Treatment of endometriosis by obstetrician-gynecologist Natalya Sergeevna Fedoruk in Dnipro.

When consulting, patients often complain of lower abdominal pain, menstrual cycle irregularities, concerns about possible infertility, or recurring discomfort during intimate activities.

The doctor conducts a thorough clinical assessment, reviews the medical history and current complaints, and, if necessary, orders additional examinations to gain an accurate understanding of the situation.

The patient receives a clear and understandable action plan: what to do first, which tests to undergo, and how to monitor changes in their condition over time.

The doctor pays special attention to differential diagnosis of the symptom causes and therapy management in order to promptly adjust treatment and prevent exacerbations.

When to see a doctor

If you notice unpleasant or recurring symptoms that cause concern or interfere with your daily life, it is important to consult a specialist. A doctor can help identify the causes of your condition and recommend the necessary examinations. You should make an appointment with an obstetrician-gynecologist if you have endometriosis and notice:

• Constant or periodic lower abdominal pain
• Increased discomfort on or before menstruation
• Menstrual cycle disturbances, such as irregularity or heavy bleeding
• Pain or unpleasant sensations during sexual intercourse
• Difficulty conceiving when trying to get pregnant
• Symptoms recurring or worsening over time
• Interference with normal work, rest, or sleep
• No improvement in symptoms with self-care measures or previously prescribed treatment
• Worsening of unpleasant sensations after stress or infections
• Symptoms are appearing for the first time and causing concern
• Need for a second opinion on an already established diagnosis
• Need to adjust treatment if current therapy is ineffective

If you experience these symptoms or situations, consulting specialists at our clinic will help you understand what is happening and choose the best steps for your health. Do not leave these issues unattended — timely consultation will allow you to control your condition and avoid complications.

Emergencies or When to See a Doctor Immediately

• Sudden and severe increase in lower abdominal pain
• Sudden and heavy bleeding from the genital tract
• High fever accompanied by a significant deterioration in overall condition
• Combination of severe pain with dizziness, weakness, or loss of consciousness

If you experience any of these symptoms, do not wait for a scheduled appointment—seek urgent medical attention. Our clinic offers a home visit service so you can receive timely medical care in the comfort of your own home.

Causes and Risk Factors of Endometriosis

Understanding the possible causes and factors influencing the development of endometriosis helps to better prepare for examination and treatment planning. Doctors assess various mechanisms and circumstances that may affect the condition.

Main Causes / Mechanisms (Briefly)

• Features of migration and implantation of endometrial cells outside the uterus
• Hormonal changes affecting the growth of the mucous membrane
• Immune system disorders reducing the clearance of excess cells from tissues
• Hereditary predisposition and family history of endometriosis
• Inflammatory processes in the pelvic organs that promote tissue spread

Risk Factors

• Age from the onset of menstruation up to 40 years
• Early onset of menstruation and short menstrual cycles
• No pregnancy or late first pregnancy
• Frequent or heavy menstrual bleeding
• Chronic inflammatory diseases of the pelvic organs
• Family history of endometriosis in close relatives
• Excess weight and metabolic disorders
• Repeated surgeries on pelvic organs

Reversible Causes That Should Be Excluded

• Chronic inflammatory diseases that can be treated
• Hormonal imbalances correctable with medication
• Conditions that mimic symptoms and require additional examination

Endometriosis develops under the influence of multiple factors, and precise determination of causes requires medical examination and comprehensive evaluation.

Diagnostics

The diagnostics of endometriosis are aimed at identifying possible causes of complaints and planning further steps. The doctor helps to systematically analyze symptoms and select the necessary tests to assess the condition and develop a monitoring or treatment plan.

Approach to Diagnostics

• Taking a detailed medical history: clarifying symptoms, menstrual history, and past illnesses
• Physical and gynecological examination to detect possible changes
• Performing basic laboratory tests as indicated
• Ordering additional examinations if necessary to clarify or rule out other causes
• Interpreting results and discussing the plan of further actions
• Monitoring symptom dynamics and response to therapy if needed
• Adjusting the examination plan as new information becomes available

Typical Examinations as Indicated

Diagnostics may include:

• Ultrasound examination of the pelvic organs
• Blood laboratory and hormonal tests
• MRI for detailed study of tissue changes
• Hysteroscopy or laparoscopy in complex cases or when there is uncertainty
• Tissue biopsy if necessary

What to Bring to the Appointment

• Previous results of ultrasound, MRI, or other examinations
• List of medications and their dosages
• Symptom and menstrual cycle diary
• Medical records if available
• Questions and complaints to discuss with the doctor

Endometriosis diagnostics requires a comprehensive approach and time for accurate assessment; therefore, it is important to follow the doctor’s recommendations and undergo examinations as indicated.

Treatment

Treatment of endometriosis is aimed at reducing symptoms and slowing the progression of the disease. The therapy plan is selected individually, taking into account your complaints, examination results, and any possible concomitant conditions.

Therapy Goals

• Reduce the severity of pain and discomfort
• Correct possible menstrual cycle and hormonal imbalances
• Improve quality of life and restore normal organ function
• Prevent possible complications and recurrent exacerbations

Main Treatment Approaches

• May include medication therapy aimed at regulating hormonal balance
• Use of physiotherapy and rehabilitation methods to reduce inflammation and pain
• Application of non-drug approaches, including lifestyle modification and diet
• Surgical interventions to remove endometriosis lesions, if indicated
• Therapy is always individualized and tailored to the patient’s characteristics and disease course

What the Doctor Does

• Selects and adjusts the treatment plan based on examination and test results
• Takes into account any accompanying diseases when choosing therapy
• Monitors possible side effects and changes the treatment regimen if necessary
• Explains criteria for effectiveness and the importance of regular monitoring
• Coordinates actions with other specialists if needed

What to Expect: Planning and Monitoring

• Evaluation of condition changes is performed regularly and as needed
• If there is no effect or symptoms worsen, the therapy plan is adjusted
• Follow-up visits help monitor progress and adapt the approach
• Improvement timelines are individual and depend on the body’s characteristics and chosen therapy

To develop an individualized plan, schedule a consultation with Dr. Natalya Sergeevna Fedoruk.

Prevention

Prevention plays an important role in reducing the risk of developing and progressing endometriosis. The preventive plan is selected individually, taking into account the specifics of your health and the doctor’s recommendations.

Main measures of primary prevention

• Monitoring hormonal balance and seeking medical advice promptly if changes occur
• Maintaining a healthy lifestyle and weight
• Avoiding stressful situations whenever possible
• Regular treatment and prevention of inflammatory diseases of the pelvis
• Giving up harmful habits that affect overall health

Screening and secondary prevention / regular monitoring

• Regular gynecological examinations as recommended by a doctor
• When indicated — monitoring hormonal levels and blood tests
• Tracking symptoms and seeking prompt care if they change
• Screening for possible complications and associated conditions

Practical tips

• Discuss the optimal level of physical activity with your doctor
• Monitor your diet and hydration, and avoid excessive consumption of foods that may increase inflammation
• Consult promptly if your condition changes or new symptoms appear
• Regularly follow the recommendations and examinations prescribed by your doctor
• Keep chronic conditions that affect your health under control

Preventive measures for endometriosis help maintain health and minimize risks, but they require an individual approach and consultation with a specialist.

Important to Know

The treatment of endometriosis requires a comprehensive approach and attention to detail. It is important not only to reduce symptoms but also to identify the causes and factors that influence the development and course of the disease. Early assessment of the condition helps to select the appropriate strategy and reduce the risk of complications or progression. Regular monitoring and adjustment of the treatment plan are often necessary as the situation changes. It is also important to consider the impact of lifestyle, emotional state, and comorbidities.

• Treatment is aimed at identifying and addressing provoking factors, not just symptoms
• Early consultation with a doctor helps to choose the optimal strategy and avoid complications
• Dynamic observation allows for plan adjustments and improvement of therapy outcomes
• Stress, physical activity, and quality of sleep can affect the condition and symptoms
• Self-medication may obscure the disease picture and delay proper diagnosis
• The clinic’s physician provides consistent monitoring and support at all stages of treatment

For a more comprehensive understanding of endometriosis and its treatment, we recommend reading our detailed article, which covers important aspects from A to Z. If you have any questions, a specialist consultation will help you understand and choose the right path to improve your well-being.

Self-care Before the Appointment: What You Can and Cannot Do

Before your appointment for endometriosis, it is important to follow safe measures that will help maintain your condition without the risk of complications. If your symptoms worsen, be sure to urgently contact Dr. Natalia Sergeevna Fedoruk.

What You Can Do Before the Appointment

• Write down when and how the symptoms began, what alleviates or worsens your condition
• Keep a symptom diary: intensity, triggers, and timing of symptoms
• Bring a list of all medications and supplements you are taking to the appointment
• Take your temperature and blood pressure if you know how, and record the results
• Reduce physical activity and ensure rest to avoid additional stress
• Drink enough water to prevent dehydration
• Maintain a regular sleep schedule and try to avoid severe stress
• Avoid trial and error with new medications or remedies without consulting your doctor
• Take simple pain relievers only if they are generally safe and there are no contraindications

What You Should Not Do Before the Appointment

• Do not stop or change medications without consulting your doctor
• Do not start combining new medications or supplements on your own
• Do not use unproven folk remedies without medical advice
• Do not neglect regular monitoring of symptoms and recording changes
• Do not ignore worsening pain or other symptoms while waiting for your appointment
• Do not self-treat in ways that might mask characteristic signs of the disease
• Do not delay consulting a doctor if your condition worsens or new symptoms appear

If you experience urgent symptoms, seek immediate help from Dr. Natalia Sergeevna Fedoruk.

How I Can Help as a Doctor with Endometriosis

During a consultation for endometriosis, I offer a comprehensive review of your condition to identify possible causes and assess the severity of your symptoms. Together, we will create a plan for examinations and treatment, taking into account all the specifics of your health and any accompanying diseases. It is important not only to select appropriate therapy but also to monitor the progress to make timely adjustments if necessary.

During an endometriosis consultation, I can assist you with the following:

• Conduct a detailed analysis of symptoms and medical history to identify potential causes
• Evaluate the severity of symptoms and identify possible risks
• Analyze current prescriptions and potential side effects of therapy
• Develop a plan for next steps: examinations, treatment, and monitoring
• Consider comorbid conditions and medications for a comprehensive approach
• Provide recommendations on lifestyle and daily routines tailored to your individual needs
• Discuss criteria for monitoring and schedule follow-up visits to assess therapy effectiveness
• Perform initial diagnostics to determine causes and conduct differential symptom assessment
• Adjust the treatment plan if effectiveness is insufficient or side effects occur

Medical support for endometriosis covers all stages — from the initial examination to ongoing monitoring and prevention of complications. This approach helps to tailor treatment as much as possible to your goals and health condition.

What questions can you ask a doctor about endometriosis

During a consultation about endometriosis, you can discuss the following issues with Natalya Sergeevna Fedoruk:

• Lower abdominal and pelvic pain that interferes with daily life
• Menstrual irregularities and irregular bleeding
• Difficulties conceiving and possible effects on pregnancy
• Discomfort during sexual intercourse
• Recurring or worsening symptoms that cause concern
• Insufficient effectiveness of current treatment or undesirable side effects
• Need for clarification regarding test results
• Planning further steps and monitoring your condition

In case of sudden severe pain, heavy bleeding, or pronounced weakness, urgent medical attention is required—do not wait for a scheduled appointment.

Questions you can discuss during the appointment

• What is happening to me and what could it be?
• Why have the symptoms appeared now?
• How can I tell if the pain is related to endometriosis or another condition?
• What examinations are necessary in my specific case?
• Which tests or investigations are mandatory, and which can be skipped?
• How should I prepare for examinations and the doctor’s visit?
• What treatment and management options are available for endometriosis?
• Is it possible to completely get rid of the symptoms, or is this a chronic condition?
• What should I do if the prescribed treatment does not lead to improvement?
• Can I avoid surgery or strong medications?
• How long does treatment usually last, and how often should I come for follow-up?
• What signs indicate improvement or deterioration of the condition?
• What should I do if symptoms suddenly worsen or flare up?

By consulting a doctor, you have the opportunity to thoroughly discuss your concerns and receive recommendations tailored to your personal circumstances. In case of emergency situations or uncertainty about the urgency of symptoms, always seek urgent medical help or call a doctor to your home.

How the Consultation Proceeds

A consultation for endometriosis involves reviewing your complaints, assessing your condition, and developing a plan for further action. The extent of examinations is determined individually, based on indications, and depends on your symptoms and medical history. It is not always possible to make a definitive diagnosis during a single visit, but it is an important step to understand the situation and decide on the approach.

1. Clarifying complaints and the purpose of the visit: we find out what exactly is troubling you, when symptoms began, what affects them, and what you expect from the appointment.
2. Collecting medical history and risk factors, including menstrual history, past illnesses, and lifestyle characteristics.
3. Discussing previous treatments and examinations; we recommend bringing test results and a list of medications you are taking.
4. Performing an examination and necessary tests based on indications to obtain an initial clinical picture.
5. Preliminary analysis: what is most likely causing your symptoms and what needs to be ruled out, without making a final diagnosis.
6. Developing an examination plan, which may include ultrasound, blood tests, MRI, and other procedures as needed.
7. Discussing general principles of treatment and management—without prescribing specific medications, focusing on your well-being.
8. Setting follow-up timelines, recommendations for monitoring changes, and situations when you should contact a doctor before the planned visit.

If this is your first consultation, special attention is given to clarifying symptoms and searching for possible causes. If previous treatment has been ineffective, we thoroughly analyze the reasons and adjust the subsequent steps.

Preparation for the Appointment

To ensure an effective consultation with your obstetrician-gynecologist, it is important to prepare in advance and have all necessary documents and information. This will help the doctor make a quicker and more accurate diagnosis or develop a monitoring and treatment plan.

• Bring a list of all current medications (names, dosages, how you take them).
• Bring the results of previous examinations: ultrasounds, blood tests, MRI (if available).
• Write down your main complaints: when symptoms started, what worsens or relieves your condition.
• If instructed, come on an empty stomach — do not eat or drink for about 8–12 hours (unless advised otherwise; confirm when booking your appointment).
• Do not stop taking prescribed medications without consulting your doctor.
• Avoid using cosmetics and creams in the examination area before the appointment.
• If possible, bring any questions you want to discuss with the doctor.
• Come prepared with complete information about your menstrual cycle and any accompanying symptoms.
• Avoid consuming coffee and alcohol before the appointment if this may affect test results.

If you have any doubts about how to prepare, it is best to clarify the details by phone when making the appointment. Do not change your medication routine without consulting your doctor.

About the Doctor

Natalya Sergeyevna Fedoruk is an obstetrician-gynecologist with over 10 years of experience. In her practice treating endometriosis, she often works with patients during the initial diagnostic stage, in cases of recurring symptoms, and when previous treatment has not yielded the desired results.

The specialist places strong emphasis on a thorough analysis of complaints and medical history, as well as on regular monitoring and adjustment of the treatment plan as needed. Patients receive a detailed explanation of their current condition and a clear plan of further actions tailored to their individual characteristics.

Why Patients Choose Dr. Natalya Sergeevna Fedoruk

When treating endometriosis, Dr. Natalya Sergeevna Fedoruk offers a comprehensive approach that combines diagnosis, treatment, and ongoing monitoring. She pays special attention to identifying underlying causes and possible accompanying conditions, which helps build an effective strategy without unnecessary tests. Unlike other specialists, she thoroughly analyzes the results of previous examinations and takes medication tolerance into account. This is the hallmark of her approach, aimed at minimizing side effects and tailoring therapy to the patient’s needs.

• A clear and understandable treatment plan with step-by-step stages and effectiveness monitoring
• Examinations only when indicated, without unwarranted prescriptions or unnecessary procedures
• Consideration of comorbidities and medications to ensure the safety and effectiveness of therapy
• Monitoring of symptom dynamics with the possibility to adjust treatment if results are insufficient
• Review of previous prescriptions and medication tolerance to optimize treatment
• Explanation of treatment plans, alternatives, and risks in simple and accessible language
• Focus on preventing exacerbations to reduce the frequency and severity of symptoms

This approach enables patients to receive comprehensive care tailored to their individual characteristics and situation. The work is conducted taking into account real needs and changes in condition, making treatment more controlled and transparent.

Case Studies

Diagnostic investigation of primary symptoms

A middle-aged patient presented with persistent lower abdominal pain and menstrual cycle disturbances. It was important to exclude other possible causes of such symptoms and to confirm or rule out the suspicion of endometriosis. The physician conducted a comprehensive examination, took a detailed medical history, and ordered necessary tests as indicated, including ultrasound and laboratory analyses. Results showed a reduction in symptom severity and improvement in overall condition over several weeks. The patient continued follow-up with scheduled control visits and adjustments to recommendations as needed.

Therapy adjustment in case of lack of effect

A young woman came with complaints of endometriosis symptoms, while previously prescribed treatment had not resulted in noticeable improvement. During the visit, an assessment was made of previously applied methods and possible reasons for low effectiveness. The physician proposed to adjust the management strategy by including additional tests and modifying the treatment plan in accordance with current guidelines and the patient’s individual characteristics. Partial symptom improvement was observed after one month, followed by a plan for dynamic monitoring and treatment adaptation.

Management of chronic course with comorbidities

A mature-aged patient diagnosed with endometriosis complicated by pelvic varicose veins and other chronic conditions sought comprehensive care. All concomitant conditions and prior interventions were reviewed, considering their impact on treatment tactics. The physician ensured coordinated therapy for safe and effective symptom control. Over several months, stabilization of the condition and improved quality of life were noted with regular visits and treatment adjustments.

Symptom exacerbation and prevention plan

A middle-aged patient reported a sudden worsening of pain syndrome and intensification of other symptoms amid stress. The physician promptly assessed the situation, excluding acute complications, and developed a plan for observation and supportive therapy. Attention was given to preventing recurrent exacerbations and controlling risk factors. After a week of monitoring, the condition stabilized, and the further plan included regular follow-up visits with therapy adjustments as necessary.

Second opinion and analysis of a complex case

A woman sought a second opinion following ambiguous test results and a prolonged period of symptoms resistant to straightforward interpretation. The physician thoroughly reviewed the medical history, performed an additional examination, and recommended further clarifying investigations. Based on the evaluation, a new management plan was developed considering the case’s specifics. The patient gained a clear understanding of the situation and received recommendations for next steps, which helped ensure control and reduce anxiety.

How long does the consultation last?

The consultation usually takes between 30 to 60 minutes; please confirm the duration when booking.

How to prepare for the appointment?

Write down your main complaints, symptom history, and bring a list of medications you are taking.

What should I bring to the appointment?

It is recommended to bring results of previous examinations, images, medical records, and a list of medications.

Do I need to come on an empty stomach?

Usually no, unless otherwise specified at the time of booking.

How many visits are typically required for treatment?

The number of visits depends on the situation and the chosen management and therapy strategy.

When can I expect the first results of the treatment?

Initial changes may vary individually and depend on the treatment method used.

What should I do if my condition worsens before the appointment?

In case of sudden deterioration or dangerous symptoms, seek immediate medical attention.

Can treatment be combined with my current medications?

Discuss all medications with your doctor and do not change your regimen on your own.

Is it possible to have an online consultation?

Yes, online consultation is available upon booking and is suitable for initial assessment.

Can I come with tests I have already done?

Yes, please bring all results for a comprehensive evaluation of your situation.

Do I need to come for follow-up appointments?

Follow-up visits are recommended to monitor treatment effectiveness and make adjustments.

Can I get a second opinion?

Yes, the doctor is willing to review your results and provide recommendations for your case.

What should I do if symptoms return after improvement?

Do not delay seeking help; timely adjustment of the treatment plan is important.

What examinations are required during treatment?

The list of examinations is determined individually based on the doctor’s recommendations.

How do I know if the treatment is working?

Effectiveness is assessed by a reduction in symptoms and overall improvement according to your doctor’s advice.

Can I come with children?

Please clarify the policy regarding children in the clinic when booking.

How to prepare for examinations?

Check the specific requirements for each test when booking; usually no special preparation is needed.

What should I do if I cannot come to the appointment?

Notify us in advance to reschedule without losing time or disrupting the treatment plan.