Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women

Fuldeore, Mahesh; Soliman, Ahmed M.

doi:10.1159/000452660

Cited by 207 publications

(181 citation statements)

References 37 publications

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“…The previous research has characterized some symptoms associated with diagnosed endometriosis, including abdominopelvic pain, dysmenorrhea, menorrhagia, and dyspareunia [35, 36]. However, to our knowledge, no previous literature reviews have focused on identifying and evaluating patient-completed and/or symptom-based endometriosis screening tools for adult women specifically, although other reviews have been undertaken to characterize diagnostic practices in endometriosis.…”

Section: Discussionmentioning

confidence: 99%

Patient-completed or symptom-based screening tools for endometriosis: a scoping review

Surrey

Carter

Soliman

et al. 2017

Arch Gynecol Obstet

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PurposeThe objective of this review was to evaluate existing patient-completed screening questionnaires and/or symptom-based predictive models with respect to their potential for use as screening tools for endometriosis in adult women. Validated instruments were of particular interest.MethodsWe conducted structured searches of PubMed and targeted searches of the gray literature to identify studies reporting on screening instruments used in endometriosis. Studies were screened according to inclusion and exclusion criteria that followed the PICOS (population, intervention, comparison, outcomes, study design) framework.ResultsA total of 16 studies were identified, of which 10 described measures for endometriosis in general, 2 described measures for endometriosis at specific sites, and 4 described measures for deep-infiltrating endometriosis. Only 1 study evaluated a questionnaire that was solely patient-completed. Most measures required physician, imaging, or laboratory assessments in addition to patient-completed questionnaires, and several measures relied on complex scoring. Validation for use as a screening tool in adult women with potential endometriosis was lacking in all studies, as most studies focused on diagnosis versus screening.ConclusionsThis literature review did not identify any fully validated, symptom-based, patient-reported questionnaires for endometriosis screening in adult women.

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Section: Discussionmentioning

confidence: 99%

Patient-completed or symptom-based screening tools for endometriosis: a scoping review

Surrey

Carter

Soliman

et al. 2017

Arch Gynecol Obstet

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“…One limitation of our study is that more than 50% of the study sample was non-African American women although uterine fibroid disease is known to be more prevalent among African American women; a finding that was corroborated by our study as well. In addition, when interpreting the results of this study, several possible sources of bias summarized in previous reports should be kept in mind 22. For example, this study includes data from individuals who responded to the survey and excludes individuals who were not members of the three respondent panels.…”

Section: Discussionmentioning

confidence: 99%

“…All panel respondents were required to accept the site terms and privacy policy before opting into the panel. Recently published results from this survey focusing on the prevalence and symptom burden among patients with endometriosis used the same methodology and a similar analytic approach as outlined in the following paragraphs 22. A weighting algorithm with propensity score adjustment for distributions in age, education, race, region, and household income was used so that the survey sample would be representative of the general US population 25.…”

Section: Methodsmentioning

confidence: 99%

Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: findings from a cross-sectional survey analysis

Fuldeore¹,

Soliman²

2017

IJWH

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PurposeTo estimate the prevalence of women diagnosed with uterine fibroids and the associated symptom burden in the US.Patients and methodsResponses of women aged 18–54 years, who completed an online survey, were analyzed. Data were weighted based on age, education, race, geographic region, income, and propensity score to derive national estimates of the prevalence of women diagnosed with uterine fibroids and associated symptom burden. Weighted means and percentages were reported. Prevalence across age and ethnic groups was examined. Symptom burden among women with and without uterine fibroids was compared using weighted logistic regressions.ResultsOf 59,411 respondents who met study inclusion criteria, 7.7% reported receiving a diagnosis of uterine fibroids. Of these, 5,670 women (1,402 in the uterine fibroid group and 4,268 in the control group) were excluded from analysis because they had a hysterectomy. Among the non-hysterectomized study participants, 3,031 self-reported a diagnosis of uterine fibroids (prevalence: 5.8%, 95% confidence interval [CI]: 5.5%–6.1%); prevalence increased as women aged and was greatest in the 50–54 age group (11.4%; 95% CI: 10.4%–12.4%). In addition, prevalence was greater in black vs white women (9.8%; 95% CI: 8.7%–11.0% vs 5.4%; 95% CI: 5.1%–5.7%). A greater percentage of women with uterine fibroids (vs those without) experienced severe heavy menstrual bleeding (16.7% vs 7.7%), severe constipation/bloating/diarrhea (7.7% vs 4.7%), severe passage of clots (6.7% vs 2.4%), severe spotting/bleeding between periods (1.7% vs 1.0%), and severe pelvic pressure (1.6% vs 0.6%). Among uterine fibroid patients with these typical uterine fibroid-related symptoms, 56.4%, 32.3%, 26.4%, 25.8%, and 20.4% reported heavy menstrual bleeding, passage of clots, spotting/bleeding between periods, constipation/bloating/diarrhea, and pelvic pressure, respectively, as extremely bothersome.ConclusionUterine fibroids impose a heavy burden on women aged 18–54 years in the US.

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“…Endometriosis affects an estimated 89 million women of reproductive age worldwide; in other words, it affects 6% to 10% of all women [1, 2, 15]. …”

Section: Discussionmentioning

confidence: 99%

“…Prevalence of endometriosis being diagnosed in US women is estimated to be 6.1% [15]. The most common presenting symptoms are menstrual pelvic pain and/or cramping, nonmenstrual pelvic pain and/or cramping, and infertility and dyspareunia.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Cyclical Hemothorax: Thoracic Endometriosis Syndrome

Rawala

Khaliq

Iqbal

et al. 2018

Case Reports in Pulmonology

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Endometriosis is a common condition in which endometrial cells and stroma are deposited in extrauterine sites. Its prevalence has been estimated to be 10% of reproductive age females. It is commonly found in the pelvis; however, it may be found in the abdomen, thorax, brain, or skin. Thoracic involvement is a relatively rare presentation of this common disease. Thoracic endometriosis commonly presents as pneumothorax in 73% of patients. A rarer presentation of thoracic endometriosis is hemothorax (<14%) or hemoptysis (7%). Thoracic endometriosis is an uncommon cause of a pleural effusion. We present a case of 28-year-old African American female with no other medical conditions. She presented to the hospital with worsening right-sided pleuritic chest pain, dyspnea, and menorrhagia. She had been complaining of pleuritic chest pain for 5 years, the onset of which corresponds to the start of her menstrual cycle and is relieved with cessation of menses. Initial laboratory studies revealed a severe microcytic anemia with normal coagulation profile. Chest X-ray showed small right pleural effusion and suspicious for airspace disease. A computed tomography (CT) of chest was ordered for further clarification and identified large right pleural effusion. CT-guided thoracentesis removed 500 ml of serosanguinous fluid consisting of blood elements. There can be multiple sites involved with endometriosis and can present with wide range of symptoms that occur periodically with menses in young woman. The history and pleural fluid findings of this case are suggestive of Thoracic Endometriosis Syndrome. The diagnosis of this is often missed or delayed by clinicians, which can result in recurrent hospitalization and other complications. As internists we should be suspicious of atypical presentations of endometriosis and treat them early before complications develop. This case also highlights the importance of suspecting atypical etiologies for pleural effusion.

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Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women

Cited by 207 publications

References 37 publications

Patient-completed or symptom-based screening tools for endometriosis: a scoping review

Patient-completed or symptom-based screening tools for endometriosis: a scoping review

Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: findings from a cross-sectional survey analysis

A Rare Case of Cyclical Hemothorax: Thoracic Endometriosis Syndrome

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