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Advanced Gynecology

Advanced Gynecology,In Service of
Midlife Health.

Surgical-level expertise for the gynecologic conditions of midlife — abnormal bleeding, fibroids, endometriosis, and pelvic pain — from evaluation through minimally invasive treatment.

Many of the conditions that complicate perimenopause and midlife — heavy or irregular bleeding, fibroids, endometrial changes, pelvic pain — require more than symptom management. With advanced minimally invasive and robotic-assisted surgical expertise, our providers evaluate and treat these conditions definitively, within the same practice that manages your hormonal health.

Minimally Invasive & Robotic-Assisted Gynecologic Surgery
Our Approach

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 definitively:

  • Abnormal & heavy uterine bleeding
  • Fibroids
  • Endometrial evaluation
  • Endometriosis
  • Pelvic pain
  • Minimally invasive surgical treatment
“The ability to operate is, above all, the ability to know when surgery is — and isn't — the answer.”
01
Evaluation & 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.

Bleeding after menopause is never normal — and almost always answerable with proper evaluation.
Evaluation may include
  • Detailed bleeding history
  • Pelvic ultrasound
  • Endometrial biopsy when indicated
  • In-office hysteroscopy
  • Cause-directed treatment planning
Most evaluation is completed comfortably in the office, without hospital visits.
02
Diagnosis & Options

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.

Our providers offer the complete spectrum: 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.

Fibroid care should present every option — not just the one a practice happens to offer.
Options may include
  • Monitoring & symptom management
  • Medical therapy
  • Hysteroscopic removal
  • Robotic-assisted myomectomy
  • Hysterectomy when appropriate & chosen
Treatment recommendations weigh your symptoms, age, proximity to menopause, and preferences.
03
Complex Care

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 expert evaluation, particularly when hormone therapy decisions are involved.

Our providers provide both medical management and minimally invasive surgical treatment of endometriosis, and bring particular value to the nuanced question of managing endometriosis history alongside menopausal hormone therapy.

Endometriosis care in midlife requires both surgical expertise and hormonal fluency — together.
Care includes
  • Comprehensive pain evaluation
  • Imaging & diagnostic workup
  • Medical & hormonal management
  • Minimally invasive surgical treatment
  • HRT planning with endometriosis history
Treatment balances symptom control, your stage of transition, and long-term considerations.
04
Comprehensive Evaluation

Pelvic Pain

Persistent pelvic pain has many possible sources — gynecologic, muscular, urinary, gastrointestinal — and untangling them requires unhurried evaluation rather than a quick label. Pain that has been dismissed elsewhere receives a fresh, systematic look here.

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.

Chronic pain deserves a diagnosis — not just a prescription.
Evaluation considers
  • Gynecologic causes
  • Pelvic floor muscle dysfunction
  • Bladder & urinary contributors
  • Endometriosis & adhesions
  • Coordinated multidisciplinary referral
Pelvic floor physical therapy is coordinated when muscular dysfunction contributes to pain.
05
Surgical Expertise

Minimally Invasive Gynecologic Surgery

When surgery is the right answer, the approach matters. Our providers specialize in minimally invasive and robotic-assisted gynecologic surgery — techniques that mean smaller incisions, less pain, shorter recovery, and a faster return to your life.

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.

Smaller incisions, faster recovery — and the same physician before, during, and after.
Surgical expertise includes
  • Robotic-assisted surgery
  • Laparoscopic procedures
  • Hysteroscopic surgery
  • Myomectomy & hysterectomy
  • Second opinions on recommended surgery
Considering surgery recommended elsewhere? Thoughtful second opinions are welcome.
Integrated by Design

Surgical Expertise,
Inside Your Midlife Care

Most practices separate hormonal care from surgical gynecology — leaving patients to coordinate between offices that don't share context. At Mulberry, they are one practice and one physician: 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 comfortably 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 by Default

Robotic-assisted and laparoscopic techniques for smaller incisions and faster recovery.

Hormonal Fluency

Surgical decisions made with full understanding of your menopausal and hormonal context.

One Continuous Relationship

The same physician from first evaluation through surgery and every visit after.

Minimally Invasive & Robotic-Assisted Surgery

Our providers specialize in minimally invasive and robotic-assisted gynecologic surgery, with a practice philosophy that reserves surgery for when it is truly the best answer — and perform it exceptionally when it is.

Your Visit

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.

01 Detailed discussion of your symptoms, history, and any prior evaluation or imaging
02 Focused examination and in-office ultrasound when indicated
03 Additional diagnostic steps — endometrial sampling or hysteroscopy — scheduled or performed as needed
04 Honest discussion of every appropriate option: monitoring, medical therapy, and surgical treatment
05 A clear plan — with your questions answered and your preferences leading the decision
Bring prior records and imaging if you have them — second-opinion consultations are always welcome.

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 our providers.