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

Kimberly Drinkell, Hannah Fajzel, Kiera Tordon
In: Undergraduate Research in Natural and Clinical Science and Technology Journal · 2023 · vol. 7 , pp. 1–11 · doi:10.26685/urncst.450 · W4324353080
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This review identifies patient factors like pain normalization and practitioner factors such as dismissive attitudes as significant contributors to diagnostic delays for endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This paper is a literature review examining social determinants that contribute to long diagnostic delays in endometriosis, focusing on delays in both first consultation and referral to specialized care. The authors searched PubMed, PsycInfo, and Web of Science and included 22 full-text, original English-language studies published from 2012 onward, categorizing contributing factors as patient-related (e.g., certain demographics, pain normalization, stigma about women’s health, lack of self-advocacy) and practitioner-related (e.g., dismissive attitudes, insufficient knowledge/technical competence, and authority-based patient relationships). A key limitation is that, as a review of published studies with specified inclusion criteria, it synthesizes evidence without adding new primary data. This paper is centrally about endometriosis — it reviews social determinants underlying diagnostic delay for endometriosis diagnosis.

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Abstract

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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Abstract

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. ##plugins.themes.bootstrap3.article.details## This work is licensed under a Creative Commons Attribution 4.0 International License.

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Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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