ESSE Care

ESSE Care Expert care for endometriosis, adenomyosis, fibroids, and infertility with a whole-body approach.

ESSE Care is a boutique women’s health clinic offering advanced minimally invasive gynecological surgery, fertility support, and integrative wellness care. Led by Dr. Karli Provost Goldstein, the team specializes in treating conditions such as endometriosis, adenomyosis, infertility, and chronic pelvic pain. ESSE Care’s mission is to provide personalized, compassionate care that improves quality of life for women of all ages.

When chronic pelvic pain, painful periods, or infertility disrupt your life, endometriosis excision surgery may be your ...
04/14/2026

When chronic pelvic pain, painful periods, or infertility disrupt your life, endometriosis excision surgery may be your path forward.

At ESSE Care, we specialize in true excision—removing endometriosis at its root rather than simply burning it away—using minimally invasive techniques designed to give you the best chance of long-term relief.

Most patients go home the same day or stay one night in the hospital. Recovery is gradual, with most returning to desk w...
04/13/2026

Most patients go home the same day or stay one night in the hospital. Recovery is gradual, with most returning to desk work within 2-4 weeks and full activity by 6-8 weeks. Complete internal healing can take 3-6 months.

What to expect after surgery:

✅𝐏𝐚𝐢𝐧 𝐦𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭:Prescription medications for the first week, then over-the-counter options. Heating pads and gentle movement help with discomfort.
𝐀𝐜𝐭𝐢𝐯𝐢𝐭𝐲 𝐫𝐞𝐬𝐭𝐫𝐢𝐜𝐭𝐢𝐨𝐧𝐬: Avoid heavy lifting (over 10 pounds) and core-intensive exercise for 6 weeks. Depending on your surgery, pelvic rest for at least 2 weeks.
𝐅𝐨𝐥𝐥𝐨𝐰-𝐮𝐩 𝐜𝐚𝐫𝐞: First visit at 1-2 weeks for wound check and pathology results, with ongoing monitoring for recurrence and symptom management.
𝐀𝐝𝐝𝐢𝐭𝐢𝐨𝐧𝐚𝐥 𝐬𝐮𝐩𝐩𝐨𝐫𝐭: Pelvic floor physical therapy often recommended at 6-8 weeks; nutritional, pain management, and mental health support available as needed.

04/13/2026

𝐖𝐡𝐚𝐭 𝐫𝐨𝐥𝐞 𝐝𝐨𝐞𝐬 𝐛𝐢𝐫𝐭𝐡 𝐜𝐨𝐧𝐭𝐫𝐨𝐥 𝐩𝐥𝐚𝐲?
The pill helps suppress ovulation, keep the lining thin, and prevent ovarian cysts.

𝐏𝐫𝐨𝐬:
• Can lead to lighter cycles
• Helps prevent ovarian cysts/endometriomas

𝐂𝐨𝐧𝐬:
• Endo can still progress or recur
• Some patients may worsen even on the pill

𝐊𝐞𝐲 𝐓𝐚𝐤𝐞𝐚𝐰𝐚𝐲:
Birth control does not halt endo forever, but it can help manage certain aspects like the ovarian component.

04/10/2026

Less than a year ago, B.G. had her third surgery at a leading health center and was told that extensive endometriosis was left.

Instead of accepting that as her reality, she chose to pursue further care and keep searching for answers.

Now, she is two months post-op and focused on healing.

Implantation is not just about the embryo. It is about the environment.The uterine lining, immune system, inflammatory l...
04/09/2026

Implantation is not just about the embryo. It is about the environment.

The uterine lining, immune system, inflammatory landscape of the pelvis, nervous system, and structural integrity of the uterus and ovaries are all part of the same conversation. When even one piece is off, implantation can be affected.

Gynecologic conditions such as endometriosis, fibroids, adenomyosis, hydrosalpinx, and chronic inflammation can alter this environment in ways that are not always visible on standard testing, yet still interfere with implantation.

At ESSE Care, we approach fertility through this broader lens.

During our Clinical Roundtable, we will be reviewing real patient cases to understand how the environment can be restored to support successful implantation. Our physicians will provide expert insight on:

🌿 How pelvic inflammation, immune signaling, and stress influence implantation
🩺 When surgical intervention can help remove sources of inflammation
🧬 How fertility treatment is timed and sequenced to support implantation
🌸 How integrative therapies help prepare the body for implantation

This is a conversation for anyone who has been told everything looks normal, yet still does not have answers.

https://hubs.ly/Q04b3ZVQ0



After repeated implantation failures, many are left wondering if the embryo is the issue. Often, there is more to the st...
04/08/2026

After repeated implantation failures, many are left wondering if the embryo is the issue. Often, there is more to the story that has not yet been explored.

Implantation is not a single moment. It is a coordinated process between the embryo and its environment.

Conditions such as endometriosis, fibroids, adenomyosis, chronic endometritis, or tubal disease can create an inflammatory environment that disrupts immune signaling, alters the uterine lining, and affects the timing required for implantation. When that environment is not optimal, even high-quality embryos may not implant.

This is why patients with normal labs, normal imaging, and genetically tested embryos can still experience repeated failure.

During our Clinical Roundtable, we will be reviewing real patient cases to understand how implantation can be supported more successfully. Dr. Talebian will provide expert insight on:
🔍 How inflammation and immune signaling influence implantation
🧬 What defines endometrial receptivity beyond standard testing
🌱 How we evaluate and sequence care to improve implantation success

You deserve a workup that looks at the whole environment, not just the embryo.

https://hubs.ly/Q04b3NfN0



04/06/2026

If you’re dealing with endometriosis or painful cycles, small things can make a big difference.

Here are a few simple practice to try after a long day on your feet:
1. Lay on the floor, put your legs up against a wall, and just breathe. This position helps improve circulation and takes pressure off your pelvis.
2. You can also try gentle, restorative poses using pillows for support and adding heat to your lower abdomen for extra relief.

On harder days, slow it down and support your body. On better days, move in ways that feel good to you.

Endometriosis Excision Surgery: Step by Step During the surgery, your surgeon will: 1. Insert a camera through a small i...
04/01/2026

Endometriosis Excision Surgery: Step by Step

During the surgery, your surgeon will:

1. Insert a camera through a small incision near the navel to visualize the pelvic cavity.
2. Make additional small incisions for surgical instruments.
3. Systematically inspect all pelvic surfaces, organs, and structures for endometriosis.
4. Carefully excise all visible endometriosis lesions, removing them completely at their base.
5. Address any adhesions (scar tissue) that may be distorting anatomy.
6. Remove endometriomas if present.
7. Perform any additional necessary procedures to restore anatomy, optimize fertility, or achieve the patient’s goals for surgery.
8. Ensure careful hemostasis (control of bleeding).
9. Close the small incisions with absorbable sutures.

The surgery typically takes 2-5 hours depending on the extent and location of disease, but it can take longer in more complex cases.

03/30/2026

Sometimes cramps are there from the very beginning which is called dysmenorrhea. Other times, periods may start off manageable and become more painful over time. This is known as secondary dysmenorrhea and it can be linked to conditions like endometriosis.

No matter what you’ve been told intense period pain is not normal.

Your pain should not cause you to:
⁍ Miss school
⁍ Sit out of sports
⁍ Lay the bathroom floor
⁍ Throw up
⁍ Pass out

When on your period, you deserve to feel supported, heard, and pain free.

03/27/2026

Endometriosis isn’t just physical, it’s a whole-body disease.

Chronic inflammation is of the main symptoms and can lead to elevated anxiety levels.

When the body is in a constant fight-or-flight state or dealing with long-term sleep deprivation, that stress builds over time. For many, this leads to more intense or chronic anxiety alongside the physical symptoms of endometriosis.

That’s why care often includes more than treating the condition itself, and focuses on supporting mental health as well. Healing isn’t just about managing your symptoms, but getting back to feeling like yourself again.



03/26/2026

The body has a natural rhythm where cortisol should be high in the morning to get us moving and low at night to let us rest.

For those with Endometriosis, the chronic inflammation often keeps the body in a constant state of stress. This can lead to a nervous system that feels depleted and a cortisol curve that follows the wrong rhythm. It’s exactly why that 4 AM insomnia happens followed by feeling exhausted in the morning.

Using a combination of acupuncture and targeted supplements like L-Theanine can help:
• Calm the brain to help you fall and stay asleep.
• Support the nervous system so your adrenals can recover.
• Balance cortisol to manage inflammation and restore energy.



-Theanine

03/24/2026

Most people don't realize that a typical uterus is only about 𝟕 𝐱 𝟓 𝐱 𝟒 𝐜𝐦. That’s roughly the size of a fist or a small peach!

But with conditions like Endometriosis or Adenomyosis, things change.

With 𝐄𝐧𝐝𝐨𝐦𝐞𝐭𝐫𝐢𝐨𝐦𝐚𝐬, when these cysts grow on both ovaries, they can actually occupy more space than the uterus itself.

For 𝐀𝐝𝐞𝐧𝐨𝐦𝐲𝐨𝐬𝐢𝐬, instead of that neat "triangular" shape, the uterus can become round and bulbous, globular in appearance.

Understanding the anatomy is the first step in understanding the pain.

Address

779 North Street
Greenwich, CT
06831

Opening Hours

Monday 8am - 5pm
Tuesday 8am - 5pm
Wednesday 8am - 5pm
Thursday 8am - 5pm
Friday 8am - 5pm

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