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Am J Obstet Gynecol. 2019 Feb 6. pii: S0002-9378(19)30322-9. doi: 10.1016/j.ajog.2019.01.238. [Epub ahead of print]

Behind the Times: Revisiting Endometriosis and Race.

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Queen's University, Department of Obstetrics and Gynaecology. Electronic address:
Queen's University, Department of Obstetrics and Gynaecology; Queen's University, Department of History.
Ottawa Hospital Research Institute; University of Ottawa, Department of Obstetrics and Gynecology.


Endometriosis is a common gynecologic condition, affecting approximately 10% of reproductive aged women1-3. It commonly presents with pelvic pain, painful periods, and infertility and can significantly impact one's quality of life4-6. Early exploration into the pathophysiology of this condition identified race as a risk factor for endometriosis, with the condition predominantly identified in white women7, 8. It is still unclear if there is biological basis for this conviction, or if it can be explained by methodological and social bias that existed in the literature at that time9-11. 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 amongst women of different ethnicities12-14. Furthermore, information on diverse populations by race/ethnicity, other than "white" or "black", is quite limited15, 16. 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.


Endometriosis; ethnicity; history; race


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