Endometriosis is a disease in whichendometrial-like tissue grows and implants itself outside of the uterine cavity(Cotroneo and Lamartiniere 68). It is an estrogen-dependent, pelvicinflammatory disease in which women experience pain, irregular menstruation,and could result in infertility and the need of hysterectomies (Burney andGiduice 511). The prevalence rate for the disease is 6-10% amongst reproductivewomen (Giduice 2389). The prevalencerate of the disease is also six times higher in those who have relatives withendometriosis (Burney 281).
Also because the symptoms of endometriosis are sosimilar to that of the menstrual cycle and some women might not experience anyof the symptoms, the average women with the disease can go up to 8.5 yearsbefore receiving an accurate diagnosis (Wang 281). The exact etiology of thedisease is unclear. Many researchers have theorized that retrogrademenstruation may play a role (Cotroneo and Lamartiniere 68). During retrogrademenstruation, the endometrial cells escape the uterine cavity through thefallopian tubes (Cotroneo and Lamartiniere 69).
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The escaped endometrial cellscreates lesions and attaches to various places such as the ovaries, the cervix,and in severe cases the rectum, small, and large intestines (Karita et al.889). The only way to get an adequate diagnosis is through laparoscopicsurgery. However, researchers are actively exploring biochemical markers of thedisease because it is a cheaper and less invasive alternative to laparoscopicdiagnosing. Knowing the trends of endometriosis will benefit medicalprofessions when considering treatment plans in relations to women’s’ health,as well as making the diagnostic period shorter. The essence of this paper isto discuss the disease many women suffer from privately and the reformationthat needs to occur pertaining to women’s health.
The issue I have chosen totackle is the benefits the medicalization of endometriosis has played inwomen’s health. I have chosen this because of the ignorance many have towardsthe disease. Endometriosis affects approximately 176 million women in theworld, yet the disease is so under researched (Endometriosis). As discussed inchapter 5 of our text, medicalization allows illnesses to become real. Relatingthis to endometriosis, because the disease is fairly new, in the terms ofresearch, the medicalization of endometriosis has provided many women withrelief.
Not because they are pleased with the diagnosis of such a complexdisease, but finally someone has diagnosed and helped them understand theconditions they have been suffering with. For most women, the pathto discovering their endometriosis and finding the right treatment plan forthem is long, frustrating, painful, but in the end very rewarding. As weexamined earlier in the semester, chronic pain is common among women, poorerpersons, and minorities (Weitz 127). However women are more capable of managingtheir pain. In the article “Enduranceand contest: women’s narratives of endometriosis” the author expressed thatduring her study many women complaints found that their complaints of pain weretaken less serious than men (Markovic 351).
That alone could be a factor in whywomen choose to suffer with the pains of endometriosis in silence. It’s alsohard on providers to prescribe medication when they cannot see what the patientis going through. Many providers lack the knowledge of the severityendometriosis and very few of them have seen it and therefore are dismissive ofthe disease as imaginary (Wang 281). In addition the recent war on prescriptiondrugs, has made many professionals are less likely to prescribe pain medicineto assist with symptoms, especially since they, the doctors, don’t even knowwhat they’re treating. This leads me to the question, how can a disease socommon be so “rare”? This could be the result of professionals’ lack ofknowledge on endometriosis, their assumption that the pain is in addition withtheir regular menstrual conditions, or simply the lack of insurance to covertheir appointment.
In the article”Endometriosis: cost estimates and methodological perspective” the averagepatient hospitalized by endometriosis spends $12,644 out of pocket yearly andcost the nation $119 billion annually (Simoens et al. 397). The article states doesstate that insurance companies cover most of the payment but who has an extra$13,000 stashed just for medical bills. The average cost of the initiallaparoscopic surgery, in order to get an official diagnosis, is $4,289 (Simoenset al. 399). If the surgeon doesn’t eradicate the entire endometriotic lesions,the rate of recurrence is 6-67% (Selcuk and Bozdag 99). This could lead to theneed of additionally surgeries and other the cost, there is a risk every timeone goes under anesthesia. In addition, the patient needs recovery time andthat could put them out of work for a while.
Some women experience pain thatresults in them having to take days off from work. All of this can and will bea burden on those of the lower end of the socioeconomic group. Also thedisparities within healthcare do not help the cause either. Previously mentioned inchapter 3 of our text, social class explains the many health differences amongethnic groups (Weitz 54). Going back to Markovic’s article, minority women withendometriosis experience many barriers such as limited access totransportations to get to their appointments, language barrier, and lack of insurance(Markovic 350).
Like stated in our text, when people lack access to healthcare,small problems become significant fast (Weitz 52). In addition to the lack ofinsurance, people from lower socio-economic backgrounds are also less likely tosee a provider about pain and less likely to believe that health professionaltake their complains seriously (Markovic et al. 350). This results in the delayof their diagnosis and treatment. This could also result in the diagnosing oftheir disease in the tertiary stage where it’ll cost them or their insurancecompany a significant amount. Even with the lack of funds, hospitals andmedical center in poorer communities do not always have the funding to providestate-of-the-art equipment that is needed to serve their patients.
So not onlydo they deal with the pains of the conditions, they also tussle with thestruggles of everyday life in these lower-income communities. Weitz describes thedominance physicians maintain when meeting with their patients in chapter 11 ofour text. Because doctors receive extensive training, they are held to higherstandard and therefore the public place great trust in them (Weitz 267). DuringMarkovic and her partners’ study, they discovered that women of lower incomeand education were more receptive to the medical advice and less likely tochallenge health professionals, whereas women from higher soci-demographicbackground were less likely to be influenced by medical discourse (Markovic354). Also, they advocated and emphasized the subjectivity of their experiencemore than their counterparts from lower income (Markovic 354). Minorities werealso more skeptical to newer medical advice. For example, many providersprescribe contraceptives as treatment of abdominal pain caused endometriosis.However a survey done by the California’s Women Health showed that blacks andforeign-born Asian women preferred the traditional birth controls to theintra-uterine device compared to white women (Shih 173).
Similar to AIDS that wasnot always known as what is it today, endometriosis wasn’t always known asendometriosis. In the early 1990s, many doctors nicknamed endometriosis as “thecareer woman’s disease”, including in medical textbooks (Carpan 32). Because womenwith endometriosis are generally childless, working women with type Apersonalities the disease has been stigmatized as such (Darrow et al. 503). Itis believed that only career workingwomen develop endometriosis because if awomen delays pregnancy because of her career, her chances of becoming pregnantdecreases and her risk of getting endometriosis increase (Carpan 35). Thissuggests that even in the early 1990s many people believed that women weremeant to only be mothers and wives. It was also believed that becauseworkingwomen have more periods in their lives than pregnant women/mothers,endometriosis is the result of build up menstrual tissue.
The connotation whenpertaining to endometriosis is that it is disease in which it is the fault ofthe victim; well at least based off of the assumption that only workingwomen coulddevelop it. Relating this to our text, earlier in the semester we discussed thebelief that individuals are responsible for their health (Weitz). Granted weplay a critical role in their health, however there are externally, in the caseof endometriosis, internally, factors that contribute to poor health and weshould avoid victim blaming.After being diagnosed withendometriosis, women have two options as far a treatment: medical or surgical.It also depends on the progression of their condition (Markovic351). However evenwith all the available treatment, endometriosis can relapse in womenpost-menopausal women who received estrogen therapy as treatment (Kitawaki etal.
149). Recurrence is relatively common the first 12 months after the laparoscopicprocedure (Markovic et al. 354). Even after surgery, many patients with thedisease receive hormonal medication as treatment. This is because the hormonesin the birth control will cause the patient to not get their period (Carpan34). These missed periods results in the lining of the uterus from shedding andprevents endometriosis from getting worse (Carpan 34). However as we know,there are any ethical issues relating to birth control, well women’sreproductive health in general. These issues are the result of both people’s politicalview and religion.
The use of birth control as treatment for endometriosis alsoshows the public that there are many advantages to contraceptives other thanpregnancy prevention. It shows that now with the new GOP tax plan that defundsorganizations like Planned Parenthood should be protected because sometimesthese are the only place women with endometriosis can go to get affordablecontraceptive. As previously mentioned,endometriosis is relatively new, in terms of research, but an extremely underresearched and funded disease. In 2016, endometriosis a disease what affectsone in ten reproductive women received $11 million for research (Gusovsky).Whereas, testicular cancer a very rare cancer cost the United States $48 million(NCBI).
This leads to speculation ifthere is any bias in our healthcare when it covers to funding healthcare issuesmen and women experience. Why is a disease that affects so many women be sounder developed?With all of this beingsaid, it leads to the notion that women need to start taking control of theirhealth care and become more involved in bills and legislations that affecttheir reproductive rights. Women have to be the sole advocate of their disease,a role that usually of their nurse.
So now not only are they responsible forcontrolling and treating their conditions when they leave the doctor’s office,while the patient is with the doctor they are put in the position to adequatelyand professional describe their symptoms. All of this can be very frustration for someone who has minimalknowledge of medicine. Allin all many strides have been taken to understand the mechanisms ofendometriosis. Yes endometriosis is a complex disease but the complexity it hason individual suffering with it is far worse. The pain has been so bad thatsome women find themselves missing days at work due to the disease.
Unfortunately for finances of some women with the disease, they cannot affordto miss any days. Speaking of work, the disease also has a negative connotation,which makes individuals with endometriosis feel selfish and responsible forcondition. Educating the public on endometriosis could result in individualsseeking treatment earlier. In addition to educating the public, medical professionalsshould also be up-to-date on research pertaining to endometriosis. Not only canwomen with endometriosis not adequately express the problems they’reexperiencing, physicians are not educated on the disease. This could result in a better doctor-patientrelationship and ultimately treatment before the disease progresses.
Relatingthis back to treatment, the technology advances and use of contraceptive suchas the intra-uterine device has helped many women manage the pain associatedwith endometriosis. This illuminates the multiple benefits of birth control. Issuespertaining the biological, environmental, and ethical relationships whendiagnosing endometriosis should be further researched to adequately understandthe disease but as of now there should continue to educate and fund researchpertain endometriosis in order to get a cure.