Research reveals delays in diagnosing women with endometriosis can take at least 10 years

Lifestyle changes such as regular exercise, a balanced diet, and weight management can help alleviate symptoms.Picture:Pexels

Lifestyle changes such as regular exercise, a balanced diet, and weight management can help alleviate symptoms.Picture:Pexels

Published Sep 1, 2023


Polycystic ovary syndrome (PCOS) and endometriosis are two common gynaecological conditions that affect millions of women worldwide.

The characteristics, symptoms and treatment options of these conditions may seem similar, but it is essential to understand their differences.

As September is PCOS Awareness Month, it is an opportune time to shed light on these conditions and help individuals navigate the unique challenges.

PCOS vs. Endometriosis: Different conditions, similar effects

The World Health Organization explains PCOS as a hormonal disorder that affects the ovaries, leading to an imbalance of reproductive hormones.

It is estimated to affect approximately 5-10% of women of reproductive age, making it one of the most common endocrine disorders among women. PCOS is characterised by the growth of small cysts on the ovaries, irregular menstrual cycles, and excessive production of androgens (male hormones).

According to the American College of Obstetricians and Gynecologists (ACOG), the key symptoms of PCOS include irregular menstrual cycles or absence of periods, excessive hair growth (hirsutism) and acne, weight gain or difficulty losing weight, insulin resistance or type 2 diabetes, and infertility or difficulty conceiving.

Understanding Endometriosis

Endometriosis is a chronic condition in which the tissue that normally lines the uterus (endometrium) grows outside the uterus. It affects approximately 10% of women worldwide, making it a prevalent gynaecological disorder. Endometriosis can cause inflammation, scarring, and the formation of adhesions.

The Mayo Clinic states that the key symptoms of endometriosis include pelvic pain, especially during menstruation, painful intercourse, heavy or irregular menstrual periods, infertility or difficulty conceiving, and fatigue and gastrointestinal issues.

According to existing data, at least one in every 10 women live with endometriosis. Women with endometriosis can go as long as 10 years without receiving a diagnosis. Research sheds new light on widespread delays in diagnosis.

New research conducted by PhD student Anna Melgaard from the Department of Public Health at Aarhus University sheds light on the widespread delays in diagnosing this debilitating condition.

The study, recently published in the scientific journal Human Reproduction, analysed the healthcare use of 129,696 Danish women, with a particular focus on the 21,616 women who were eventually diagnosed with endometriosis between 2000 and 2017.

The findings are alarming.

“Women can find it difficult to distinguish between normal and abnormal symptoms and might therefore not seek medical attention immediately,’’ the researchers noted.

This lack of awareness and confusion about what is considered normal can lead to significant delays in seeking help.

But it's not just the patients who are facing challenges. Doctors, too, may contribute to the problem. ‘

’Doctors may also have insufficient knowledge about endometriosis and can tend to normalise symptoms,’’ explained study author Melgaard.

This normalisation can result in incomplete examinations, inadequate referrals, and even referrals to the wrong specialists.

Speaking to Medical News about the research, Melgaard brought to attention that, "With this study, we can underscore that the delayed diagnosis of endometriosis is not due to the fact that women do not visit the doctor."

In fact, the research highlights the need for better education and awareness among both patients and healthcare professionals.

Additionally, the World Health Organization also notes endometriosis can often present symptoms that mimic other conditions thereby contributing to a diagnostic delay.

While both PCOS and endometriosis can cause infertility and menstrual irregularities, there are distinguishing factors that can help differentiate between the two conditions.

PCOS primarily affects the ovaries and hormonal balance, whereas endometriosis involves the growth of tissue outside the uterus.

PCOS often presents with symptoms related to excess androgen production, such as hirsutism and acne, while endometriosis may manifest as severe pelvic pain.

PCOS is primarily diagnosed through hormonal and ultrasound tests, whereas endometriosis is typically diagnosed through laparoscopic surgery.

The treatment for PCOS and endometriosis varies depending on the severity of symptoms and the individual's reproductive goals.

For PCOS, lifestyle changes such as regular exercise, a balanced diet, and weight management can help alleviate symptoms.

Medications like hormonal birth control pills, anti-androgen medications, and insulin-sensitising drugs may also be prescribed. Fertility treatments, including assisted reproductive technologies (ART), can help women with PCOS conceive.

In the case of endometriosis, pain management can be achieved through over-the-counter pain relievers or prescription medications.

Hormonal therapies like birth control pills and hormonal patches can help manage symptoms. In more severe cases, laparoscopic surgery may be performed to remove endometrial tissue, adhesions, or cysts.

Dr Nosipho Danielle Mhlanga in collaboration with Kotex® encourages women to seek medical assistance if they suspect PCOS based on symptoms.

“Early diagnosis and management improves quality of life.”