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Endometriosis: the hereditary factor ii ENDOMETRIOSIS: THE HEREDITARY FACTOR II
We have to refer to the original supposition that only white middle-class women contract endometriosis to understand why some doctors have misunderstood racial distribution of this disease. Medical textbooks told them SO. References to endometriosis tended to profile the "typical" patient, and. in nearly every case, she was the slightly privileged white woman. Endometriosis, then, had its own built-in bias, and in the minds of some doctors, it was as much a part of the diagnosis as any other telling symptom. This commitment to an outdated medical bias excluded black. Asian, Middle Eastern, and even Jewish women, among other ethnic groups. Doctors who treated such women dismissed the diagnosis of endometriosis—no matter how obvious a case it was and assigned the condition another name. What were the fates of these patients?
Kayla fits this indicator perfectly. A former dancer, Kayla is a native Californian of Japanese and Korean extraction, now teaching in New York and a patient of mine. She performed for ten years with a touring dance company, and many times she went on stage suffering from extreme pelvic pain. ‘The doctor said I had pelvic inflammatory disease, and that I'd probably gotten it from sexual contact with my boyfriend," she told me. "I took antibiotics again and again, but they helped only for a short time. When I quit the troupe to start teaching. I tried a different doctor. She said I had endometriosis, and she put me on hormone pills."
Being told that she had endometriosis was an unexpected revelation for Kayla. For nearly fifteen years, she was automatically diagnosed as having a sexually transmitted disease, and she believed it as fervently as she believed in the legitimacy of the medical system. Now she is questioning the diagnosis of endometriosis, even though she can measure the improvement in her health. What has happened is that Kayla's sense of self-esteem has suffered because her friends have told her that Asian women do not gel endometriosis! She wants to know for certain what is wrong with her.
Kayla's dilemma has been common among other Asian women and more so among black women, many of whom have faced stereotyping in medical care. Kayla has endometriosis, not pelvic inflammatory disease. The difference between the two needs to be clarified. In endometriosis, pelvic organs can appear inflamed due to a reaction to the prostaglandins released by endometrial tissue. Endometriosis is not caused by or related to bacterial or viral infection', therefore, antibiotics will not help Pelvic inflammatory disease (PID), in contrast, is caused by bacterial infection, which will inflame pelvic organs. If antibiotics are not given to control the disease, it can lead to progressively severe symptoms of pain and progressive damage to pelvic organs.
Doctors in certain areas of this country do not see many cases of endometriosis and they may be confused when confronted with such patients, be they white, black. Off Asian. Others, referring to an older text tor guidance, accept the racial stereotype. But with an enigmatic disease like endometriosis, exceptions and modifying factors cross all facial lines.
If you are a black or Asian who tends toward menstrual cramps, often with increasing severity over time, if you arc active sexually and experience pain during intercourse, and if you are of child bearing age and have never conceived either with forethought or accidentally— you may have endometriosis. If doctors insist you are suffering from recurring viral infections of the bladder, pelvic inflammatory disease, or psychosomatic illness, do not hesitate to get a second or third opinion. Seek out doctors who arc specialists in treating patients with this disease. Endometriosis doesn't discriminate!
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