Are There Predictors of Early Diagnosis of Endometriosis Based on Clinical Profile? A Retrospective Study

Abstract

Objectives: Significant delays occur in referring cases for care of endometriosis, despite women suffering for years. This study was conducted to assess whether there is a specific symptom profile characteristic of endometriosis to alert physicians for earlier referrals. Methods: In this retrospective observational cohort study, patient data of the women who attended Sultan Qaboos University Hospital from January 2011 to December 2019 with a diagnosis of endometriosis was collected from the hospital’s electronic data archive and analyzed. Results: Cases of N = 262 endometriosis patients were studied. The diagnosis was surgical in 198 (75.6%) of patients and the remaining 64 (24.4%) were diagnosed by clinical assessment and imaging. The mean age at diagnosis was 30.7±6.8 years (range = 15–51). The presence of ovarian endometrioma on ultrasound served as an alert for earlier referral. The mean age at diagnosis for those who had an endometrioma was 30.3±6.7 years and 32.4±7.1 years for those without an endometrioma without a significant difference. The mean age at diagnosis for those who did not have pain was 31.2 years and those with pain was 30.0 years (p =0.894; CI: -2.58–2.91). Among the 163 married women in the sample, 88 (54.0%) had primary infertility, and 31 (19.0%) had secondary infertility. There was no significant difference between the groups in the mean age at diagnosis (analysis of variance test; p =0.056). Over the nine-year period, diagnosis was made at progressively younger ages (p =0.047). Conclusions: Based on this study, no specific symptom profile appears to predict an early diagnosis of endometriosis. However, over the years the diagnosis of endometriosis is made earlier likely due to increasing awareness of women and their physicians about the disease.

Addressing Cultural Stigma: Endometriosis Diagnosis in the Arab World

“…Endometriosis significantly impacts various aspects of women's quality of life (Bourdelid et al, 2019;El-Kader et al, 2019). The diagnosis of endometriosis has posed a notable challenge, resulting in a substantial body of literature dedicated to addressing this issue and mitigating its long-term effects on women's well-being (Ballard et al, 2006;Hudelist et al, 2012;Mousa et al, 2021;Shukri et al, 2022). It is widely acknowledged that rectifying the diagnostic delay in endometriosis yields benefits not only for women but also extends to their families, communities, and the broader healthcare system.…”

“…It is crucial to note that women afflicted with endometriosis exhibit a range of symptoms, encompassing pelvic pain, psychological distress, and infertility (Shukri et al, 2023). These manifestations are frequently misconstrued as mere "Period pain" or "PMS" -the latter being defined as a compilation of symptoms that precede a woman's menstrual cycle.…”

“…One significant aspect is the reproductive and social stigma associated with the condition (Sims et al, 2021). Notably, teenagers make up approximately 9% of women diagnosed with endometriosis (Shukri et al, 2022). This demographic underscores the importance of addressing this issue comprehensively.…”