Endometriosis Specialist
Your Pain Is Real. You Are Not Alone.
Endometriosis is a chronic, often painful condition that affects millions of women — yet it is frequently misunderstood, dismissed, or diagnosed years late. At Haven OBGYN, we believe your symptoms deserve to be taken seriously, and you deserve answers, validation, and compassionate, expert care.
As a board-certified OB-GYN and minimally invasive gynecologic surgeon (MIGS) with a strong focus on pelvic pain and endometriosis management, Dr. Nikita Mishra provides comprehensive evaluation, advanced imaging, individualized treatment plans, and minimally invasive surgical options when appropriate.
What Is Endometriosis?
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, which can lead to:
- Inflammation
- Pain
- Scarring & adhesions
- Fertility challenges
- Chronic symptoms that impact daily life
It is NOT just "bad cramps" — it is a complex medical condition that requires thoughtful, individualized care.
Endometriosis Can Affect:
Ovaries
Fallopian Tubes
Uterus
Pelvis
Bowel or Bladder (in advanced cases)
Common Symptoms of Endometriosis
If your symptoms disrupt your daily life, work, relationships, or emotional wellbeing — we're here to help evaluate and support you.
Pain Symptoms
- Severe period cramps
- Chronic pelvic pain
- Pain during intercourse
- Pain with bowel movements
- Painful urination
- Lower back or ovulation pain
Bleeding Symptoms
- Heavy periods
- Irregular bleeding
- Spotting before periods
Digestive Symptoms
- Bloating
- Constipation
- Diarrhea
- Nausea around menstruation
Fertility & Other
- Difficulty conceiving
- Recurrent pregnancy loss
- Fatigue
- Pain that worsens over time
Why Endometriosis Is Often Missed
Many women go years without a diagnosis because:
We take a thorough, patient-centered approach to understanding your symptoms and concerns.
Our Diagnostic Approach
Endometriosis requires a careful, multi-layered evaluation.
Comprehensive Medical History
We explore:
- Pain patterns (cyclic vs non-cyclic)
- Bowel and bladder symptoms
- Sexual discomfort
- Family history
- Prior treatments
- Fertility goals and concerns
Trauma-Informed Pelvic Exam
Only when appropriate and always with your comfort first. We prioritize consent, privacy, and respect at every step.
Advanced Ultrasound (2D + 3D)
While ultrasound cannot "diagnose" endometriosis definitively, it can help evaluate and sometimes suggest:
- Ovarian endometriomas
- Features of deep infiltrating disease in some cases
- Adhesion patterns
- Uterine abnormalities
- Coexisting conditions
- Subtle structural changes
Diagnostic Laparoscopy (If Needed)
Laparoscopy is the gold standard for definitive diagnosis and surgical treatment of endometriosis.
Treatment Options for Endometriosis
There is no single approach that works for everyone. We tailor treatment to your symptoms, goals, medical history, and reproductive plans, and we make decisions together through shared decision-making.
Medical Management
Medical therapy can help reduce symptoms and inflammation and is often a first step for pain relief:
These treatments do not remove endometriosis but can help manage symptoms for many patients.
Minimally Invasive Surgery (MIGS)
Core StrengthIf symptoms are severe, persistent, or impacting fertility or quality of life, surgery may be recommended after careful discussion.
Laparoscopic Endometriosis Excision
This approach aims to:
Excision is generally preferred over ablation for long-term management, although outcomes can vary based on individual factors.
Hysteroscopy
Useful when evaluating uterine abnormalities or abnormal bleeding that may coexist with endometriosis.
Adhesiolysis
Releases areas of scarring that may contribute to pain or restrict organ movement.
Fertility-Focused Care
For patients trying to conceive, we design a personalized plan that may include:
Our goal: support your reproductive goals and, when feasible, natural conception, while also coordinating care with fertility specialists when appropriate.
Learn About Fertility CareHolistic Support
Endometriosis affects the whole person. We address:
We may collaborate with pelvic floor physical therapists, GI specialists, pain management, and mental health professionals to create a comprehensive support network. You deserve a multidisciplinary approach.
Coexisting Conditions
Endometriosis often overlaps with other conditions. We evaluate and treat the broader picture, not just one diagnosis.
What Makes Haven Different
MIGS Surgical Expertise
A MIGS-forward practice with training in advanced laparoscopic care for complex pelvic pain and endometriosis.
On-Site 2D & 3D Ultrasound
Convenient, detailed imaging that can support evaluation and treatment planning.
Trauma-Informed Care
Your comfort, trust, and consent matter deeply at every step.
Fertility-Sensitive Approach
We integrate your reproductive goals into both medical and surgical decision-making.
Comprehensive Pain Evaluation
We look beyond the uterus — including pelvic floor, bowel, bladder, hormones, and overall wellbeing.
Unhurried Visits
A thorough endometriosis evaluation takes time. We ensure visits are thoughtful and not rushed.
When to Seek Help for Endometriosis
Your pain deserves to be understood and taken seriously.
Find Clarity, Support & Expert Care
We're honored to support your journey toward relief, healing, and hope. Schedule an endometriosis evaluation at Haven OBGYN to explore your options with a team that listens and cares.