Misdiagnosis: Reproductive Health and Our Environment

1.

It is winter in New York City. I wake up sweating in the middle of the night, and I can't sleep because I'm too hot. The night sweats wake me several more times before my alarm finally goes off at 6:30 a.m. In the morning I'm anxious; this shouldn't be happening so frequently.

The winter advances from the isolated weather of January into the endless darkness of February and March. It's been three months since I stopped taking birth control pills to regulate my fickle cycle, and my period has not returned. In the middle of the day, a flash of heat spreads over me, starting at the back of my neck, crawling over the back of my head, and ending on the other side of my body, between my rib cage and stomach. A cold chill immediately follows. I add this to a growing list of concerns to share with my doctor.

Nothing can prepare you for being told in your twenties that your reproductive system is similar to that of a fifty-year-old woman, your ovaries have shrunk to the size of raisins, and you most likely will never again have another menstrual cycle. I was twenty-eight when a gynecologist told me that I had something called premature ovarian failure (POF), a reproductive disorder affecting one percent of women in the United States. POF means that your body lacks sufficient eggs to produce regular ovulation or menstrual cycles. According to many doctors, it is unlikely that anyone with POF will ever become pregnant and carry a fetus to full term.

2.

Our world is besieged with pollutants. Exposure to toxic contaminants cuts across race and class lines, and every being is vulnerable to environmental hazards. In a recent interview, Dr. Elizabeth Guillette, an associate research scientist in anthropology at the University of Florida, told me that the best way to deal with the impacts of pollutants on our bodies is to limit our exposure to them.

Yet few working-class and working-poor people of color have any such choice. Typically, we work in industries where we are exposed to environmental toxins as farmworkers, factory workers, domestic workers. The increasing assaults on immigration and decreasing federal worker-protection laws limit our opportunities to deal with our concerns through federal regulatory agencies. Our neighbors are the waterways, power plants, and waste facilities poisoned by the government and corporations. And our exposure to toxins is having disastrous impacts on our reproductive systems.

Farmworkers who formerly worked on the North Shore of Lake Apopka -- one of the most polluted lakes in Florida and the location of two Superfund sites -- have been suffering from chronic health problems ranging from reproductive disorders to lupus since the closing of the farms in 1998.[1] In a 2006 community health survey of former Apopka farmworkers, most of whom were African American, 13 percent said they had a child born with a birth defect; 21 percent had at least one problem pregnancy; and 16 percent had miscarriages. At least three farmworkers who became pregnant while working in the same Immokalee labor camp in southwest Florida in 2004 gave birth to children with severe birth defects. The farmworkers contend that they were in the fields during and shortly after pesticides were sprayed -- both prior to and during pregnancy.

We are seeing increased rates of endometriosis as a result of exposure to dioxins, toxic chemical compounds produced by various industrial processes. According to Dr. Elizabeth Lee Vliet, who runs a holistic women's health practice, women are increasingly being diagnosed with early menopause, early onset of menses, delayed menses, and increased miscarriages. They are also giving birth more and more to children born with severe physical deformities. We are also seeing more women with polycystic ovarian syndrome (PCOS), the most common cause of female infertility. And, Vliet told me, "There is research that shows that PCOS is higher among [Latina] and African American young women. I don't know if the research at this point gives us a clear indication of why that is."