Advanced Gynecology,In Service of
Midlife Health.
Consultation and surgical care for the gynecologic conditions of midlife — abnormal bleeding, fibroids, endometriosis, adenomyosis, ovarian cysts, and pelvic pain — from evaluation through minimally invasive treatment when appropriate.
Many of the conditions that complicate perimenopause and midlife — heavy or irregular bleeding, fibroids, endometrial changes, pelvic pain — require more than symptom management. Andrew Nyein, DO performs robotic-assisted and laparoscopic surgery, and evaluates and treats these conditions within the same practice that manages your hormonal health.
When Midlife Symptoms
Need More Than
Hormonal Answers
Not every midlife symptom is hormonal. Heavy bleeding may be fibroids; persistent pain may be endometriosis; bleeding after menopause always warrants endometrial evaluation. Distinguishing hormonal symptoms from structural conditions is exactly where surgical training matters.
Advanced gynecology at Mulberry exists to support the midlife mission — evaluating thoroughly and treating appropriately:
- Abnormal & heavy uterine bleeding
- Fibroids
- Endometrial evaluation
- Endometriosis
- Pelvic pain
- Minimally invasive surgical treatment
Abnormal Uterine Bleeding
Heavy periods, bleeding between cycles, prolonged bleeding, or any bleeding after menopause deserves real evaluation — not reassurance alone. Causes range from hormonal fluctuation to polyps, fibroids, and endometrial changes that require definitive diagnosis.
Evaluation is comprehensive and largely in-office: detailed history, pelvic ultrasound, and endometrial assessment or hysteroscopy when indicated. Treatment is then matched to the actual cause — from hormonal management to minimally invasive procedures.
Fibroids
Uterine fibroids are extremely common in the decade before menopause and can cause heavy bleeding, pressure, pain, and fatigue from blood loss. Many require no treatment — but those that affect your life deserve a full discussion of modern options.
Andrew Nyein, DO, discusses the full range of options: watchful monitoring, medical management, and minimally invasive surgical treatment including hysteroscopic and robotic-assisted approaches — with honest counseling about what fibroids typically do as menopause approaches.
Endometriosis
Endometriosis doesn't always end at midlife — and for some women, perimenopause changes or unmasks symptoms. Pain, painful intercourse, and bleeding irregularities from endometriosis deserve careful evaluation, particularly when hormone therapy decisions are involved.
Andrew Nyein, DO, provides medical management of endometriosis and performs robotic-assisted and laparoscopic surgery for endometriosis, and can help plan hormone therapy when you have a history of endometriosis.
Pelvic Pain
Persistent pelvic pain has many possible sources — gynecologic, muscular, urinary, gastrointestinal — and untangling them requires unhurried evaluation rather than a quick label. If your pain hasn't been explained, we take a fresh, systematic look.
Evaluation combines detailed history, examination, and targeted imaging, with treatment matched to findings: medical therapy, pelvic floor physical therapy coordination, in-office procedures, or minimally invasive surgery when a structural cause is identified.
Minimally Invasive Gynecologic Surgery
When surgery is the right answer, the approach matters. Andrew Nyein, DO performs robotic-assisted and laparoscopic surgery for endometriosis, ovarian cysts, fibroids, and adenomyosis.
Equally important is the continuity: your surgeon is the physician who evaluated you, who counsels you honestly about alternatives, who operates, and who follows you afterward — with your hormonal and preventive care continuing seamlessly in the same relationship.
Surgical Care,
Inside Your Midlife Care
Hormonal care and surgical gynecology are often handled in separate offices — leaving patients to coordinate between offices that don't share context. At Mulberry, they are one practice and one care team: the surgeon evaluating your bleeding already knows your hormone therapy, your history, and your goals.
Advanced gynecology here exists for one purpose — to keep structural conditions from standing between you and a healthy midlife.
Diagnosis Before Treatment
Systematic evaluation — ultrasound, biopsy, hysteroscopy — so treatment targets the real cause.
In-Office First
Many procedures performed in the office, without hospital logistics.
Every Option on the Table
Monitoring, medical therapy, and surgery presented honestly — with the trade-offs of each.
Minimally Invasive When Appropriate
Robotic-assisted and laparoscopic techniques, when surgery is the right option.
Hormonal Fluency
Surgical decisions made with full understanding of your menopausal and hormonal context.
One Continuous Relationship
Your care is with Andrew Nyein, DO, from first evaluation through surgery and follow-up.
Andrew Nyein, DO performs robotic-assisted and laparoscopic surgery, with a practice philosophy that reserves surgery for when it is the right option for you.
What To Expect
During Your
Consultation
Your consultation is unhurried and thorough — whether you're seeking evaluation of new symptoms or a second opinion on treatment recommended elsewhere.
Definitive Answers.
Thoughtful Treatment.
If abnormal bleeding, fibroids, endometriosis, or pelvic pain are affecting your life — or you'd like a second opinion on surgery recommended elsewhere — begin with a comprehensive consultation with Andrew Nyein, DO.