Editing Endometriosis (section)

==History==
Endometriosis was first discovered microscopically by [[Carl von Rokitansky|Karl von Rokitansky]] in 1860,<ref name="batt">{{cite book| vauthors = Batt RE |title=A history of endometriosis|year=2011|publisher=Springer|location=London|isbn=978-0-85729-585-9|pages=13–38|doi=10.1007/978-0-85729-585-9}}</ref> although the earliest antecedents may have stemmed from concepts published almost 4,000 years ago.<ref name="nezhat">{{cite journal | vauthors = Nezhat C, Nezhat F, Nezhat C | title = Endometriosis: ancient disease, ancient treatments | journal = Fertility and Sterility | volume = 98 | issue = 6 Suppl | pages = S1-62 | date = December 2012 | pmid = 23084567 | doi = 10.1016/j.fertnstert.2012.08.001 | doi-access = free | title-link = doi }}</ref> The [[Hippocratic Corpus]] outlines symptoms similar to endometriosis, including uterine ulcers, adhesions, and infertility.<ref name=nezhat/> Historically, women with these symptoms were treated with [[leech]]es, [[straitjacket]]s, [[bloodletting]], chemical [[douche]]s, [[Female genital mutilation|genital mutilation]], pregnancy (as a form of treatment), hanging upside down, surgical intervention, and even killing due to suspicion of [[demonic possession]].<ref name=nezhat/> Hippocratic doctors recognized and treated chronic pelvic pain as a true organic disorder 2,500 years ago, but during the Middle Ages, there was a shift into believing that women with pelvic pain were mad, immoral, imagining the pain, or simply misbehaving.<ref name=nezhat/> The symptoms of inexplicable chronic pelvic pain were often attributed to imagined madness, female weakness, promiscuity, or [[hysteria]].<ref name=nezhat/> The historical diagnosis of hysteria, which was thought to be a psychological disease, may have indeed been endometriosis.<ref name=nezhat/> The idea that chronic pelvic pain was related to mental illness influenced modern attitudes regarding individuals with endometriosis, leading to delays in correct diagnosis and indifference to the patients' true pain throughout the 20th and into the 21st century.<ref name=nezhat/>

Hippocratic doctors believed that delaying childbearing could trigger diseases of the uterus, which caused endometriosis-like symptoms. Women with dysmenorrhea were encouraged to marry and have children at a young age.<ref name=nezhat/> The fact that Hippocratics were recommending changes in marriage practices due to an endometriosis-like illness implies that this disease was likely common, with rates higher than the 5-15% prevalence that is often cited today.<ref name=nezhat/> If indeed this disorder was so common historically, this may point away from modern theories that suggest links between endometriosis and dioxins, [[Polychlorinated biphenyl|PCBs]], and chemicals.<ref name=nezhat/>

The early treatment of endometriosis was [[surgery|surgical]] and included [[oophorectomy]] (removal of the ovaries) and hysterectomy (removal of the uterus).<ref name="pmid17857917">{{cite journal | vauthors = Meigs JV | title = Endometriosis—Its Significance | journal = Ann. Surg. | volume = 114 | issue = 5 | pages = 866–74 | date = November 1941 | pmid = 17857917 | pmc = 1385984 | doi = 10.1097/00000658-194111000-00007 }}</ref> In the 1940s, the only available hormonal therapies for endometriosis were high-dose [[testosterone (medication)|testosterone]] and [[high-dose estrogen]] therapy.<ref name=barbieri1992>{{cite journal | vauthors = Barbieri RL | title = Hormonal therapy of endometriosis | journal = Infertility and Reproductive Medicine Clinics of North America | volume = 3 | issue = 1 | pages = 187–200 | date = January 1992 | quote = The hormonal therapy of endometriosis continues to evolve. In the 1940s and 1950s, high-dose testosterone and diethylstilbestrol regimens were the only hormonal agents available in the treatment of endometriosis. These agents, although efficacious, were associated with intolerable side effects. The current armamentarium of hormonal GnRH analogues, danazol, and synthetic progestins is efficacious and has fewer side effects.}}</ref> High-dose estrogen therapy with [[diethylstilbestrol]] for endometriosis was first reported by Karnaky in 1948 and was the main [[medication|pharmacological]] treatment for the condition in the early 1950s.<ref name="Aiman2012">{{cite book | vauthors = Aiman J |title=Infertility: Diagnosis and Management|url=https://books.google.com/books?id=D4_TBwAAQBAJ&pg=PA261|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-1-4613-8265-2|pages=261–}}</ref><ref name="Josimovich2013">{{cite book| vauthors = Josimovich JB |title=Gynecologic Endocrinology|url=https://books.google.com/books?id=9vv2BwAAQBAJ&pg=PA387|date=11 November 2013|publisher=Springer Science & Business Media |isbn=978-1-4613-2157-6|pages=387–}}</ref><ref name="Kistner1995">{{cite book| vauthors = Kistner RW |title=Kistner's Gynecology: Principles and Practice|url=https://books.google.com/books?id=WAdtAAAAMAAJ|year=1995|publisher=Mosby|isbn=978-0-8151-7479-0|page=263}}</ref> [[Pseudopregnancy]] (high-dose estrogen–progestogen therapy) for endometriosis was first described by Kistner in the late 1950s.<ref name="Aiman2012" /><ref name="Josimovich2013" /> Pseudopregnancy, as well as progestogen monotherapy, dominated the treatment of endometriosis in the 1960s and 1970s.<ref name="Kistner1995" /> These agents, although efficacious, were associated with intolerable side effects. [[Danazol]] was first described for endometriosis in 1971 and became the main therapy in the 1970s and 1980s.<ref name="Aiman2012" /><ref name="Josimovich2013" /><ref name="Kistner1995" /> In the 1980s, [[GnRH agonist]]s gained prominence for the treatment of endometriosis and by the 1990s had become the most widely used therapy.<ref name="Josimovich2013" /><ref name="Kistner1995" /> Oral GnRH antagonists such as [[elagolix]] were introduced for the treatment of endometriosis in 2018.<ref name="pmid30763525">{{cite journal | vauthors = Barra F, Grandi G, Tantari M, Scala C, Facchinetti F, Ferrero S | title = A comprehensive review of hormonal and biological therapies for endometriosis: latest developments | journal = Expert Opin Biol Ther | volume = 19 | issue = 4 | pages = 343–360 | date = April 2019 | pmid = 30763525 | doi = 10.1080/14712598.2019.1581761 | s2cid = 73455399 }}</ref>