The Agony of Endometriosis

Middlesex Community College The Agony of Endometriosis Kayley Martinez English Composition 121-10 Professor Class 5 November 2023 Martinez 1 Imagine a world where most of the female identifying journey is free from the silent and painful struggle of endometriosis. Where the excruciating and invisible scars that hide within are not just acknowledged but understood. Endometriosis is a plague that affects older women but has now recently affected the younger generation. Most women stay silent and often get misdiagnosed with this condition. Now, what is Endometriosis? Well according to MerriamWebster, the definition is as follows, “Endometriosis is the presence and growth of endometrial tissue in places other than the uterus that often result in severe pain and infertility”. Endometriosis, a misunderstood gynecological disorder, that causes debilitating pain and reproductive issues not only needs more research but needs awareness and effective treatment. To start off, it is quite difficult to be diagnosed with this certain type of condition. According to World Health Organization (WHO), “Endometriosis affects roughly 10% of reproductive aged women and girls globally”. Some women however get misdiagnosed by their gynecologist since Endometriosis is very similar to Polycystic Ovary Syndrome (PCOS). The history of Endometriosis is very vague as well. Karl Freiherr von Rokitansky, an Austrian physician and pathologist discovered Endometriosis back in 1860. He studied and conducted research on at least 30,000 autopsies which most people opposed to at the time which made him one of the first to detect the condition which later helped future physicians identify endometriosis. The way to get “properly” diagnosed is through tests and screening tools such as ultrasounds and magnetic resonance imaging (MRI). According to WHO, “Although several screening tools and tests have been proposed and tested, none are currently validated to accurately identify or predict individuals or populations that are most likely to have the disease.” Another issue that makes diagnosing this condition difficult is that Endometriosis can mimic and present as other conditions. Martinez 2 In addition to this, another issue that Endometriosis provides to its victims is depression and many other symptoms. The main and common symptom that is shown is pelvic pain. Usually, the pelvic pain is linked during the menstrual cycle. Even though most women get cramps, those who suffer with this condition state that the cramps are 10x worse than the average cramp which could potentially get worse. Infertility is another common symptom as well. Luckily (for some), they don’t experience symptoms at all. For those who don’t experience symptoms, they usually find out either through infertility or surgery. A dangerous symptom that these victims could face as well is excessive bleeding. Sometimes women get heavy periods, but people who do have endometriosis bleed more which could send these women to the hospital due to loss of blood. These symptoms can be life threatening and they occur more before the natural menstrual cycle. According to Mayo Clinic, “For those with symptoms, endometriosis sometimes may seem like other conditions that can cause pelvic pain. These include pelvic inflammatory disease or ovarian cysts.” Women also gain body dysmorphia due to the constant weight gain which some if not all women get due to this condition. Every woman is different when it comes to symptoms, but it is alarming and most definitely eye-opening. To follow along, Endometriosis is again a difficult process to diagnose. Most females get the condition at an early age which makes the process difficult. Since endometriosis can mimic other conditions, it usually gets misdiagnosed with PCOS. Now, what is PCOS? PCOS (Polycystic Ovary Syndrome) is a condition where the ovaries produce too much of androgens (male sex hormone). The symptoms are very identical to Endo, but they are very much different. Treatment for this condition is also hard to obtain as well. Some factors that play into it is the severity of the condition, age, symptom severity and often plans of future pregnancies. Most OBGYNS would recommend medication such as Danazol which lowers estrogen levels so that Martinez 1 the symptoms are more bearable. If that doesn’t work, then the next step would obviously be surgery. The two surgeries that would be recommended are Laparoscopy or a Hysterectomy. Laparoscopy is a surgery that removes damaged or diseased tissues. A Hysterectomy is a surgery to remove the uterus which in of itself is a lot more mentally challenging. Most women dream of becoming a parent and with this issue, they suffer depression since their chances of becoming a parent drop to none. Sadly, these medications and surgeries are not a cure for the disease. The condition could still be present since most of the cysts happen outside of the uterus (i.e., anus, heart, kidneys, etc.). According to Dr. Rosanne Kho, an obstetrician-gynecologist affiliated with Cleveland Clinic states, “We need to be very aware. As physicians who treat patients with endometriosis, we must be aware of the possibility of residual or recurrent endometriosis, if not ovarian remanent tissue or the presence of ovarian tissue that can then stimulate the endometriotic cells.” Most doctors are not aware of endo which is by far upsetting to say the least. Endometriosis also has stages. Each stage is different and there are at least 4 stages. These stages are divided and would give at least a standpoint as to where these tissues have spread. Stage I is minimal spotting, Stage II is semi-moderate spotting, Stage III is moderate spotting, and the last stage would be severe spotting. These come with “points” that helps the OBGYN to at least see which stage the potential carrier is on. Since this is still an ongoing study, not a lot of research has been done to accurately pin-point where someone would be placed on since the stages could change over time. Endometriosis could also be a genetic issue, but at this current moment it is still unknown. According to Women’s Reproductive Health (WRH), “Twin studies have shown increased concordance for endometriosis in monozygotic (identical) twins compared to dizygotic (fraternal) twins with heritability estimated at 52%. Although Martinez 2 endometriosis often clusters in families, it is not a single-gene (monogenic) disease that is caused solely by inheriting a rare genetic variant from parents. Instead, endometriosis is a common complex condition that is caused by a combination of multiple genetic and environmental factors.” Sadly enough, Endometriosis is also tied with ovarian cancer if not treated on time, but the risk of gaining that type of cancer is very slim. Thus, this epidemic of endometriosis needs to be researched more. Women’s voices need to be heard especially when it comes to their reproductive rights. The cases that have been documented are gut-wrenching and certainly eye-opening. It’s absolutely mind boggling, how most doctors misdiagnose or better yet just brush off endometriosis as some weight issue. To this day, there are young women who are facing this issue, yet they get denied by their OBGYN’s. Some women are absolutely scared to even bring up this issue without facing backlash from men that don’t know anything about reproductive issues. Certainly, there are medications and surgeries that women can take, but those options really don’t work. These doctors need to find a cure since this could potentially affect human civilization. Also, most clinics are doing studies at this current moment! Even though this is just a women-based issue, signing petitions or just helping loved ones go through this process could help. These women should not feel alone and should not be shamed for going through something as painful as this condition is. Despite its well-known prevalence within millions of daily lives…it is still one of the most poorly understood condition. There is still hope that one day, there will be a cure for this horrible condition, so that young women and children do not have to deal with this type of pain again. Th quality of life and having support systems will just over-all boost the confidence of women in general. As someone passes by just remember that person could be going through this exact pain Martinez 1 and suffering without help or support. So as stated in the intro, just imagine a world where this type of condition doesn’t silent women. Martinez 2 WORK CITED: “Definition of ENDOMETRIOSIS.” Www.merriam-Webster.com, 31 Oct. 2023, www.merriam-webster.com/dictionary/endometriosis#:~:text=Medical%20Definition-. Accessed 6 Nov. 2023. “Endometriosis - Symptoms and Causes.” Mayo Clinic, 2018, www.mayoclinic.org/diseasesconditions/endometriosis/symptomscauses/syc20354656#:~:text= Other%20symptoms%20include%20cramps%20that.Cleveland Clinic. “Endometriosis after Hysterectomy - Dr. Rosanne Kho.” Endometriosis : Causes Symptoms - Diagnosis - and Treatment, 29 Oct. 2020, www.endofound.org/endometriosis-afterhysterectomy-dr.-rosanne-kho. Accessed 6 Nov. 2023 “Endometriosis: Symptoms, Causes, Treatment & Tests.” Cleveland Clinic, 27 July 2022, my.clevelandclinic.org/health/diseases/10857-endometriosis. “What Is Endometriosis? — Nuffield Department of Women’s & Reproductive Health.” Www.wrh.ox.ac.uk, www.wrh.ox.ac.uk/research/endometriosis-care-what-is-endo. World Health Organization. “Endometriosis.” Www.who.int, World Health Organization, 24 Mar. 2023, www.who.int/news-room/fact-sheets/detail/endometriosis.