Behind the times: revisiting endometriosis and race

• Published in: American journal of obstetrics and gynecology Vol. 221; no. 1; pp. 35.e1 - 35.e5
• Main Authors: Bougie, Olga, Healey, Jenna, Singh, Sukhbir S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2019
• Subjects: African Americans; African Continental Ancestry Group; Bias; Confounding Factors, Epidemiologic; endometriosis; Endometriosis - ethnology; Endometriosis - history; Endometriosis - physiopathology; ethnicity; European Continental Ancestry Group; Female; Gynecology - history; history; History, 20th Century; History, 21st Century; Humans; Prevalence; race; Racism; Social Class; endometriosis; history; ethnicity; race
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2019.01.238

Endometriosis is a common gynecologic condition, affecting approximately 10% of reproductive-aged women. It commonly presents with pelvic pain, painful periods, and infertility and can significantly have an impact on one’s quality of life. Early exploration into the pathophysiology of this condition identified race as a risk factor for endometriosis, with the condition predominantly identified in white women. It is still unclear whether there is a biological basis for this conviction or whether it can be explained by methodological and social bias that existed in the literature at that time. Although there is more recent literature exploring the association between endometriosis and race/ethnicity, studies have continued to focus on the prevalence of disease and have not taken into account possible variation in disease presentation among women of different ethnicities. Furthermore, information on diverse populations by race/ethnicity, other than white or black, is quite limited. This paper explores the history of how the association between endometriosis and whiteness was established and whether we still ascribe to a certain stereotype of a typical endometriosis patient today. Furthermore, we discuss the potential implications of such a racial bias on patient care and suggest areas of focus to achieve a personalized and patient focused approach in endometriosis care.