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.
| History | Biology |
| Dusenbery, Maya. Doing harm: The truth about how bad medicine and lazy science leave women dismissed, misdiagnosed, and sick. HarperCollins, 2018. | Koninckx, P.R., Ussia, A., Adamyan, L., Tahlak, M., Keckstein, J. and Martin, D.C., 2021. The epidemiology of endometriosis is poorly known as the pathophysiology and diagnosis are unclear. Best Practice & Research Clinical Obstetrics & Gynaecology, 71, pp.14-26. |
| Jackson, Gabrielle. Pain and Prejudice: How the Medical System Ignores Women—And What We Can Do About It. Greystone Books Ltd, 2021. | Chapron, C., Marcellin, L., Borghese, B. and Santulli, P., 2019. Rethinking mechanisms, diagnosis and management of endometriosis. Nature Reviews Endocrinology, 15(11), pp.666-682. |
| Mantel, Hilary. Giving up the ghost: A memoir. Macmillan, 2003. | Coxon, L., Horne, A.W. and Vincent, K., 2018. Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms. Best Practice & Research Clinical Obstetrics & Gynaecology, 51, pp.53-67. |
| Norman, Abby. Ask me about my uterus: A quest to make doctors believe in women’s pain. Bold Type Books, 2018. | De Ziegler, D., Borghese, B. and Chapron, C., 2010. Endometriosis and infertility: pathophysiology and management. The Lancet, 376(9742), pp.730-738. |
| Acién, Pedro, and Irene Velasco. “Endometriosis: a disease that remains enigmatic.” International Scholarly Research Notices 2013 (2013). | Wang, Y., Nicholes, K. and Shih, I.M., 2020. The origin and pathogenesis of endometriosis. Annual Review of Pathology: Mechanisms of Disease, 15, pp.71-95. |
| Benagiano, Giuseppe, and Ivo Brosens. “The history of endometriosis: identifying the disease.” Human Reproduction 6.7 (1991): 963-968. | Jabr, F.I. and Mani, V., 2014. An unusual cause of abdominal pain in a male patient: Endometriosis. Avicenna Journal of Medicine, 4(4). |
| Benagiano, Giuseppe, Ivo Brosens, and Donatella Lippi. “The history of endometriosis.” Gynecologic and obstetric investigation 78.1 (2014): 1-9. | Nezhat, C., Falik, R., McKinney, S. and King, L.P., 2017. Pathophysiology and management of urinary tract endometriosis. Nature Reviews Urology, 14(6), pp.359-372. |
| Dinsdale, Natalie L., and Bernard J. Crespi. “Endometriosis and polycystic ovary syndrome are diametric disorders.” Evolutionary Applications (2021). | Wei, J.J., William, J. and Bulun, S., 2011. Endometriosis and ovarian cancer: a review of clinical, pathologic, and molecular aspects. International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists, 30(6), p.553. |
| Dinsdale, Natalie, Pablo Nepomnaschy, and Bernard Crespi. “The evolutionary biology of endometriosis.” Evolution, medicine, and public health 9.1 (2021): 174-191. | Nisenblat, V., Bossuyt, P.M., Farquhar, C., Johnson, N. and Hull, M.L., 2016. Imaging modalities for the non‐invasive diagnosis of endometriosis. Cochrane Database of Systematic Reviews, (2). |
| Hoffmann, Diane E., and Anita J. Tarzian. “The girl who cried pain: a bias against women in the treatment of pain.” Journal of Law, Medicine & Ethics 29.1 (2001): 13-27. | Kruitwagen, R.F., Poels, L.G., Willemsen, W.N., de Ronde, I.J., Jap, P.H. and Rolland, R., 1991. Endometrial epithelial cells in peritoneal fluid during the early follicular phase. Fertility and sterility, 55(2), pp.297-303. |
| Knapp, Vincent J. “How old is endometriosis? Late 17th-and 18th-century European descriptions of the disease.” Fertility and sterility 72.1 (1999): 10-14. | Weimar, C.H., Macklon, N.S., Post Uiterweer, E.D., Brosens, J.J. and Gellersen, B., 2013. The motile and invasive capacity of human endometrial stromal cells: implications for normal and impaired reproductive function. Human reproduction update, 19(5), pp.542-557. |
| Nezhat, Camran, Farr Nezhat, and Ceana Nezhat. “Endometriosis: ancient disease, ancient treatments.” Fertility and sterility 98.6 (2012): S1-S62. | Chui, M.H., Wang, T.L. and Shih, I.M., 2017. Endometriosis: benign, malignant, or something in between?. Oncotarget, 8(45), p.78263. |
| Story, Lisa, and Stephen Kennedy. “Animal studies in endometriosis: a review.” ILAR journal 45.2 (2004): 132-138. | Agarwal, S.K., Chapron, C., Giudice, L.C., Laufer, M.R., Leyland, N., Missmer, S.A., Singh, S.S. and Taylor, H.S., 2019. Clinical diagnosis of endometriosis: a call to action. American journal of obstetrics and gynecology, 220(4), pp.354-e1. |
| Wang, Yeh, Kristen Nicholes, and Ie-Ming Shih. “The origin and pathogenesis of endometriosis.” Annual Review of Pathology: Mechanisms of Disease 15 (2020): 71-95. | Rizk, B., Fischer, A.S., Lotfy, H.A., Turki, R., Zahed, H.A., Malik, R., Holliday, C.P., Glass, A., Fishel, H., Soliman, M.Y. and Herrera, D., 2014. Recurrence of endometriosis after hysterectomy. Facts, views & vision in ObGyn, 6(4), p.219. |
| de Almeida Asencio, F., Ribeiro, H.A., Ribeiro, P.A., Malzoni, M., Adamyan, L., Ussia, A., Gomel, V., Martin, D.C. and Koninckx, P.R., 2019. Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports. Gynecological Surgery, 16(1), pp.1-11. | |
| Shafrir, A.L., Farland, L.V., Shah, D.K., Harris, H.R., Kvaskoff, M., Zondervan, K. and Missmer, S.A., 2018. Risk for and consequences of endometriosis: a critical epidemiologic review. Best practice & research Clinical obstetrics & gynaecology, 51, pp.1-15. |
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