Endometriosis Specialist Austin and Fibroids: What to Know

Endometriosis Specialist Austin and Fibroids: What to Know

If you are searching for an endometriosis specialist in Austin or trying to understand how fibroids fit into your symptoms and treatment choices, you are not alone. Endometriosis and uterine fibroids are two of the most common gynecologic conditions, yet they are frequently misunderstood and underdiagnosed. The good news: Central Texas offers access to board-certified obstetrician-gynecologists, minimally invasive gynecologic surgeons, reproductive endocrinology and infertility specialists, and interventional radiologists who can tailor care to your goals.

Endometriosis vs. Fibroids at a Glance

  • Endometriosis: Tissue similar to the uterine lining grows outside the uterus, often on the ovaries, fallopian tubes, pelvic peritoneum, or bowel. It commonly causes pelvic pain, painful periods, pain with sex, and sometimes infertility. About 1 in 10 people of reproductive age are affected, according to NIH and the Office on Women’s Health.
  • Uterine fibroids: Noncancerous growths of the uterine muscle that can cause heavy or prolonged menstrual bleeding, pelvic pressure, bladder or bowel symptoms, and sometimes fertility or pregnancy complications. NIH estimates most women develop fibroids by age 50, though many are asymptomatic.

It is possible to have both conditions at the same time, and symptoms can overlap. A specialist can help tease apart the likely drivers of your pain or bleeding and design a stepwise plan.

When to See an Endometriosis or Fibroid Specialist in Austin

Consider a specialist if you have:

  • Severe period pain that limits school, work, or daily activities
  • Pain with sex, bowel movements, or urination, especially around your period
  • Heavy bleeding that leads to anemia, fatigue, or flooding through pads or tampons
  • Pelvic pressure, a visibly enlarged abdomen, or frequent urination
  • Trouble conceiving after 6 to 12 months of trying
  • No relief after trying first-line treatments with your primary OB-GYN

In Austin, look for board-certified OB-GYNs with additional expertise in minimally invasive gynecologic surgery (MIGS), endometriosis excision, or reproductive endocrinology, depending on your goals for pain relief, fertility, or both.

How Specialists Diagnose These Conditions

A careful history and pelvic exam are the starting points. Your clinician may also recommend:

  • Pelvic ultrasound: First-line imaging for fibroids to assess number, size, and location; can sometimes suggest ovarian endometriomas.
  • MRI: Helpful when anatomy is complex, fibroids are numerous, or adenomyosis is suspected.
  • Laparoscopy: A minimally invasive surgery that remains the definitive way to diagnose endometriosis and allows treatment at the same time. Many clinicians will also offer empiric medical treatment based on symptoms without surgery when appropriate.
  • Blood tests: To check for anemia in heavy bleeding and to rule out other conditions.

Evidence-Based Treatments You Can Access in Austin

Endometriosis management

  • Pain control: NSAIDs can reduce inflammatory pain for some patients.
  • Hormonal suppression: Combined oral contraceptives, progestin-only pills, depot medroxyprogesterone, or levonorgestrel IUDs can decrease pain by suppressing endometrial-like tissue activity.
  • GnRH modulators: Oral GnRH antagonists such as elagolix have FDA approval for moderate to severe endometriosis pain. These medications lower estrogen levels and can cause hot flashes and bone mineral density loss; clinicians often use add-back therapy and limit duration per FDA labeling.
  • GnRH agonists: Leuprolide acetate and others may be used short term, typically with add-back hormones to protect bone health.
  • Surgery: Laparoscopic excision or ablation of endometriosis can relieve pain and may improve fertility in selected cases. High-volume minimally invasive surgeons in Austin can often perform outpatient procedures with small incisions and faster recovery.
  • Multidisciplinary care: Pelvic floor physical therapy, nutrition counseling, and pain psychology can augment medical and surgical treatment.

Fibroid management

  • Watchful waiting: If fibroids are small and symptoms are mild, regular monitoring may be all that is needed.
  • Medical therapy: NSAIDs for cramps; hormonal contraceptives or levonorgestrel IUDs for bleeding control; tranexamic acid as a nonhormonal option for heavy menstrual bleeding on period days.
  • GnRH modulators: Oral combinations containing a GnRH antagonist with add-back therapy have FDA approval to reduce heavy menstrual bleeding from fibroids. GnRH agonists can also shrink fibroids temporarily, sometimes used before surgery.
  • Uterine-sparing procedures: Uterine fibroid embolization (UFE) by an interventional radiologist blocks fibroid blood flow to shrink them; MRI-guided focused ultrasound is a noninvasive option for select candidates. Discuss future pregnancy goals, as data on fertility after UFE are mixed.
  • Surgery: Myomectomy removes fibroids and preserves the uterus; approaches include hysteroscopic (inside the cavity), laparoscopic or robotic, and open surgery depending on size and number. Hysterectomy is definitive for those who do not desire future pregnancy.

Your Austin-based team will tailor options to your symptoms, health status, fertility goals, and preferences, starting with the least invasive approach likely to help.

Choosing the Right Specialist in Austin

To find a good fit:

  • Check credentials: Board certification in OB-GYN; fellowship training in MIGS or reproductive endocrinology for complex endometriosis or fertility; interventional radiology credentialing for UFE.
  • Ask about experience: Annual case volumes for laparoscopic excision, myomectomy, hysteroscopy, UFE, or MR-guided focused ultrasound.
  • Align on goals: Pain relief, bleeding control, fertility preservation, or definitive management.
  • Team-based care: Collaboration with pelvic floor physical therapists, pain specialists, gastroenterologists, or fertility clinics when needed.
  • Second opinions: Reasonable for major surgery decisions or persistent pain.

Professional directories can help you identify specialists: ACOG’s Find an Ob-Gyn tool and the AAGL directory for minimally invasive gynecologic surgeons are reputable starting points.

Preparing for Your Appointment

  • Keep a symptom diary noting pain timing, severity, and triggers; track bleeding days and flow.
  • Bring prior imaging, operative notes, and lab results.
  • List medications tried and what helped or did not.
  • Clarify your top three goals, such as reducing pain, controlling bleeding, or maximizing fertility.
  • Ask about recovery timelines, impact on work or caregiving, and long-term management plans.

Common Questions

Do fibroids turn into cancer? Fibroids are benign and do not transform into cancer. A rare uterine cancer called leiomyosarcoma can occur, but it is not thought to arise from benign fibroids. Imaging and clinical judgment help assess risk.

Can I get pregnant with endometriosis or fibroids? Many people do. Endometriosis can affect fertility by inflammation and scar tissue; submucosal fibroids can affect implantation. Treatment plans often prioritize fertility-preserving options and may include myomectomy or timed fertility care.

How long should medical therapy be used? Duration depends on the medication and your response. Some therapies have FDA-recommended limits due to potential bone loss; your clinician may use add-back hormones and periodic bone health assessments.

The Bottom Line

If pain or bleeding is disrupting your life, help is available. An endometriosis specialist in Austin can differentiate endometriosis from fibroids, explain options based on the latest evidence, and coordinate a plan that respects your goals. Early evaluation and a team approach often lead to better outcomes and fewer disruptions in work, school, and family life.

This article is for information only and does not replace personal medical advice. Consult a qualified clinician for diagnosis and treatment.

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