Thursday, 24 December 2009

The Puerto Rican Connection

There have been several studies that have examined the way in which endometriosis effects the lives of women throughout a few different countries. However, most of these studies have come from Western nations, mainly the UK and the USA. Data on the incidence and symptoms of endometriosis throughout the rest of the world is fairly scarce and it would be presumptuous to assume that endometriosis affects people in the same way all over the world. So it is excellent news to find a recent study published by the Ponce school of medicine in Puerto Rico. Just in case you were wondering Puerto Rico is an island nation (although technically an archipelago) just to the East of the Dominican Republic and North of Venezuela. What is very interesting is that this is one of the few studies I have come across that deals with endometriosis in a predominately Hispanic population.

It is of great importance to collect as much data as possible on endometriosis from as many countries as possible. There are several reasons why this is so important, for example it lets politicians and world leaders recognise that this disease exists everywhere and is not the sole burden of a select few countries. Also imagine if it was found that women in a certain population or country were found to have a very low incidence of endometriosis. a finding such as this may finally tell us why some women are more susceptible to the disease than others and may even provide clues on how to prevent the disease.

But I digress, back to the Puerto Rican study. I’ll give you a brief overview of what the study found and highlight points of interest. This study surveyed 108 women with endometriosis and these were the main findings.

40% of the women reported a family history of endometriosis. This is interesting as it is much larger than other countries. For example in Brazil it was reported as 8.9%, Japan 8.8% and the United States 8.1%.

The menstrual characteristics of the women surveyed seemed fairly normal, starting their periods at around 11 ½ years old and with an average cycle length of 28.5 days, 5.5 days of menstruation.

The symptoms of endometriosis in these women seem to echo those found around the world. The majority of women experienced dysmenorrhoea (94.4%), incapacitating pain (74.3%), Dyspareunia (70.1%) and sub infertility (63.6%).

Other symptoms that coexisted with those mentioned above included: Back and leg pain (75.7%), gastrointestinal upsets (69.2%), dizziness/headaches (60.7%), depression (51.4%), fatigue (44.9%), dyschezia (painful bowel movements, 44.9%), vaginal pain (35.5%) and dysuria (painful urination, 22.4%).

Depressingly the length of time to diagnosis seems no different in Puerto Rico, with the average time to be diagnosed around 8.9 years, which is quite typical, sadly.

Although this is an enlightening study, it is not without its faults. From a surveying point of view not many people took part, and those that did have more severe forms of endometriosis (although it has long been recognised that stage of the disease bares little correlation to the severity of symptoms). Also as with any survey you are relying on people judging things from memory, which if they happened a long time ago, may not be entirely accurate. Despite this we are in desperate need for more studies such as this from countries all over the world and it is also interesting to see that even in countries as far away as the UK and Puerto Rico, women’s experiences of endometriosis remain very similar.

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