Women’s Health Center
Four to eleven years is the usual gap between a woman's first endometriosis symptom and her diagnosis. That gap is made of sentences, not waiting lists.
About This Center
Four to eleven years.
That is the usual gap between the first symptom of endometriosis and the day somebody finally writes the word down, and the gap is not made of waiting lists. It is made of sentences. Periods hurt. Everybody gets that. You are young, it will settle once you have had children. By the time a diagnosis arrives most women have heard some version of those lines from a relative, a pharmacist and at least two doctors, and have quietly concluded that the problem is their tolerance and not their pelvis.
At the other end of the same corridor sits the opposite failure. Women with nothing wrong at all are sold annual ovarian cancer screening, hormone panels that answer no question, and courses of vaginal laser treatment. A unit is judged on both ends. Shorten the wait for the women who have something. Decline the women who have nothing, and say why.
Free consultation
Describe the symptom in days and in what you stopped doing
Tell us how many days a month the pain or the bleeding takes from you, and what you have stopped doing because of it, since those two answers carry more diagnostic weight than any adjective. Say whether pain comes only with periods or at other times as well, whether it happens during sex, opening the bowels or passing urine, and whether painkillers touch it. Send any ultrasound or MRI on a disc and not only the report, along with previous operation notes, smear and HPV results with dates, and recent blood counts including ferritin. List every hormonal treatment you have tried with how long you stayed on it and why you stopped. Mention whether you want a pregnancy now, later or not at all, because that answer reorders every option below.
What the delay is made of
Two beliefs keep the wait long, and they are held as firmly by patients as by clinicians. The first is that severe period pain is a matter of temperament. The second is that endometriosis announces itself through the pelvis alone, so a woman arriving with migraine, exhaustion, bowel trouble and low mood is treated as four separate small problems instead of one large one. A study published in 2026 took that second belief apart with unusual force.
Four kinds of the same disease
Researchers analysed 22,438 women with endometriosis drawn from a large American research programme, using nineteen recorded symptoms and coexisting conditions to sort them into groups without deciding the categories in advance. Four distinct patterns emerged. One combined heavy pain with gastrointestinal symptoms and low mood. Another was predominantly psychological and neurological, meaning anxiety, migraine and depression in women whose pelvic complaints were not the loudest thing about them, and the authors described that group as a direct challenge to a diagnostic framework built around gynaecology alone. Women who also had adenomyosis fell into two high-pain groups with no minimally symptomatic group at all, which tells you something about how that combination is lived. Membership of the highest-burden group tracked with worse general health, less social satisfaction and greater difficulty getting healthcare in the first place. The team concluded that young women presenting with the non-classical picture should be screened for endometriosis specifically to shorten the delay.
Set against a four to eleven year wait, that finding has a blunt operational meaning. A woman whose file says migraine, irritable bowel and anxiety, and whose periods have never been discussed properly, is exactly the woman the delay was built for.
So the first appointment here spends its time on history rather than on equipment. How many days a month does the pain take. What has been given up because of it, and what has been quietly rearranged around it. Does it come with the bowels, the bladder or with sex. Was there ever a hormonal treatment that helped, and how long was it given before somebody decided it had failed. Those questions cost nothing, they carry most of the diagnostic information, and they are the reason a first appointment here runs long and starts with a chair.
Pelvic pain, and how it is worked up
One thing changed in the last few years that women are rarely told about. It changes what should happen next.
Endometriosis used to require an operation to diagnose. A laparoscopy was called the gold standard, which in practice meant that a woman had to be considered ill enough to justify a general anaesthetic before she could be believed, and many were sent away without a date. The European guidance revised in 2022 no longer treats surgery that way. Detailed transvaginal ultrasound performed by somebody trained to look for this specific disease, and MRI where the ultrasound cannot reach, now carry enough weight that a diagnosis can be made and treated without opening the abdomen at all. Surgery has moved to where it belongs, which is treatment of disease already identified, or investigation when the imaging is clear and the symptoms are not. The word detailed in that paragraph is carrying weight. A routine pelvic ultrasound looking for cysts and fibroids will miss deep disease behind the uterus and around the bowel, because that is not what the person holding the probe was looking for. The scan that matters here takes twenty to thirty minutes, examines the sliding movement between the uterus and the rectum, and specifically hunts nodules in the space behind the cervix.
Treatment then runs on two tracks that are chosen by what the woman wants from the next few years, and not by disease severity alone. Hormonal suppression settles pain for many women and can be continued for years, and the choice between a combined pill taken continuously, a progestogen, a hormonal coil and the newer oral treatments turns on side effects and on tolerance, since no single option is superior, while surgery removes disease that hormones cannot reach, restores anatomy distorted by adhesions, and matters most where fertility is the goal or where the bowel or ureter is involved. Adenomyosis, the sister condition where the disease sits inside the wall of the uterus itself, responds differently and is often the reason a woman told she has endometriosis fails to improve after excellent surgery.
Pain that has run for years also stops being purely a pelvic problem. The nervous system amplifies signals it has been receiving for a long time, the pelvic floor muscles hold themselves rigid in anticipation, and a woman can have every visible lesion removed and still hurt. That is not failure of the operation and it is certainly not imagination. It means the second half of the treatment, which involves pelvic floor physiotherapy and pain medicine, was never started, and it is why those two are booked here at the same appointment as the surgery, well before it has a chance to disappoint.
Bleeding, fibroids and the uterus
Heavy bleeding is the commonest reason a uterus is removed. Most of those uteruses did not need to come out.
The ladder below exists, every rung of it is available here, and the argument for starting low is that the low rungs are reversible while the top one is permanent.
This table scrolls sideways on a narrow screen. Swipe or drag to see every column.
| Option | What it does, and what it asks of you |
|---|---|
| Tablets during the period | Tranexamic acid and anti-inflammatory painkillers taken only on bleeding days reduce blood loss meaningfully and cost you nothing hormonally. Frequently skipped because they sound too simple to work, and they are the right first move for a woman who wants a pregnancy soon. |
| Hormonal coil | A small device releasing progestogen directly into the uterus, fitted in a few minutes, lasting years and reversible on removal. It is the single most effective step on the ladder that does not involve an operating theatre, and it also treats the pain of adenomyosis in many women. |
| Pills and injections | Combined pills taken without a break, oral progestogens and the newer treatments that suppress the ovarian signal directly. Useful, adjustable and easily stopped, with side effect profiles that differ enough between them that failing one says little about the next. |
| Endometrial ablation | A short day procedure destroying the lining of the uterus. Effective for bleeding, useless for fibroids that distort the cavity, and it ends the possibility of pregnancy, so contraception is still required afterwards and the decision belongs to women who have finished having children. |
| Myomectomy | Removal of fibroids while keeping the uterus, done through the cervix, through keyholes or open depending on where they sit. It preserves fertility. New fibroids can grow afterwards, which is a real limitation and is the sentence most often left out of the consultation. |
| Artery embolisation | A radiologist blocks the blood supply to the fibroids through a wrist or groin puncture, with no abdominal incision and a faster recovery. Effect on future fertility is less certain than after myomectomy, so it suits women who have finished having children or who never wanted them, and it is a poor choice where a pregnancy is the point of treating the fibroid at all. |
| Hysterectomy | Removal of the uterus, which ends bleeding permanently and is the right answer for some women. It is the last rung for a reason, and it deserves to be reached rather than jumped to. The ovaries are a separate decision and should never be removed casually alongside it. |
Of that list the hormonal coil is the one most consistently underused, so it is worth showing what it actually does instead of describing it in adjectives. A retrospective series followed 27 women with abnormal bleeding for at least six months after fitting. Mean haemoglobin rose from 9.4 to 11.6 grams per decilitre, a measured recovery from anaemia rather than an impression of one, and the proportion whose bleeding lasted longer than seven days fell from 74 percent to none. Ten of the 27 stopped bleeding altogether and 25 reported satisfaction, while one device came out on its own and two women discontinued, one for persistent bleeding and one for weight gain. The study is small and looked backwards, so treat the exact figures loosely, but the direction of it is consistent with everything larger.
Anaemia deserves a line of its own, because it is treated as a footnote to the bleeding when it is often the thing actually ruining the woman's life, and exhaustion, breathlessness on stairs, hair loss and difficulty concentrating are commonly attributed to stress in a woman whose ferritin has been on the floor for three years. Iron is checked, and iron is replaced, before anybody discusses an operation.
Screening that works, and screening that does not
Screening a well person is a different act from investigating a sick one. The burden of proof is different too. A test offered to somebody with no symptoms has to earn its place by showing that it makes people live longer, because everything it does otherwise, including the false alarms and the operations that follow them, lands on people who would have been fine.
This table scrolls sideways on a narrow screen. Swipe or drag to see every column.
| Test | Who it is for | Our position |
|---|---|---|
| Cervical screening with HPV testing | Every woman in the eligible age range, whether or not she has had the vaccine. | Offered without hesitation. Testing for the virus first instead of looking at cells first finds more disease and safely lengthens the interval between tests, so fewer appointments do more work. |
| Breast imaging | Women in the national screening age band, and earlier where family history or a known gene changes the calculation. | Offered, with the interval and the method set by risk and not by preference. Dense breast tissue changes what mammography is able to see, and that is discussed openly with the woman it applies to. |
| Ovarian screening with CA-125 and ultrasound | Nobody at average risk. Women carrying a high-risk gene are managed on an entirely separate pathway. | Declined, for the reason set out below. This is the single most requested test on this page and the answer is still no. |
| Bone density scanning | Women after an early menopause, after long steroid use, after a fracture from a minor fall, or with other clear risk factors. | Offered where a risk factor exists, since the result changes treatment. Not offered as a routine addition to a general check. |
| The full female hormone panel | Women being investigated for a specific question such as absent periods, infertility or suspected early menopause. | Declined as a package. Hormones swing across a cycle and across a life, so a panel drawn without a question attached generates findings that need chasing and answer nothing. |
The ovarian line in that table costs us bookings. Here is the evidence behind it.
Why annual ovarian screening does not save lives
The largest trial ever run on this question followed more than two hundred thousand postmenopausal women in the United Kingdom from 2001 to 2020, screening one group with repeated CA-125 blood tests interpreted against each woman's own trend, plus ultrasound. It found no reduction in deaths from the disease. A secondary analysis published in 2026 asked whether that null result was a flaw in the trial design or something about the cancer itself, by reconstructing the natural history of high-grade serous ovarian cancer, the commonest and most lethal type. The estimated window in which that cancer is detectable while still early ran to under six months. Simulating screening continued beyond the trial period produced a mortality reduction of at most 15 percent. Reaching a 20 percent reduction would require a test that stretched the early-stage window to a full year and caught at least seven cases in ten inside it, which is not what current tests do. The authors were plain about the implication, which is that clinically useful ovarian screening will need genuinely new tests, and not more frequent old ones.
What replaces it is less satisfying and more honest. Persistent bloating, feeling full quickly, pelvic or abdominal pain and needing to pass urine more often, when those are new and last most days for three weeks, are investigated promptly instead of watched. A high-risk family history is referred for genetic assessment, which puts a woman on a different pathway altogether with real options on it, and a woman who books an annual scan for reassurance is told plainly what the scan can and cannot give her before she pays for it.
Where this unit hands over
A general gynaecologist operating occasionally on a cancer is a worse outcome than a referral. Pretending otherwise is how women end up having a second operation to correct the first, which is a poor trade for everybody except the person who kept the booking.
So the boundary is drawn explicitly. Suspected or confirmed cancer of the ovary, uterus, cervix or vulva leaves this service on the day it is suspected and goes to the gynaecological oncology team, who operate on these diseases as their whole practice and who work inside a multidisciplinary meeting with pathology and medical oncology in the room. Suspicious breast findings go to the breast unit on the same principle. Complex fertility treatment goes to reproductive medicine. Pregnancy care belongs with obstetrics, and for a woman living abroad it belongs with obstetrics in her own city, since antenatal care is a relationship maintained over months rather than a procedure that can be flown to.
What this unit keeps is the large and neglected middle. Pain, bleeding, fibroids, endometriosis, adenomyosis, ovarian cysts that are not cancer, contraception, prolapse, incontinence, recurrent infection, menopause, cervical abnormalities short of cancer, and the long tail of problems that are not dangerous and are ruining somebody's life. That middle is where the delay lives. It is also where a unit earns its reputation, or fails to.
The pelvic floor, and the mesh question
Prolapse and leaking are extraordinarily common and extraordinarily under-reported. They are also among the few conditions in medicine where supervised physiotherapy genuinely competes with surgery. Many women with mild to moderate prolapse and most women with stress leaking improve enough with a properly taught pelvic floor programme that no operation is needed, and a pessary, which is a supportive device fitted in clinic and changed periodically, handles a great many of the rest without an anaesthetic. Both are offered first here, and neither is a consolation prize, since a woman who avoids an operation she did not need has had the better outcome and not the second-best one.
Where surgery is right, the mesh question arrives, and it arrives loaded with a decade of litigation and headlines. Both the marketing and the panic are wrong. The evidence sits between them and deserves better than either.
A Cochrane review updated in 2026, covering 22 randomised trials and 3,095 women, sets out the trade-off in numbers. Comparing vaginal mesh repair against native tissue repair in women who were continent beforehand, mesh may increase new stress incontinence at three to seven years, with a relative risk of 1.77, while reducing recurrence of the prolapse itself, with a relative risk of 0.40. Both findings were rated low certainty by the reviewers, and that rating should be read as part of the finding rather than as a footnote to it. The same review found that adding a small sling at the time of prolapse surgery probably reduces later incontinence in women who already leak or who leak when the prolapse is pushed back, and that delaying the sling and doing it only if needed remains a reasonable alternative.
Then there is what women actually feel afterwards, which is measured less often than it should be. A single-institution review contacted 110 women a median of roughly two and a half years after prolapse surgery. Satisfaction was high and regret was low, and neither differed significantly between those who had mesh and those who did not. The interesting finding sat elsewhere. Among women reporting moderate to severe regret, what they regretted most was having had a hysterectomy as part of the repair, and separately, not having had mesh placed. Sexual health concerns, reported by 16 percent, tracked strongly with lower satisfaction and are asked about here before the operation.
Read those two studies together and the conclusion is not that one technique wins.
It is that the uterus should not be removed reflexively during a prolapse repair, that the trade-off between recurrence and new leaking belongs to the woman making the decision, and that sexual function is part of the consent conversation.
Menopause, and why the route matters
Hormone therapy remains the most effective treatment for hot flushes, night sweats and the genital and urinary symptoms of oestrogen loss, and a generation of women went without it because of how one large trial was reported and then repeated. Correcting it has been slow, partly because the people who would benefit most stopped asking and the people who should have offered stopped raising it.
A 2026 review comparing the major international guidelines against each other found something more useful than a restatement of the headline. Only the British NICE guidance and the European menopause society guidance treat clinical complexity, meaning multiple conditions, frailty and cancer survivorship, as a founding principle instead of a list of exclusions. The American statements set out risk categories without a coherent framework for the complicated patient. Interactions between hormone therapy and the other drugs a woman is already taking are addressed inconsistently across all of them, and there is no agreed prescribing algorithm. Observational evidence runs consistently in one direction on a point that matters enormously in practice, which is that oestrogen absorbed through the skin as a patch or gel carries a more favourable cardiovascular and clotting profile than the same hormone swallowed, particularly in women who already carry risk.
That last sentence is the practical one. Route is not a detail.
Two further things get lost. The vaginal and urinary symptoms of menopause, meaning dryness, pain with sex, urgency and recurrent urine infections, respond to a tiny local dose of oestrogen that behaves quite differently from systemic treatment and is appropriate for many women who cannot or will not take the systemic form. And for women who cannot use hormones at all, the non-hormonal options are real and not token, including the newer drugs acting directly on the brain's temperature control, and they are prescribed here and not merely mentioned.
Early menopause, meaning ovaries that stop before forty, is a separate matter entirely and is frequently mishandled as though it were an early arrival of a normal event. It is not. Those women need replacement at least until the usual age of menopause for their bones, their hearts and their brains, and the conversation about whether to treat should not be conducted in the same terms as for a woman of fifty-two.
What we do not offer
Istanbul is one of the world's busiest markets for cosmetic gynaecology. Silence on that is not neutrality.
We do not perform vaginal laser or radiofrequency treatment for menopausal dryness, laxity or so-called rejuvenation. The evidence is now unusually clear. It is worth stating in full, because the marketing rests on studies that were never designed to test anything.
What happened when the laser was compared with a dummy device
Early enthusiasm for the fractional carbon dioxide laser came from studies in which every participant knew she was being treated, and those reported satisfaction rates above 90 percent. Seven double-blind trials have since compared the laser against a sham device that looks and sounds identical, and a meta-analysis of them published in 2024 found the largest single improvement was in pain during sex, at 16.3 percentage points, which did not reach statistical significance. A 2025 review of that evidence concluded that outcomes such as the appearance of the vaginal wall on examination and its appearance down a microscope are not reliable measures of whether a woman feels better, that any effect of laser over sham is unlikely to be clinically meaningful, and that until a properly powered study defines a minimum difference worth having, the laser should not be used clinically for these symptoms. Local oestrogen, which is inexpensive and well studied, treats the same problem.
We do not perform labiaplasty or other genital cosmetic surgery on normal anatomy. The great majority of women asking have anatomy squarely within the normal range and have compared themselves against images that were edited. What we do is examine, describe what normal actually looks like across a population, and offer a psychological consultation. Genuine functional problems, meaning tissue that catches, tears, causes pain during exercise or intercourse, or asymmetry after childbirth or surgery, are treated operatively and are a different conversation.
Nor do we offer hymen repair, vaginal tightening, or so-called G-spot procedures. On the first of those, no clinical benefit exists to weigh against the risk, and we recognise that some women ask under coercion or fear instead of choice, so the response is a private consultation and, where wanted, help rather than a surgical booking.
And we do not sell annual packages of scans and blood tests to women with no symptoms. A well woman appointment consists of a conversation, blood pressure, weight, cervical screening when it is due, breast imaging when it is due, and a discussion of contraception or menopause if either applies. Adding an ultrasound and a panel of tumour markers to that produces incidental findings, further scans and occasionally an operation on something that was never going to hurt anybody.
What a first appointment involves
Longer than most women expect. Much of it can be done by video before any travel is booked.
Thirty minutes of history, uninterrupted
Periods, pain, bleeding, bowels, bladder, sex, mood, sleep, previous treatments and what happened to each. A menstrual diary from two or three cycles beforehand is worth more than any test and takes a minute a day to keep. Nothing described here is unusual to a gynaecologist.
Examination, explained and declinable
What is being looked for is described first, a chaperone is present, and the examination stops the moment you say so. For women who have experienced assault, or who have vaginismus, or for whom this is culturally difficult, it can be deferred entirely to a later visit or replaced with an abdominal approach and MRI.
The scan that takes half an hour
Where endometriosis or adenomyosis is suspected, the ultrasound is the detailed kind, checking whether the uterus slides freely against the bowel and hunting nodules behind the cervix. It is booked as a long slot deliberately, because the short version is what produces the normal scan that sends a woman away for another two years.
Blood, and only where it answers something
Full blood count and ferritin in anybody bleeding heavily, thyroid function where the picture fits, and hormone tests only when a specific question needs them. Tumour markers are not part of a routine assessment and are ordered when a scan has raised a question that they can help settle.
A plan with a review date attached
Written down, with what is being tried, how long it needs to be given before anybody judges it, and what happens if it fails. Hormonal treatments need three months before a verdict, and stopping one at week six then declaring it useless is the commonest reason a woman ends up on an operating list she did not need.
Coming to Istanbul
Assessment and medical treatment take two to three days, covering the consultation, the detailed scan, blood tests and a follow-up to discuss results face to face. A hormonal coil or an outpatient hysteroscopy fits inside that. Laparoscopic surgery for endometriosis, a myomectomy or a prolapse repair means seven to ten days in Istanbul, with the stay set by the flight rather than by the wound, since sitting still on a long flight in the fortnight after pelvic surgery is what causes clots. Where the bowel or the ureter is involved the stay runs longer and is discussed before anything is booked. Most nationalities enter Turkey visa-free or on an electronic visa completed online in minutes, and a letter of invitation is issued for anyone whose application needs one. Interpreters cover Turkish, English, Arabic, Russian and German as standard, with other languages arranged in advance, and for consultations of this kind a female interpreter is available and is offered by default without being asked for. Airport transfer and a hotel near the hospital are arranged alongside the appointments so the whole assessment falls inside one working week. A companion is welcome throughout, including into the consultation, and can be asked to step out for any part of it.
One honest limit belongs here. Pregnancy care is not a travel service. Antenatal care is a relationship built over months with somebody who can see you next week, so a woman living abroad should hold that care at home, and we will write to whoever provides it. What does travel well is the gynaecology on this page, most of which begins with a video consultation and a scan report and often ends without a flight at all.
What moves the cost
The single largest driver is which rung of the ladder you end up on. That is decided by the assessment and never in advance. A hormonal coil fitted in clinic and an extensive laparoscopic excision of deep endometriosis involving the bowel occupy opposite ends of the same department, and a figure quoted before anybody has seen your scan is describing a procedure somebody hopes you will need.
Within surgery, four things move the number. How long the operation takes, which for endometriosis depends on how much disease is found and how stuck things are, and which cannot be known precisely beforehand. Whether a second specialty is needed in theatre, since deep disease on the bowel requires a colorectal surgeon and disease near the ureter requires a urologist, and since their presence has to be planned in advance and cannot be improvised on the morning. Which route is used, meaning keyhole, vaginal or open, and whether robotic assistance is involved. And how many nights are spent in hospital afterwards. Outside theatre the additions are easy to leave out of a quotation and worth pinning down. Whether the detailed ultrasound and any MRI sit inside the figure. Whether pathology on whatever is removed is included, which it should be, since a specimen that goes unexamined has wasted the operation. Whether pelvic floor physiotherapy sessions are counted or billed each time. Whether the hormonal treatment prescribed afterwards, which for endometriosis may run for years, is your responsibility to source at home. Whether the follow-up video consultations are included and for how long. And whether an interpreter is charged separately.
Your own situation moves it as much as the menu does. A woman with a single fibroid, a clear scan and no previous surgery is a straightforward case. A woman with three previous operations, dense adhesions, disease involving the bowel and a strong wish to preserve fertility is a different piece of work altogether, and the second woman is not being upsold when she is told so.
Four questions make a quotation comparable. Name the exact procedure, including which route. Ask what is included if the surgery turns out to be more extensive than the scan suggested. Ask what the follow-up covers and for how long. And ask what happens, and who pays, if the plan changes on the day. Those four are answered in writing before anything is booked.
Follow-up once you are home
Most of what determines whether this worked happens after the flight. Almost none of it happens in a theatre.
For endometriosis the critical element is the medical treatment that follows surgery, because disease left untreated hormonally comes back and the recurrence rate over five years is not small. You leave with the prescription, the reasoning, the expected side effects and a named alternative if the first one is intolerable, plus a letter your own doctor can act on to continue it, and video review happens at six weeks and again at six months, and sooner if pain returns, since pain returning early usually means the medical treatment needs changing and not that the surgery failed. After a coil is fitted the first three to six months are the unsettled ones, with irregular spotting that resolves in most women and that causes early removal in some who were not warned it was coming. You are warned. After prolapse or incontinence surgery the physiotherapy programme continues at home for months and is the difference between a repair that lasts and one that does not, and it is sent as a written and filmed programme, never described in a corridor.
Cervical screening, breast imaging and bone density where relevant continue on the ordinary schedule in your own country, and the discharge letter states the intervals in plain terms, without reference to guideline numbers, so that a general practitioner anywhere can pick them up without having to look anything up first. Keep the operation note itself. Any future surgeon will want to know exactly what was removed and what was left, and reconstructing that later from memory wastes an appointment at best.
Frequently asked questions
Do I need an operation to find out whether I have endometriosis?
Why will you not do an annual ovarian cancer scan?
Is there a way to stop heavy bleeding without losing my uterus?
Should mesh be used in my prolapse repair, or is native tissue safer?
Does vaginal laser treatment work for dryness or laxity?
Is hormone therapy for menopause safe, and does the form matter?
I have migraine, bowel problems and low mood. Could that be gynaecological?
How long should I plan to stay in Istanbul?
Written by the Biruni Hospital medical editorial team.
Reviewed by Dr Yunus Emre Yavuz, Obstetrics and Gynaecology.
References
- Goroshchuk O, Perez-Gomez N, Carmona F, et al. Characterizing endometriosis and adenomyosis symptom clusters and their impact on quality of life in the All of Us Research Program. Human Reproduction. 2026;41(8):1310-1323.
- Lange JM, Ahmad I, Dengos IJ, et al. Can ovarian cancer screening work, a secondary analysis of the UK Collaborative Trial of Ovarian Cancer Screening. British Journal of Cancer. 2026.
- Patil SS, Jadhav V, Pathak N. A study of the effect of the levonorgestrel intrauterine system on the management of abnormal uterine bleeding. Cureus. 2025;17(11):e96235.
- Baessler K, Christmann-Schmid C, Haya N, et al. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Cochrane Database of Systematic Reviews. 2026;2(2):CD013108.
- Bryans H, Sharma A, Abraham N. Satisfaction and decisional regret after mesh versus non-mesh apical pelvic organ prolapse surgery. Neurourology and Urodynamics. 2026;45(6):1152-1160.
- Li FG, Abbott J. Laser for genitourinary syndrome of menopause, what we know and what we need to know. Climacteric. 2025;28(4):414-422.
- Yanachkova V, Lebanova H, Stoev S. Menopausal hormone therapy in clinically vulnerable women, a narrative review of guidelines and real-world evidence. Medicina. 2026;62(4):712.
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