutilation reconstruction and brings a broader global women's health perspective to the conversation, centered on dignity, healing, and surgical restoration. Dr. Ahmed Al Minawi brings a regional surgeon's perspective from Egypt, reflecting on healthcare in Egypt broadly, the unusually severe and fibrotic endometriosis cases seen at Healing Mama Africa, and the extraordinary dedication behind offering these surgeries free of charge. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.

In this episode of The Endometriosis Podcast, Dr. Nicholas Fogelson and Dr. Shanti Mohling take on one of the most emotionally charged and misunderstood topics in pelvic pain care: hysterectomy. Drawing on decades of surgical experience, they unpack common myths, clarify confusing terminology, and explain when hysterectomy may—or may not—be an appropriate part of endometriosis treatment. This thoughtful, nuanced conversation emphasizes individualized care, informed consent, and the importance of excision surgery alongside any uterine decision Highlights: Why hysterectomy does not cure endometriosis—and why it can still be helpful for some patients with pelvic pain The difference between hysterectomy, ovary removal, and fallopian tube removal (and why the distinctions matter) Adenomyosis, fibroids, and other uterine pain sources that can influence surgical decisions Effects of hysterectomy on hormones, menopause timing, sexual function, and pelvic organ support How surgical technique, experience, and thorough excision impact long-term outcomes and recurrence risk For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.

In this thought-provoking episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling delve into new research that challenges how we understand adenomyosis in relation to endometriosis. They break down the proposed subtypes of adenomyosis— from interna and externa to intramural and adenomyomas— and discuss how these patterns may arise from childbirth, uterine surgery, or molecular changes shared with endometriosis. Along the way, they revisit century-old theories, weigh the evidence for different pathways of disease development, and explore what this means for treatment decisions, fertility preservation, and patient pain. Highlights: Defining adenomyosis and how it differs from—and overlaps with—endometriosis Subtypes of adenomyosis: interna, externa, intramural, and adenomyomas Theories of origin: tissue injury and repair, retrograde menstruation, embryonic remnants, and genetic mutations Why hysterectomy can sometimes relieve pain when conservative surgery cannot Understanding why patients with minimal disease may have severe pain while others with advanced disease experience little or none For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.

In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling dive deep into the complex overlap between endometriosis and nerve-related pelvic pain. They discuss a pivotal paper by Dr. Marc Possover on laparoscopic treatment for endometriosis and vascular entrapment of the sacral plexus — groundbreaking work that opened new paths for addressing sciatica caused by pelvic disease. The conversation explores how nerve irritation and compression can manifest, why menstrual cycle patterns matter, and how careful patient selection guides surgical decisions. If you or someone you know has unexplained sciatic or pelvic pain that worsens cyclically, this episode is essential listening. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com Follow us on Instagram: @Nicholasfogelson and @drshantimohling Highlights: Why "sciatica" describes symptoms — not a standalone diagnosis — and how to trace its true source. The critical differences between sciatic nerve endometriosis, sacral nerve root involvement, and vascular compression. How menstrual cycle timing can provide vital clues to nerve-related pain origins. The role of neuropelveology in surgically addressing complex pelvic nerve pain What patients can realistically expect from surgery — and why improvement, not perfection, is the goal. Download a transcript of this episode.

In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling relaunch The Endometriosis Podcast with an in-depth look at one of the most crucial surgical decisions for patients with deep endometriosis: how aggressive should bowel surgery be? You'll hear their thoughts on recent meta-analysis comparing conservative techniques (like shave and discoid resection) to radical approaches (like segmental bowel resection). Dr. Fogelson and Dr. Mohling break down how disease severity, nerve preservation, and surgical judgment all shape patient outcomes — and why sometimes a more radical surgery is not only necessary, but life-changing. Along the way, they share real-world cases, challenge common assumptions, and invite listener questions. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com Follow us on Instagram: @Nicholasfogelson and @drshantimohling Highlights: What the research reveals about constipation risks after conservative vs. radical bowel surgery How nerve-sparing strategies protect long-term bowel and pelvic health When a conservative approach succeeds — and when deeper excision is needed for lasting relief Why flexible decision-making during surgery leads to better outcomes than imaging alone How understanding the differences between superficial and deep disease leads to more effective treatment Download a transcript of this episode.

Dr. Nicholas Fogelson, MD, and Libby Hopton discuss new literature on endometriosis. Studies include a comparison of excision and ablation surgeries for superficial endometriosis, and a literature review on treating the disease with hormonal contraception. Also, a look at how endometriosis may be connected to the state of a patient's microbiome, and more.

Dr Nicholas Fogelson, MD, and researcher Libby Hopton discuss new literature on endometriosis and answer question from the endometriosis patient community. Topics include endometriosis research production, BPA and endometriosis incidence, outcomes after resection of bladder endometriosis, and others This episode was originally published in January 2017.