The recorded history of endometriosis is nearly as old as written documentation itself. Description of endometriosis dates back as far as ancient Egypt where around 1500 BC the Ebers Papyrus detailed painful menstruation disorder, along with over 700 other medical conditions and their treatments in its 110 pages. Multiple cultures had historically detailed symptoms of what we now assume was endometriosis.
However it wasn't until nearly three thousand years later, in 1860, that an official list of symptoms, identifying features, and descriptions aggregating much of the information about endometriosis was published by Carl von Rokitansky, a German pathological physician who specialized in autopsy. It would be another 60 years before John A. Sampson published his paper “Perforating Hemorrhagic (Chocolate) Cysts of the Ovary” in 1921 in which the most detailed and comprehensive breakdown of what would, seven years later, be coined by the same author as endometriosis. This study was the jumping off point for many of the most prevalent theories for how endometriosis functions and develops including the prevalent implantation and retrograde menstruation theory.
After becoming firmly established in the medical community as a pathology, higher quality research around endometriosis began to take off in the 1940s. In the subsequent decades there was heavy experimentation with testosterone and estrogen as treatments for endometriosis. However due to these hormones' extreme and far reaching side effects on the human body, use of these treatments were limited. The late 50s and 60s brought about the usage of another sex hormone, in the form of progesterone, which unfortunately had a large amount of similar side effects to that of testosterone and estrogen therapies.
The world of endometriosis treatment was changed forever in the early and mid 1980s with the large-scale production of GnRH (gonadotropin-releasing hormone), which allowed for treatments with fewer and less severe side effects than previous treatment methods, while showing promising alleviation of endometriosis symptoms. To this day, GnRH agonists and antagonists are commonly prescribed for endometriosis. Along with GnRH based treatments, progestin-based contraceptives such as IUDs, injections, and pills can now be used to alter the menstrual cycle and manage endometriosis symptoms. The utilization of hysterectomies (the removal of the uterus) and oophorectomies (the removal of the ovaries) was and is consistently used throughout history with inconsistent documentation on when the procedures were used as a treatment for endometriosis. However, the modern usage of these procedures is being phased out as a treatment for endometriosis due to the large list of side effects, including guaranteeing infertility in patients suffering from this disease. The future of endometriosis research is the pursuit of reducing side effects from current common treatments as well as the development of fertility-preserving and non-hormonal treatment methods.
Works Cited:
Acién, P., & Velasco, I. (2013). Endometriosis: A Disease That Remains Enigmatic. ISRN Obstetrics and Gynecology, 2013, 1–12. https://doi.org/10.1155/2013/242149
Barbieri, R. L. (1992). Hormone treatment of endometriosis: The estrogenthreshold hypothesis. American Journal of Obstetrics and Gynecology, 166(2), 740–745. https://doi.org/10.1016/0002-9378(92)91706-g
Garner, C. (1994). Uses of GnRH Agonists. Journal of Obstetric, Gynecologic & Neonatal Nursing, 23(7), 563–570. https://doi.org/10.1111/j.1552-6909.1994.tb01922.x
Magner, L. N. (2011). A history of medicine. Informa Healthcare.
Mayo Foundation for Medical Education and Research. (2019, October 16). Endometriosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661.
Sampson, J. A. (1921). Perforating hemorrhagic (chocolate) cysts of the ovary. American Journal of Obstetrics and Gynecology, 2(5), 526–533. https://doi.org/10.1016/s0002-9378(21)90294-1
Schriock, E. D. (1989). GnRH Agonists. Clinical Obstetrics and Gynecology, 32(3), 550–563. https://doi.org/10.1097/00003081-198909000-00019
Comments