Endometriosis: what is it and what is it impact?
ENDOMETRIOSIS EXPLAINED
Endometriosis is a chronic, progressive, and inflammatory disease, it is caused when the lining of the womb, known as endometrial tissue, is found in other areas within the body but outside of the uterus. The disease affects between 10-12% of women (and people assigned women at birth) worldwide. Some people with endometriosis experience no symptoms, but many experience symptoms that have a heavy impact on their lives - with physical, economic, and mental health symptoms being the most prominent. However, despite being a common and debilitating disease, the most frequently used diagnosis process is far from simple and effective. This blog will explore the delayed diagnosis process alongside its implications, the symptoms associated with endometriosis and how these are managed, and the substantial impact that endometriosis has upon financial burden and social equality.
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DIAGNOSIS PROCESS
The diagnosis process for endometriosis is often delayed for many years which can result in the endometriosis growing and spreading, causing an increase in symptoms and making it more difficult to manage.
This delay is primarily due to the most common method of diagnosis being an invasive laparoscopy procedure. Some research has shown that a combination of low invasive and holistic tests (including patient interviews, diagnostic imaging such as ultrasound etc.) could reduce the wait time and prevent the endometriosis from progressing.
Yet, other research has suggested that these low-invasive tests are ineffective for identifying some types of endometriosis.Therefore, more research is needed to find the most suitable diagnosis process to prevent endometriosis from growing and causing more physical and psychological problems for the patients.
Furthermore, some studies propose that menstrual stigma and the belittlement of women’s pain considerably contribute to diagnosis delay, highlighting the need for both social change and medical research.
THE SYMPTOMS & LIVING WITH ENDOMETRIOSIS
The diagnosis process for endometriosis is not only a lengthy wait, but a painful wait too. The physical symptoms of endometriosis can include, but are not limited to: menstrual pain, back pain, chronic pelvic pain, pain during and after sex, discomfort during urination and bowel movements, irregular bleeding, and infertility. As well as the direct symptoms, those suffering with endometriosis have higher rates of comorbid conditions than those without endometriosis. For example, studies provide evidence that there is a positive correlation between having endometriosis and ovarian cancer.
The psychological toll of the disease adds an additional burden. Anxiety and depression are common for those with endometriosis, which is likely due to the severe pain and reduced quality of life.
The most common management strategies are pain relief and birth control methods, which are often unsuitable and do not address struggles with infertility and comorbid cancers.
Recently, a new drug has been approved for endometriosis pain management. This oral pill combines relugolix, estradiol, and norethisterone and works by decreasing progesterone and estrogen, replacing them with the hormones needed to maintain stable function, reduce pain and prevent the progression of endometriosis. However, as this is a new treatment, and there is no data currently available on the long term effects. While this is not a cure, it represents a positive step forward in research for effective management strategies for endometriosis.
SOCIO-ECONOMIC IMPACT
So far, we’ve discussed the impact of endometriosis on the individual; however, it also has significant wider socio-economic consequences.
In countries that offer free healthcare, the long delay in diagnosis imposes a significant cost on the healthcare services. On the other hand, in countries without free healthcare, women are forced to burden the financial costs of a delayed diagnosis. Additionally, research indicates that women with endometriosis often experience less salary growth, are more likely to earn lower wages, and face a higher risk of leaving the workforce. These are particularly detrimental to gender equality. For those employed, they may also face reduced productivity or need to take sick leave, further hindering gender equity and the economy.
Endometriosis has a profound impact on various aspects of life, including education, career choices and opportunities, relationships, and starting a family. Delays in diagnosis and treatment only exacerbate the impact on the individual’s life course. Addressing these challenges is crucial for improving gender equality.
CONCLUSION
In conclusion, endometriosis affects 10% of women and has a significant negative impact on both individuals and wider society, yet it is still not taken seriously enough in the medical field. We advocate for more research to develop an all-encompassing and more efficient diagnosis process, facilitate suitable symptom and progression management, and ultimately, a cure. The new pain-management pill is promising, but progress needs to continue. In addition to research, workplaces can provide a more accessible environment for those suffering with endometriosis to ensure that the condition is not detrimental for gender equality or the economy.
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