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Dr. Karli Provost Goldstein

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Greenwich, CT
Dr. Karli Provost Goldstein

🧒Patient🤒.Surgeon👩‍⚕️🩺.Mama🤰
🥼 Functional gynecology, endometriosis excision surgery, fertility, wellness.

Founder of Esse Care Reproductive Surgery and Wellness

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.

04/06/2026

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.

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.

03/24/2026

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.

03/10/2026

In honor of Endometriosis Awareness Month, I am sharing my story in 60 seconds.

It’s been a whirlwind of IVF, surgeries, and a full hysterectomy. If you're stuck in the cycle of "unexplained" symptoms, you aren't alone. Today, I’m on hormone replacement and feeling better than I have in years.

1 in 10 women suffer from endometriosis, yet diagnosis still takes an average of 7-10 years. We need to change this.

03/03/2026

Wishing everyone a very Happy Endometriosis Awareness Month!

March is a dedicated time to highlight a condition that impacts millions of people. For us however, Endo awareness is a year-round commitment.

We are proud to support our patients, advocates, and the entire community as we work together to educate and provide care.

AwarenessHappy Endometriosis Awareness Month

02/27/2026

𝐖𝐡𝐚𝐭 𝐞𝐱𝐚𝐜𝐭𝐥𝐲 𝐢𝐬 𝐄𝐧𝐝𝐨 𝐌𝐚𝐩𝐩𝐢𝐧𝐠?

It’s a combination of imaging and physical exams used to create a "map" of where endometriosis might be hiding before surgery.

𝐓𝐡𝐞 𝐌𝐚𝐩 𝐂𝐚𝐧 𝐇𝐞𝐥𝐩 𝐖𝐢𝐭𝐡:
• Planning the surgical team and getting the right specialists.
• Having a better idea of how long surgery might last.

𝐓𝐡𝐞 𝐃𝐫𝐚𝐰 𝐁𝐚𝐜𝐤𝐬:
• It’s not perfect and disease can still be missed on scans.
• Specialized ultrasounds can be long and often painful for those with pelvic tenderness.

Even with a map, endo can be unpredictable. Being prepared for anything is the best way to head into the OR.

02/12/2026

In this case study, we put mapping to the test. While it flagged some initial findings, it failed to detect the widespread disease that was found in the OR:

❌ The Misses: Uterosacral ligament disease, re**al disease, bladder involvement, and appendiceal endo—all of which were labeled "normal" on the scan.

✅ The Finds: About 50-60% of the lesions in this specific patient.

The takeaway: Imaging is a helpful roadmap, but it doesn't show the whole story. Nothing replaces a thorough patient history and a prepared surgical team in the OR. This case study is a prime example of why "clear" imaging doesn't always mean a clear pelvis.

01/28/2026

Simply put, secondary dysmenorrhea is a fancy word for period pain that begins after the first menstrual period. While primary dysmenorrhea starts from the very first period experienced, secondary dysmenorrhea happens when periods become painful at any point later in life.

𝐂𝐨𝐦𝐦𝐨𝐧 𝐜𝐚𝐮𝐬𝐞𝐬 𝐢𝐧𝐜𝐥𝐮𝐝𝐞:

• 𝐄𝐧𝐝𝐨𝐦𝐞𝐭𝐫𝐢𝐨𝐬𝐢𝐬: 30–80% of patients with pelvic pain have endo.
• 𝐀𝐝𝐞𝐧𝐨𝐦𝐲𝐨𝐬𝐢𝐬: Disease within the uterine wall itself that can develop in adolescence, adulthood, or after children.
• 𝐅𝐢𝐛𝐫𝐨𝐢𝐝𝐬: Specifically if they are inside the uterine cavity (though many are not painful).
• 𝐂𝐨𝐧𝐠𝐞𝐧𝐢𝐭𝐚𝐥 𝐀𝐧𝐨𝐦𝐚𝐥𝐢𝐞𝐬: Uterine shapes like a bicornuate uterus or uterine septum.
• 𝐎𝐭𝐡𝐞𝐫 𝐟𝐚𝐜𝐭𝐨𝐫𝐬: Infections around the uterus, tubes, and ovaries, or adhesive disease/isthmocele.

01/23/2026

True or False: You can’t have diaphragmatic endometriosis without a history of lung collapse.

Answer: ❌ False.

Endometriosis can occur on the diaphragm even if you’ve never had a lung collapse. Some patients develop small defects or lesions on the diaphragm without ever experiencing lung issues. That’s why during endometriosis surgery, the diaphragm should always be carefully evaluated to identify and remove lesions and repair areas to prevent future complications.

01/21/2026

How do we treat painful in*******se?

Treatment starts with a detailed history, pelvic exam, and muscle assessment to understand the root cause.

From there, care may include imaging, pelvic floor physical therapy, medical or surgical treatment if needed, and integrative support like sexual therapy and wellness care.

A collaborative, whole-person approach can make a real difference.

No matter your age, ongoing pelvic or menstrual pain deserves proper evaluation and support.

12/17/2025

Thanks for the sweet swag. Love my Barbie ID holder. And flash it when I get the worst room while the ortho bros waltz in and get the best.

No offense I have great ortho bro friends ;) but let’s face it- surgery is still a predominantly male dominated world. Despite fewer complications and lower risk of death from female surgeons.

The road is uphill and long towards respect. Patients and families and staff are more likely to call a male Dr By “Dr ____” and much more likely to call the female surgeon by first name or terms with less respect.

Address

779 North Street
Greenwich, CT
06831

Opening Hours

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

Telephone

+16468449602

Website

https://esse.care/

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