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Endometriosis Research Study Newsletter  |  Spring 2011

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T       The History of Endometriosis






Endometriosis is a late-comer in medical knowledge about diseases. Since endometriosis is an internal disease, it is not surprising that historically the symptoms were poorly understood. For the most part, doctors did not have any way to look inside the body. Autopsies and anatomic dissections were performed in ancient Egypt, and in southern Italy before the time of Christ. But from 150 C.E. until after the Middle Ages human dissection was prohibited for religious and ethical reasons.


It was not until 1690 that an astute German physician, Daniel Schoen, published Disputatio Inauguralis Medica de Ulceribus Ulceri, in which he clearly described what we now know as endometriosis. In 1774 a Scottish physician wrote, "in its worst stages, this disease affects the well-being of the female patient totally and adversely, her whole spirit is broken, and yet she lives in fear of still more symptoms such as further pain, the loss of consciousness and convulsions."  Indeed, that sounds like endometriosis!


Throughout the 18th century women were often considered to have "hysteria" rather than a gynecologic condition that caused pain. Some physicians tried to counter this notion, arguing that "hysteria is not an idiosyncrasy . . ., it is obviously a major symptom of this deeply rooted disease." As for infertility, that was always blamed on the woman, but not specifically attributed to endometriosis. Recognition by the medical profession of endometriosis as a disease improved after it was clearly described by Dr. Carl von Rokitansky in 1860.  Since 1925 it has been known as "endometriosis," which combines "endometrium" (the lining of the uterus) with "-osis" (meaning abnormal). In this case the endometrial tissue was found in an abnormal place.


Surgical treatment of severe endometriosis started in the early 1900's, when anesthesia had advanced enough that surgery was relatively safe. Hormone therapies were not available until the mid-1900's. Large doses of estrogen were the first hormonal therapy used. The side effects were severe, and the success rates relatively low.


Although now we have many medical and surgical treatments for endometriosis, our knowledge about the disease is still in its infancy. We know what it looks like, but we don't know why it is there. We know that in some women it is inherited, but we are just beginning to know what genes are involved.  As a participant in this research study, you are helping Juneau Biosciences write the next chapter in understanding endometriosis.