Endometriosis has deep historical roots with early mentions in ancient civilizations, challenging the idea of its recent emergence.
Gender biases in healthcare lead to delays in endometriosis diagnosis and dismissal of women's pain, impacting care received.
Genetic, hormonal, and environmental factors contribute to the complex origins and prevalence of endometriosis.
Historical gender biases and medical mistrust perpetuate dismissals of women's symptoms, hindering research and awareness of endometriosis.
Deep dives
History and Taboo around Menstruation
Historical texts from ancient Egypt and Greece provide some of the earliest records of menstrual dysfunction linked to pain and infertility. Despite these early mentions, the stigma and taboo surrounding menstruation have contributed to a lack of detailed historical documentation on endometriosis, as discussing menstrual issues has historically been considered improper or taboo.
Gender Inequality in Medicine
Endometriosis epitomizes gender disparities in healthcare, highlighting biases against women in medical treatment and diagnosis. Misconceptions and underestimation of women's pain, delays in diagnosis, dismissing symptoms, and the association of worth with fertility impact the care women receive for endometriosis.
Modern Disease or Ancient Affliction?
Endometriosis is often labeled as a modern epidemic, suggesting a recent emergence, when in fact, historical evidence dates back to ancient civilizations. The clinical recognition of endometriosis in the last century does not imply its modern onset, but rather a long-standing condition that has been underdiagnosed and misunderstood.
Evolutionary Perspective and Genetic Factors
Studies suggest genetic and environmental influences in endometriosis. The condition's prevalence challenges the idea of natural selection against it, with potential links to prenatal testosterone exposure. The complex interplay of genetics, hormones, and environmental factors underscores the multifaceted nature of the disease's origins and prevalence.
Historical Context of Medical Field and Autopsies
In the 19th century, women healers held significant medical knowledge that was lost due to restrictive medical licensing laws favoring white, wealthy men. Autopsies became popular, leading to the understanding of disease pathology. Pioneering figures like Karl von Rokitansky and John Sampson made crucial contributions in linking symptoms to specific diseases, with Sampson naming endometriosis in 1921.
Gender Disparities and Biases in Medical System
The medical system perpetuates a knowledge gap and trust gap, where women's health issues receive less scientific research and face disbelief in reported symptoms. Historical gender biases led to misconceptions like hysteria, linking women's health problems to their uterus. The medical community's unconscious bias contributes to dismissals of women's symptoms as psychogenic, leading to under-treatment and misdiagnoses.
Challenges in Understanding and Treating Endometriosis
Endometriosis faces challenges due to misclassification as a benign condition, limiting research and awareness. With significant impacts on fertility and overall health, endometriosis remains inadequately understood and underfunded compared to other conditions. Ongoing research aims to improve diagnostic markers and treatment options, highlighting the importance of changing perceptions and language surrounding this often-overlooked disease.
Chances are you know someone with endometriosis, or perhaps you’re affected yourself. But despite its incredibly high prevalence, endo remains almost criminally understudied, undertreated, and underacknowledged. In this episode, we aim to shed light on many aspects of endometriosis, first by examining the “what” and “how” of this disease: what’s actually going on inside your body with endometriosis and how does it cause the symptoms that it does? Then we turn our sights to the why, exploring not only the possible evolutionary origins of this disease but also the deep historical roots contributing to the struggle many people still face today in obtaining a diagnosis. We discuss how although hysteria is no longer a valid medical diagnosis, it has left its mark on medicine in the form of implicit bias that leaves many people feeling unlistened to and unbelieved. We then wrap up the episode with a look at endometriosis by the numbers and some current research that leaves us feeling slightly more hopeful about the growing awareness of this disease and the need for effective treatments.
