Factors Associated with Time to Endometriosis Diagnosis in the United States.
Level 4 - case-series / case-control
Cross-sectional survey assessing retrospective self-reported diagnostic timelines without a control group.
PubMed 28440744 · doi:10.1089/jwh.2016.6003
What was done
An online cross-sectional survey evaluated 638 US women aged 18–49 who reported a physician's diagnosis or suspicion of endometriosis within the prior 10 years. The survey captured symptom history and used univariate analyses to identify factors linked to time from symptom onset to first consultation, and from first consultation to final diagnosis.
What was found
Mean time from symptom onset to diagnosis was 4.4 years. Over half (56%) sought care for specific symptoms: menstrual pain (31.6%), nonmenstrual pain (27.3%), or dyspareunia (7.5%). Obstetricians/gynecologists made 84% of diagnoses (49% surgical, 51% nonsurgical). Mean time to first consultation was shorter for women aged 40–49 versus under 18 years (14.2 vs. 43.5 months, p < 0.0001) and for those seeking care for specific pain symptoms versus routine care (24.9–28.4 vs. 61.4 months, p < 0.01). Mean time from first consultation to diagnosis was shorter in women aged 40–49 versus under 18 years (12.4 vs. 34.5 months, p = 0.0009) and when diagnosed by an obstetrician/gynecologist versus a non-specialist (21.5 vs. 40.3 months, p = 0.041).
Why it matters
This study provides US-specific benchmarks on diagnostic timelines for endometriosis, showing that younger age and initial presentation to non-gynecologists significantly prolong delays.
Limits
The study relied on retrospective self-report via an online survey, introducing potential recall and selection biases. Diagnosis was not independently verified by medical records, over half of diagnoses were nonsurgical (lacking laparoscopic confirmation), and multivariate adjustment was not reported.