Women’s Health: Endometriosis

Even as women's fertility health makes advancements today, endometriosis is still a significant challenge to the American public health system. According to Eisenberg and Chahine (2021), 11% of American women between the ages of 11 and 44 have endometriosis, a condition where tissue similar to the uterus lining grows outside the uterus. This is a significant fertility health issue because, in addition to difficulty in conceiving, women suffer symptoms such as painful menstrual cramps, bleeding between menstrual periods, and digestive problems (Eisenberg & Chahine, 2021). Endometriosis's negative impact on women's fertility and quality of life makes it a significant health threat that relevant stakeholders should commit more resources to address. 

Causes of Endometriosis

Endometriosis is a unique disease because medical experts have not established its exact cause despite years of research. Smolarz et al. (2021) state that experts have listed its potential causes, including retrograde menstruation, as the primary cause. In this case, menstrual blood is displaced into the peritoneal cavity via the oviducts. However, there is no definite evidence to support this claim, given that 80% of women with open fallopian tubes experience retrograde menstruation, and yet only some of them demonstrate the symptoms of endometriosis (Smolarz et al., 2021). The doubts raised on the theory of retrograde menstruation give credence to other theories, such as the local disorder of mechanisms responsible for preventing adhesion. This leads to implantation in the peritoneum, which leads to high cytokine macrophage production, including interleukin and necrosis factor (Smolarz et al., 2021). The combination of these factors lead to painful cramps during menstruation.

There is also the school of thought that endometriosis is caused by immune diseases such as hypothyroidism and rheumatoid arthritis. This claim is based on the assumption that the pathogenesis of endometriosis may be affected by the immune system, including epigenetic and genetic factors. However, Şerifoğlu et al. (2023) argue that there is limited evidence to support this assertion, noting that although endometriosis patients also manifest symptoms of autoimmune diseases, the available data from 20 years' worth of research on the topic is contradictory and not enough to establish a cause-effect relationship. Therefore, it is conclusive that there are verified causes of endometriosis, making it one of the most challenging health conditions to prevent. 

Population Susceptible to Endometriosis

Nevertheless, there are risk factors that make it easier to identify populations that are most susceptible to endometriosis. Eisenberg and Chahine (2021) list early menarche as the most critical risk factor to recognize because women who had their menstrual cycle before the age of eleven had heightened risks of endometriosis. Similarly, infertile women who are heavy smokers, women who drank at least 10 g of alcohol daily, and those with low body mass index were also at risk of the conditions. Unconventional risk factors include menstrual cycles of less than 27 days, a small number of births, and being of the Caucasian race (Eisenberg & Chahine, 2021). Understanding these risk factors makes it easier to identify the population susceptible to endometriosis and initiate the necessary procedures to prevent severe and mortal cases.

Endometriosis Prevention and Treatment

The inability to identify endometriosis causes makes it challenging to formulate and implement prevention measures while treating the condition equally complicated. Experts recommend several strategies to minimize the risk factors, chiefly by embracing proper nutrition. Barnard et al. (2023) recommend reducing dietary fats and increasing dietary fiber to reduce the circulating concentrations of estrogen, hence curbing the risks of endometriosis, which has been identified as an estrogen-dependent disease. Similarly, women are encouraged to eat more plants and less meat while increasing their intake of vitamins D, C, and E to reduce the condition's symptoms  (Barnard et al., 2023). Ultimately, the dietary prevention measures are more applicable to all women populations than pharmacological strategies that would inadvertently lockout women from poor economic backgrounds. 

However, sometimes prevention measures are not enough to stop endometriosis, necessitating alternative treatment plans. Hormonal therapy is standard because endometriosis goes through menstrual cycles. As such, hormonal treatment can stop ovaries from producing hormones such as estrogen, hence minimizing the symptoms of the disease (NICHD, 2020). Pain medications may also work if the symptoms are too much. NICHD (2020) indicates that pain-relieving drugs include nonsteroidal anti-inflammatory drugs and strong over-the-counter painkillers. Lastly, endometriosis patients can opt for surgical treatment, which involves removing the endometriosis patches through surgeries. 

Conclusion

Ultimately, too many women have endometriosis or are at risk of developing the condition for the world to keep silent about it. The social and economic impacts it has on its patients and the strain on public health facilities and resources make a silent pandemic that more people should speak against. Addressing endometriosis at the personal and institutional level will empower all women affected or at risk of it, leading to improved fertility health outcomes.