Endometriosis in the African American woman—racially, a different entity?

Abstract

Endometriosis has been identified in up to 10% of women in some reports; however, few studies have evaluated African American women. The purpose of this study was to localize the implantation sites of endometriosis in urban Detroit female patients. This study was a retrospective chart analysis of patients with laparoscopes for endometriosis at St. John Detroit Riverview Hospital in Detroit, Michigan. All women had concomitant disease involving the uterus and multiple genital structures. In total, 93% had uterine implants, 62% had ovarian implants, 51% had posterior cul-de-sac disease, and 44% had fallopian tube involvement. Forty-five percent had abdominal wall spread, 8% with large bowel implants, and 13% with small bowel involvement. Fifty percent had uterosacral implants, 2% had bladder involvement, 2% had perihepatic involvement, and 4% had omental implants. African American women appear to have a predilection for uterine implants of endometriosis, which may be due to genetic, environmental, or previously presented theories. Further study of urban African American females is necessary to investigate the departure from typical sites of endometriotic implant localization.

Medical conditions, pregnancy perspectives and contraceptive decision-making among young people: an exploratory, qualitative analysis

“…Furthermore, some clinicians may neglect discussing fertility with their patients [37], not take conditions seriously [35], and dismiss patients' complaints about pain, often leading to delayed diagnosis [38][39][40]. This is especially important for Black women, who experience the highest rates of infertility [41], who may have differential rates and experiences of medical conditions that can affect fertility [6,[42][43][44], and for whom the U.S.'s history of reproductive oppression, including forced sterilization, may make less likely to interact with and/or be distrustful of the medical system [45][46][47][48].…”

Can Intersectionality Help Lead to More Accurate Diagnosis?

“…Is she feeling skeptical of Carla's description of her symptoms? Is she considering other possibilities beyond pelvic inflammatory disorder, which is a common misdiagnosis for African American women with endometriosis (Shade et al 2012)? By recognizing the potential biases that the medical field may project onto each of Carla's identities and the additive nature of these biases, Carla's physician may preemptively consider the possibility that she is dismissing Carla's symptoms due to Carla's identity as a woman and/or as a person of color.…”

“…By recognizing the potential biases that the medical field may project onto each of Carla's identities and the additive nature of these biases, Carla's physician may preemptively consider the possibility that she is dismissing Carla's symptoms due to Carla's identity as a woman and/or as a person of color. Finally, the physician again may use an intersectional lens to consider how differences in presentation of endometriosis between African American and Caucasian women may impact Carla's diagnosis (Shade et al 2012).…”

Systematic Review of Prevalence of Endometriosis among Indigenous Africans

“…In the United States of America (USA), Shade et al 2012 [13], in his literature review on the endometriosis, he found only 2 papers dedicated to the African American and the endometriosis; both papers were write by Chatman in 1975& 1976. Chatman 1976, in the African American women who underwent diagnostic laparoscopy, he found an incidence of endometriosis to be 22.7%.…”

“…Paradoxically, in African American and Indigenous African the clinical presentation and anatomical location of endometriosis is marked by a more predilection for endometriosis attachment to the uterus and atypical endometriosis than in any other races, without a rationale explanation [10] [13]. Cervical endometriosis and endometrial related-ascites appears to be a more common manifestation of endometriosis in African women than in the Caucasian women [10] [16] [17].…”