Endometriosis are more capable of managing their pain. In

Endometriosis is a disease in which
endometrial-like tissue grows and implants itself outside of the uterine cavity
(Cotroneo and Lamartiniere 68). It is an estrogen-dependent, pelvic
inflammatory disease in which women experience pain, irregular menstruation,
and could result in infertility and the need of hysterectomies (Burney and
Giduice 511). The prevalence rate for the disease is 6-10% amongst reproductive
women (Giduice 2389).  The prevalence
rate of the disease is also six times higher in those who have relatives with
endometriosis (Burney 281). Also because the symptoms of endometriosis are so
similar to that of the menstrual cycle and some women might not experience any
of the symptoms, the average women with the disease can go up to 8.5 years
before receiving an accurate diagnosis (Wang 281).

The exact etiology of the
disease is unclear. Many researchers have theorized that retrograde
menstruation may play a role (Cotroneo and Lamartiniere 68). During retrograde
menstruation, the endometrial cells escape the uterine cavity through the
fallopian tubes (Cotroneo and Lamartiniere 69). The escaped endometrial cells
creates 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.

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889). The only way to get an adequate diagnosis is through laparoscopic
surgery. However, researchers are actively exploring biochemical markers of the
disease because it is a cheaper and less invasive alternative to laparoscopic
diagnosing. Knowing the trends of endometriosis will benefit medical
professions when considering treatment plans in relations to women’s’ health,
as well as making the diagnostic period shorter. The essence of this paper is
to discuss the disease many women suffer from privately and the reformation
that needs to occur pertaining to women’s health.

The issue I have chosen to
tackle is the benefits the medicalization of endometriosis has played in
women’s health. I have chosen this because of the ignorance many have towards
the disease. Endometriosis affects approximately 176 million women in the
world, yet the disease is so under researched (Endometriosis). As discussed in
chapter 5 of our text, medicalization allows illnesses to become real. Relating
this to endometriosis, because the disease is fairly new, in the terms of
research, the medicalization of endometriosis has provided many women with
relief. Not because they are pleased with the diagnosis of such a complex
disease, but finally someone has diagnosed and helped them understand the
conditions they have been suffering with.

For most women, the path
to discovering their endometriosis and finding the right treatment plan for
them is long, frustrating, painful, but in the end very rewarding. As we
examined earlier in the semester, chronic pain is common among women, poorer
persons, and minorities (Weitz 127). However women are more capable of managing
their pain.  In the article “Endurance
and contest: women’s narratives of endometriosis” the author expressed that
during her study many women complaints found that their complaints of pain were
taken less serious than men (Markovic 351). That alone could be a factor in why
women choose to suffer with the pains of endometriosis in silence. It’s also
hard on providers to prescribe medication when they cannot see what the patient
is going through. Many providers lack the knowledge of the severity
endometriosis and very few of them have seen it and therefore are dismissive of
the disease as imaginary (Wang 281). In addition the recent war on prescription
drugs, has made many professionals are less likely to prescribe pain medicine
to assist with symptoms, especially since they, the doctors, don’t even know
what they’re treating. This leads me to the question, how can a disease so
common be so “rare”? This could be the result of professionals’ lack of
knowledge on endometriosis, their assumption that the pain is in addition with
their regular menstrual conditions, or simply the lack of insurance to cover
their appointment.

In the article
“Endometriosis: cost estimates and methodological perspective” the average
patient hospitalized by endometriosis spends $12,644 out of pocket yearly and
cost the nation $119 billion annually (Simoens et al. 397). The article states does
state 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 initial
laparoscopic surgery, in order to get an official diagnosis, is $4,289 (Simoens
et 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 the
need of additionally surgeries and other the cost, there is a risk every time
one goes under anesthesia. In addition, the patient needs recovery time and
that could put them out of work for a while. Some women experience pain that
results in them having to take days off from work. All of this can and will be
a burden on those of the lower end of the socioeconomic group. Also the
disparities within healthcare do not help the cause either.

Previously mentioned in
chapter 3 of our text, social class explains the many health differences among
ethnic groups (Weitz 54). Going back to Markovic’s article, minority women with
endometriosis experience many barriers such as limited access to
transportations 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 of
insurance, people from lower socio-economic backgrounds are also less likely to
see a provider about pain and less likely to believe that health professional
take their complains seriously (Markovic et al. 350). This results in the delay
of their diagnosis and treatment. This could also result in the diagnosing of
their disease in the tertiary stage where it’ll cost them or their insurance
company a significant amount. Even with the lack of funds, hospitals and
medical center in poorer communities do not always have the funding to provide
state-of-the-art equipment that is needed to serve their patients. So not only
do they deal with the pains of the conditions, they also tussle with the
struggles of everyday life in these lower-income communities.

Weitz describes the
dominance physicians maintain when meeting with their patients in chapter 11 of
our text. Because doctors receive extensive training, they are held to higher
standard and therefore the public place great trust in them (Weitz 267). During
Markovic and her partners’ study, they discovered that women of lower income
and education were more receptive to the medical advice and less likely to
challenge health professionals, whereas women from higher soci-demographic
background were less likely to be influenced by medical discourse (Markovic
354). Also, they advocated and emphasized the subjectivity of their experience
more than their counterparts from lower income (Markovic 354). Minorities were
also more skeptical to newer medical advice. For example, many providers
prescribe contraceptives as treatment of abdominal pain caused endometriosis.

However a survey done by the California’s Women Health showed that blacks and
foreign-born Asian women preferred the traditional birth controls to the
intra-uterine device compared to white women (Shih 173).

Similar to AIDS that was
not always known as what is it today, endometriosis wasn’t always known as
endometriosis. In the early 1990s, many doctors nicknamed endometriosis as “the
career woman’s disease”, including in medical textbooks (Carpan 32). Because women
with endometriosis are generally childless, working women with type A
personalities the disease has been stigmatized as such (Darrow et al. 503). It
is believed that only career workingwomen develop endometriosis because if a
women delays pregnancy because of her career, her chances of becoming pregnant
decreases and her risk of getting endometriosis increase (Carpan 35). This
suggests that even in the early 1990s many people believed that women were
meant to only be mothers and wives. It was also believed that because
workingwomen have more periods in their lives than pregnant women/mothers,
endometriosis is the result of build up menstrual tissue. The connotation when
pertaining to endometriosis is that it is disease in which it is the fault of
the victim; well at least based off of the assumption that only workingwomen could
develop it. Relating this to our text, earlier in the semester we discussed the
belief that individuals are responsible for their health (Weitz). Granted we
play a critical role in their health, however there are externally, in the case
of endometriosis, internally, factors that contribute to poor health and we
should avoid victim blaming.

After being diagnosed with
endometriosis, women have two options as far a treatment: medical or surgical.

It also depends on the progression of their condition (Markovic351). However even
with all the available treatment, endometriosis can relapse in women
post-menopausal women who received estrogen therapy as treatment (Kitawaki et
al. 149). Recurrence is relatively common the first 12 months after the laparoscopic
procedure (Markovic et al. 354). Even after surgery, many patients with the
disease receive hormonal medication as treatment. This is because the hormones
in the birth control will cause the patient to not get their period (Carpan
34). These missed periods results in the lining of the uterus from shedding and
prevents endometriosis from getting worse (Carpan 34). However as we know,
there are any ethical issues relating to birth control, well women’s
reproductive health in general. These issues are the result of both people’s political
view and religion. The use of birth control as treatment for endometriosis also
shows the public that there are many advantages to contraceptives other than
pregnancy prevention. It shows that now with the new GOP tax plan that defunds
organizations like Planned Parenthood should be protected because sometimes
these are the only place women with endometriosis can go to get affordable
contraceptive.

As previously mentioned,
endometriosis is relatively new, in terms of research, but an extremely under
researched and funded disease. In 2016, endometriosis a disease what affects
one 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 if
there is any bias in our healthcare when it covers to funding healthcare issues
men and women experience. Why is a disease that affects so many women be so
under developed?

With all of this being
said, it leads to the notion that women need to start taking control of their
health care and become more involved in bills and legislations that affect
their 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 for
controlling 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 adequately
and professional describe their symptoms. 
All of this can be very frustration for someone who has minimal
knowledge of medicine.

            All
in all many strides have been taken to understand the mechanisms of
endometriosis. Yes endometriosis is a complex disease but the complexity it has
on individual suffering with it is far worse. The pain has been so bad that
some women find themselves missing days at work due to the disease.

Unfortunately for finances of some women with the disease, they cannot afford
to miss any days. Speaking of work, the disease also has a negative connotation,
which makes individuals with endometriosis feel selfish and responsible for
condition. Educating the public on endometriosis could result in individuals
seeking treatment earlier. In addition to educating the public, medical professionals
should also be up-to-date on research pertaining to endometriosis. Not only can
women with endometriosis not adequately express the problems they’re
experiencing, physicians are not educated on the disease.  This could result in a better doctor-patient
relationship and ultimately treatment before the disease progresses. Relating
this back to treatment, the technology advances and use of contraceptive such
as the intra-uterine device has helped many women manage the pain associated
with endometriosis. This illuminates the multiple benefits of birth control. Issues
pertaining the biological, environmental, and ethical relationships when
diagnosing endometriosis should be further researched to adequately understand
the disease but as of now there should continue to educate and fund research
pertain endometriosis in order to get a cure.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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