In this episode, Dr. Shanti Mohling and Dr. Nicholas Fogelson explore one of the most intriguing emerging questions in endometriosis care: could GLP-1 receptor agonists, such as Ozempic and Zepbound, play a role in reducing endometriosis-related symptoms? These medications are not currently FDA-approved for endometriosis, and the evidence is still early. But patient reports, survey data, and basic science raise compelling questions about how GLP-1s may affect inflammation, pain, and the broader systemic nature of endometriosis. Drs. Fogelson and Mohling discuss what is known, what remains speculative, the potential risks, and why a possible non-hormonal approach is worth watching. Highlights: How GLP-1 receptor agonists work beyond blood sugar and weight, including effects on appetite, satiety, reward pathways, the microbiome, and inflammation. Why endometriosis is increasingly understood as a systemic inflammatory disease, not just lesions in the pelvis. Early observations from patients and surveys suggesting some people with endometriosis report symptom improvement while taking GLP-1 medications. The current limits of the evidence, including the lack of randomized trials and the fact that GLP-1s are not medically indicated for endometriosis. Potential risks and side effects, including gastrointestinal symptoms, gastroparesis, gallbladder disease, pancreatitis, muscle loss, and the need for medical supervision. NOTE: Anyone considering GLP-1s should speak with their own physician about potential risks, side effects, and whether they are appropriate. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected]  Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.   

Olympic sprinter Brittany Brown joins Dr. Nicholas Fogelson to talk candidly about living, training, and competing with endometriosis at the highest level. From years of painful and heavy periods, to receiving dismissive medical advice, to eventually undergoing surgery in the middle of an elite track career, Brittany shares what it took to advocate for herself and what recovery actually looked like. They discuss the physical toll of endometriosis, the mental challenge of adjusting expectations after surgery, and why more honest conversations are needed about diagnosis, treatment, and life after "pushing through." Episode Highlights: Brittany shares how endometriosis symptoms began in college and gradually intensified during her rise as an elite sprinter How chronic pain, fatigue, and inflammation affected Brittany's body on and off the track Her medical journey and experience with medical dismissal, including being told to consider a hysterectomy or having a baby as a solution What surgery and recovery looked like for a professional athlete trying to return to high-intensity competition Brittany reflects on advocacy, visibility, and supporting other athletes navigating endometriosis and surgery For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected]  Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.  

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 [email protected]  Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.    

In this sponsored episode of The Endometriosis Podcast, Dr. Nicholas Fogelson and Dr. Shanti Mohling are joined by Dr. Bruce Lessey—the researcher who identified BCL6 as a marker of endometrial inflammation—and Chris Jackson, CEO of Cicero Diagnostics, the company that brought his discovery to market as the ReceptivaDx test. Together, they explore how a gene first studied in lymphoma research became a tool for detecting progesterone resistance and inflammation linked to endometriosis. The conversation covers how the test works, who it's most useful for, how accurate it is, what its limitations are, and where non-invasive diagnostics for endometriosis may be heading next. Highlights: What BCL6 is and how it disrupts progesterone signaling and implantation How Dr. Lessey's research became the ReceptivaDX clinical test When this test is most helpful in infertility and recurrent pregnancy loss What a positive result does—and doesn't—mean Why earlier, less invasive diagnosis could change endometriosis care For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected]  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 [email protected]  Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.    

In this episode, Dr. Nick Fogelson and Dr. Shanti Mohling take on one of the most persistent gray zones in gynecology: how to safely use hormone replacement therapy in patients with current or past endometriosis. Moving beyond the simplistic "estrogen bad" narrative, they explore what the data actually show about recurrence, cancer risk, and quality of life. The discussion weaves clinical insight with case studies, examining how progesterone's protective role, surgical completeness, and individualized dosing all shape outcomes. Highlights: The lingering misconceptions from the Women's Health Initiative study and what modern research now shows about the safety of hormone replacement. Why bioidentical progesterone should often accompany estrogen—even in hysterectomized patients with prior endometriosis. Real-world case studies revealing how residual disease and incomplete excision affect postmenopausal pain and risk. The broader benefits of HRT—stronger bones, cardiovascular protection, cognitive support—and how fear-based medicine often obscures them. Updates from the surgical front: robotic excision of endometriosis in outpatient centers, plus a preview of the next episode on MyReceptiva's diagnostic test for endometriosis. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected]  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 [email protected]  Follow us on Instagram: @Nicholasfogelson and @drshantimohling Download a transcript of this episode.    

In this illuminating episode, Dr. Shanti Mohling and Dr. Nicholas Fogelson dive into the science behind supplements and functional medicine approaches to managing endometriosis. From NAC and curcumin to the role of Vitamin D and the gut microbiome, they explore which anti-inflammatory tools hold real promise—and which ones may not. They also tackle a listener's question about persistent post-op symptoms and break down why the term "IBS" isn't always the end of the diagnostic road. Highlights: The anti-inflammatory mechanisms of NAC, alpha-lipoic acid, curcumin, and fish oil Why Vitamin D deficiency may worsen endometriosis—and how much to take Discussing the limits of zinc and resveratrol in treating symptoms The role of probiotics and gut health in managing "endo belly" Why supplement research is underfunded and how politics shapes what gets studied For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected]  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 [email protected]  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 discuss a compelling new study from the Journal of Minimally Invasive Gynecology exploring spontaneous conception and live birth rates in infertility patients after endometriosis surgery. They break down what the data reveals about excision versus ablation, the role of age, and the surprising lack of correlation between disease stage and fertility outcomes. Along the way, they examine how inflammation impacts egg viability, why BMI may not matter as much as once believed, and how social media is transforming surgical education and patient advocacy. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected]  Follow us on Instagram: @Nicholasfogelson and @drshantimohling Highlights: What a retrospective cohort study reveals about spontaneous conception rates after excision surgery Why disease stage may not determine fertility potential in endometriosis patients How inflammatory environments—not just structural damage—interfere with egg survival and implantation What the data shows about BMI having no significant impact on post-surgical fertility outcomes Why surgical video sharing on social media is reshaping education, access, and accountability in the field Download a transcript of this episode.