As medical professionals, endometriosis is more than just a women’s health issue, we need to rethink much of our heritage.

Endometriosis is not just a women’s health problem. It highlights aspects of gender inequality, the need for scientific rigor in our thinking, and how we, as physicians, operate within all religious, political and historical frameworks. I encourage you to think about

I would like to explain some of the reasons behind medical blindness in relation to women’s health issues in general and endometriosis in particular.

In my work with various expert advisory groups, I was struck by the lack of research in primary care, where endometriosis is often seen and often overlooked.

The persistent lack of funding for primary care research has had an impact on this, so governments should support primary care research and national reviews and follow through on the recommendations made. is needed.

Endometriosis is a condition in which endometrial tissue resides in a physiologically inappropriate location, outside the uterus. It affects 1 in 9 women of reproductive age and up to 30% of these women are associated with primary or secondary infertility. It can present with a variety of symptoms, not all of which are related to the menstrual cycle, making it difficult to diagnose and on average she can be delayed by 7 to 12 years.

For affected individuals, this can mean years of missing school or college, reduced ability to work, painful sex with impact on intimacy, relationships, fertility, and other non-uterine disorders. It leads to multi-organ disease involving organs, and psychological toll. Health, to name a few.

As women make up more than 50% of the country’s adult population, this places a heavy burden on the health care system and has a significant impact on the country’s productivity levels. This is one of the main reasons for mobilizing governments to develop a National Endometriosis Action Plan. (2018).

The plan sets goals and objectives to address the impact of low levels of community awareness and delayed diagnosis on people living with this chronic disease. Major projects emanating from the National Endometriosis Plan include the review of endometriosis guidelines, the creation of an Endometriosis Risk Assessment Tool (RATE) and an endometriosis online learning module for health professionals. will be These are government funded and developed projects. It is jointly sponsored by the Royal Australian and New Zealand Society of Obstetrics and Gynecology (RANZCOG) and The Jean Hales Foundation. These and other online resources can be accessed from RANZCOG and Jean Hailes on his website.

Recommendations made following national review of Australian Endometriosis Guidelines (2021), to be implemented over the next five years, and as a member of the National Endometriosis Expert Advisory Group that oversees this process, nationally, ultimately working towards women and nonbinary provision. It is reassuring to know that people with this chronic disease have the opportunity for earlier diagnosis and intervention.

One wonders how a condition that has been documented since ancient times and is so common has been ignored by the health system for generations. Or the tendency of health care professionals not to ask about the normalization of menstrual cramps and heavy menstrual bleeding was explained.

Statements such as “You can expect some pain during your period,” “The pain will go away when your body’s mechanisms mature,” and “You’ll get better if you get pregnant,” are gender-neutral statements that lack empathy and delay. There are nuances. Further research and investigations were done, but it was commonly reported by all cultural groups.

In this podcast, I explain the theory behind the long-standing neglect of endometriosis and women’s health issues. suggesting that it can be traced back to and religion. The basic principles underpinning these frameworks have been perpetuated by government systems that have digested these ideologies without scrutiny.

Since ancient Greece, Aristotle has been considered the first true biologist. Despite his generosity and kindness to his wife and family, he made the fundamental mistake of focusing on a woman’s biological ability to sustain pregnancy and lactation. Due to his ability to think rationally, he was not considered equal to men.

As one of the progenitors of our scientific foundation, these doctrines have been built over generations. And the structure of thinking about science has changed very little. To this day, women and children are classified in many cultures as the property of their male partners, and doctors believe that as part of the general population, menstrual cramps in women are as natural and taken for granted as labor cramps. It has been cultured to think that there is. .

Until recently, only religion could challenge scientific principles, as we learned from Galileo’s confrontation with the Roman Catholic Church.

Recent Law vs Wade A dismissal by the United States Supreme Court is another recent case of religious interference in science and politics. An investigation of the role played by women in the Judeo-Christian-Abrahamic religions reveals a dichotomy between Eve, the temptress and the Virgin Mary, leading to the dichotomy of the Madonna and the whore, the patriarchy of entitlement and these Both women and men are deeply cultured, and many think this way, even if they don’t subscribe to any religion.

Given that science and religion have always been dominated by men who do not have female body parts and do not menstruate or give birth, it is irrelevant to suggest that the foundations of science and religion have been rooted in ignorance. Not reasonable. about women’s issues. The trajectory of women’s health concerns has been further misguided by young and old referring to these conditions and processes as ‘private women’s businesses’. It is an inherited cultural attitude that continues to hold significant and far-reaching significance for women today.

Questions about menstrual patterns, for example, are important to clinicians when relating this commentary to endometriosis. However, ignorance and shame about menstruation permeates both our scientific and religious foundations, and has been passed down from generation to generation without any re-examination of these beliefs.

In most cultures, menarche is not celebrated and may even be categorized as a taboo topic. . This means that the girl is taken out of school and constitutes justification for childhood marriage.

A focus group for the National Endometriosis Plan reported that even physicians avoided asking details about menstrual patterns, or that when details were provided by patients, they were dismissed as part of the normal spectrum. did.

The set of medical principles we have acquired over the years were created by our scientific ancestors and influence our daily practice. More recently, we have begun to question these paradigms and reexamine common ailments such as ischemic heart disease through a gender lens. and has been influenced by traditional beliefs. But given the broader repercussions if these beliefs and shortcomings are not addressed, the damage to women and society is immense (here, here, here).

The National Endometriosis Action Plan was a landmark achievement for many reasons, and the implementation of the recommendations over the next five years by the National Endometriosis Expert Advisory Group was the long It represents an ongoing effort to undo the intergenerational harm created by flaws. Will be on time.

The arguments for the government’s commitment to ongoing community health awareness campaigns, professional education and training, community support, and funding for multidisciplinary endometriosis management are self-evident, and health professionals As such, endometriosis represents more than just a women’s health problem. We need to rethink a lot of what has been passed down to us.

Magdalena Simonis Clinical Associate Professor Emeritus is a General Practitioner and a member of the Australian Department of Health’s National Endometriosis Expert Advisory Group. She is a member of the Steering Committee for Endometriosis Online Learning, co-leader of the Royal Australian College of General Practitioners’ (RACGP) Red Book women’s health Chapter, and a member of the RACGPs Expert Committee on Quality Care.

Statements and opinions expressed in this article reflect the views of the author and do not necessarily represent official AMA policy. MJAMore Also Insight+ unless otherwise stated.

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