A systematic review on the prevalence of endometriosis in women

Moradi, Yousef; Shams-Beyranvand, Mehran; Khateri, Sorour; Gharahjeh, Saeedeh; Tehrani, Shahrzad; Varse, Fatemeh; Tiyuri, Amir; Najmi, Zahra

doi:10.4103/ijmr.ijmr_817_18

Cited by 35 publications

(24 citation statements)

References 32 publications

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“…The exact prevalence of endometriosis is unknown, but approximations range from 1% to 10% [8,9]. Prevalence is much higher amongst women suffering from infertility and chronic pelvic pain, estimated to be 47% and 42%, respectively [10,11]. Unfortunately, until the accuracy of diagnostic measures improves and education among community members and HCPs increases, the exact prevalence of endometriosis will remain unknown.…”

Section: Introductionmentioning

confidence: 99%

Patient and Practitioner: The Impact of Social Factors on Diagnostic Delay for Endometriosis

Drinkell¹,

Fajzel²,

Tordon³

2023

URNCST Journal

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Introduction:Endometriosis is a gynaecological disease with diverse symptoms that are often shared with other disorders and is characterized by long diagnostic delays. Delayed diagnosis prevents patients from receiving access to care and negatively impacts both physical and mental health. While technical limitations of the diagnostic procedure contribute to the delay, there is also significant delay in first seeking consultation as well as getting referred to specialized care that point to social differences rather than medical factors. This literature review aims to identify social determinants that contribute to these delays in endometriosis diagnosis. Methods: A literary search was conducted using PubMed, PsycInfo, and Web of Science. The search yielded a total of 549 articles. Of these, 22 articles were selected based on established search terms and criteria including that the articles had to present original data, be written in English, be published no earlier than 2012, and have full-text availability. Results: Factors contributing to diagnostic delay can be related to one of two groups: the patient and the practitioner Patient factors that increase delay include certain demographic characteristics, the extent of pain normalization, the stigma surrounding women's health, and the lack of self-advocacy. Practitioner factors that increase diagnostic delay include dismissive attitudes, the lack of knowledge and technical competence concerning endometriosis, and their relationship with patients as a position of authority. Discussion: Many identified factors share similar themes but are manifested differently amongst patients and practitioners, particularly those relating to the lack of familiarity with endometriosis and the normalization or dismissal of symptoms. Shared findings point to larger societal factors influencing both patients and practitioners. Conclusion:The findings of this review provide insight into social determinants that contribute to the long delays associated with endometriosis diagnosis. Future research should be aimed at establishing interventions for identified factors and also address larger shared social beliefs and misconceptions that maintain stigmas about women's health.

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Section: Introductionmentioning

confidence: 99%

Patient and Practitioner: The Impact of Social Factors on Diagnostic Delay for Endometriosis

Drinkell¹,

Fajzel²,

Tordon³

2023

URNCST Journal

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“…Dysmenorrhea is the cardinal complaint, present in approximately 50%-60% of women with endometriosis, followed by irregular and/or heavy menstrual bleeding (51%), non-menstrual chronic pelvic pain (CPP) (37%), deep dyspareunia (26%-55%), cyclical intestinal complaints (48%), cyclical urinary complaints (12%), and subfertility (12%-50%). [2][3][4][5] Globally, the prevalence of endometriosis is estimated to be 6%-10% among all women of reproductive age, 4,[6][7][8] more than 60% in women with CPP, 9 and around 30%-50% among women presenting with subfertility. 5,10 Epidemiological reports vary depending on data availability, study design and quality, diagnostic methods, accuracy of medical coding, geography, ethnicity, socioeconomic status, and other population distribution factors.…”

Section: Introductionmentioning

confidence: 99%

“…5,6,11 One large international meta-analysis of 17 studies that analyzed more than 127 000 women reported a pooled prevalence estimate of 18% among reproductiveage women, which appeared to be skewed upward by a higher prevalence among developing countries. 6 Relatively high rates of endometriosis have also been reported among women of Asian ethnicity compared with white female populations, 6,[12][13][14][15][16][17] which is noteworthy given that the Asian region comprises approximately 60% of the world's population, 18 approximately half of whom are women. 19 A recent meta-analysis reported a significant odds ratio of 1.63 for endometriosis diagnosis in Asian versus white women.…”

Section: Introductionmentioning

confidence: 99%

“…Relatively high rates of endometriosis have also been reported among women of Asian ethnicity compared with white female populations, 6,12–17 which is noteworthy given that the Asian region comprises approximately 60% of the world's population, 18 approximately half of whom are women 19 . A recent meta‐analysis reported a significant odds ratio of 1.63 for endometriosis diagnosis in Asian versus white women 14 .…”

Section: Introductionmentioning

confidence: 99%

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Improving the diagnosis of endometriosis in Asia‐Pacific: Consensus from the Asia‐Pacific Endometriosis Expert Panel for Endometriosis

Yen,

Hamdan,

Hengrasmee

et al. 2023

Intl J Gynecology & Obste

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Endometriosis should be diagnosed as early as possible in the continuum of care; but substantial delays of approximately 6–8 years between symptom onset and endometriosis diagnosis have been widely reported. With the purpose of improving the prompt diagnosis of endometriosis, the Asia‐Pacific Endometriosis Expert Panel (APEX) sought to address the reasons for diagnostic delays across the region, and formulate a multi‐pronged approach to overcoming these challenges. In the first instance, clinical diagnosis is preferable to surgical diagnosis, in order to facilitate earlier empirical treatment and minimize the negative sequelae of undiagnosed/untreated disease. There should be a high clinical index of suspicion in women presenting with cyclical symptoms, including those involving extrapelvic organs. Diagnostic delays in Asia‐Pacific countries are attributable to a variety of patient, physician, and healthcare factors, including poor awareness, normalization/trivialization of pain, individual/cultural attitudes toward menstruation, default use of symptom‐suppressing treatments, misdiagnosis, and a lack of diagnostic resourcing or adequate referral pathways in some areas. Suggested initiatives to reduce diagnostic delays are geared toward improving public awareness, improving clinical diagnostic skills, streamlining multidisciplinary care pathways for timely referral, updating and implementing diagnostic guidelines, lobbying policymakers and insurance companies for endometriosis support, and increasing efforts to bridge data gaps and perform further research in this field. Formulating specific action plans and gathering traction are the responsibility of individual countries within local parameters. The APEX group advocates for any initiatives and policies that support the unmet needs of women with endometriosis, to improve patient experience and outcomes.

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“…Si bien existe discrepancia en cuanto al porcentaje exacto de mujeres que sufren endometriosis, según el metaanálisis de Moradi et al 4 la prevalencia estimada de endometriosis a nivel mundial es del 18%, con mayor afectación en los países en desarrollo. Por otro lado, la incidencia de la endometriosis en cicatriz de cesárea es baja, con un estimado del 0.03-0.45%.…”

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