Endometriosis is a disease that we often don't talk about, but there's a very high chance you know someone with it. I won't spoil too much, before we begin, so let's dive into it!
Overview:
- What endo is + symptoms
- History
- Relevance to medicine + society overall
Intro to Endo
Endometriosis is classically defined as a disease of the fertile woman which is only mostly true. Endo is a condition where uterine cells are found outside of the uterus, shedding each month which can result in scarring, pain, swelling, and...yeah. Not fun. Almost 50% of people with endo are infertile, however, statistics are likely inaccurate because many doctors are unaware of endo's existence, don't consider it, or dismiss the symptoms and signs. You may have noticed I said "people" instead of women, and yes, I do mean anyone with a uterus, but people born without a uterus can also have endometriosis which is quite unfortunate for them and is usually even worse because of the difficulties in diagnosis. Endometriosis often causes pain during menstruation as the cells shed and cause inflammation, but chronic pain is common amongst approximately half of those with endometriosis. The shedding and cell clumps can literally stick organs together, which, as you can imagine, hurts. The lesions can develop their own nerve supplies...eugh and oof. Main symptom, if you have not guessed, is pain, which can be extremely debilitating and prevent people from working, going to school, or otherwise living their everyday lives. I cannot do the horror of this justice. To summarize: internal bleeding-not-bleeding, debilitating and in some cases constant pain, possible infertility, sticky organ syndrome (not actual name), lesions being strong independent jerks and growing nerve supplies. That's horrifying. No thank you.
History
We know that medicine was traditionally dominated by men (but times are changing!). Hysteria used to be a condition you could diagnose a woman with, and it literally means wandering uterus, which kinda says everything you need to know. While radium was truly gruesome and horrifying, I would argue the history of endometriosis and healthcare for women was outright barbaric. Even now there are so many misconceptions about endo, including but really not limited to:
- A hysterectomy will cure you
- iT's jUsT pEriOd pAiN. Absolutely not. Periods should not hurt so much they prevent you from living a normal life.
- Get pregnant to solve your problems
Regarding the last one...fun story. Once upon a time there was this doctor guy seeing patients as doctors do, and this person has an appointment. She has endo and is complaining of pain, so my guy tells her that having a child will resolve or lessen her symptoms. He was talking to a little girl who was at most 11 years old. I invite you to pause here, read that again, and let it sink in. That could cause her so many problems emotionally, financially, mentally, and physically, as well as socially.
Anyhow moving right along. Hippocratic doctors actually took it seriously (like, you know, real doctors) but in the Middle Ages, women with endo were thought to be imagining it, insane, immoral, or misbehaving(????). Hypothesized causes include madness, "female weakness", hysteria, and promiscuity. Even though the Hippocratic doctors at least took the disease seriously, they still had a ways to go. Delayed childbirth was thought to trigger diseases of the uterus, so marriage and pregnancy at a young age was frequently recommended. Taking a massive jump into the 1950s-70s, progesterone and estrogen were often prescribed (it was referred to as pseudopregnancy, tying back into the other theory) and sometimes helped, but they came with massive side effects.
In Modern Medicine
As I mentioned before, there are more women than ever in officially recognized medical careers. However, that does not make healthcare equal for all. Most clinical trials are run on the iDeAL hUmAn also known as the middle-aged white man, including studies on breast cancer, which affects women vastly more than men. Lots of medicines have undocumented side effects on women because females and males are biologically different. Something that came out during the pandemic vaccine blood clotting controversy is that blood problems due to birth control is far more common than blood problems due to vaccination, yet nobody was in an uproar around that. Despite the fact that endometriosis is really common, many healthcare providers cannot name symptoms or don't know that it exists. This is obviously a problem for people looking for a diagnosis. Additionally, it's a financial burden for people because of pain - in addition to treatment, it can hurt so much that they can't work. In summary: many of the problems with endometriosis lie with a lack of education and knowledge. We need more diverse medical practitioners and researchers to find problems like these and address them.
Also highly recommend the podcast "This Podcast Will Kill You" which is hosted by two epidemiologists. Episodes are usually around 1 hour to 1 hour and 15 minutes which means they're able to cover quite a lot. This post was inspired by an episode of that podcast and much of the information was pulled from there :)
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