Dr. Griffith is doing women all over the world a service with the opening of this new Center. She is pairing up with scholars and clinicians at MIT, Vanderbilt, Harvard, Cornell and Tufts. I'm very excited by the fact that people who do basic science will be working with clinicians on a disease whose research has not advanced that much in recent years. We have a few hypotheses about why women get endometriosis -- some genetic causes, inflammatory variables, and flowback of copious menstruation -- but so far little of this research has yielded results that help prevent endometriosis, or help treat it. This Center is an important step forward.
We anthropologists and evolutionary medicine folks happen to like evidence from the angle of global and ecological variation in a condition in order to set a baseline and understand pathology better. So here are some additional questions that I think we should be asking about endometriosis:
- What is the global range of variation in the presence of endometriosis in different populations? I'm not talking just about the debilitating symptoms, but the presence of endometrial tissue outside the uterus. And what is the range of variation for amount of endometrial tissue outside the uterus?
- What ecological/lifestyle factors are most commonly associated with endometriosis? I'm thinking not just energetic stress, but immunological stress, psychosocial stress, diet composition, etc.
- Are there less invasive ways to test for endometriosis (i.e., ultrasound) that will allow us to examine this disease in non-western or non-industrialized environments?
- How do daily ovarian hormone concentrations vary with endometriosis incidence?
- When and under what conditions does endometriosis co-occur with other gynepathologies, such as polycystic ovarian syndrome?