Combating Diagnostic Delay of Endometriosis in Adolescents via Educational Awareness: A Systematic Review

Cassandra N Simpson, Christine M Lomiguen, Justin Chin
Cureus · 2021 · vol. 13(5) , pp. e15143 · doi:10.7759/cureus.15143 · PMID:34164243 · W3162564881
review OA: diamond CC0 ⤵ 21 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review analyzed 27 articles to identify reasons for diagnostic delay of endometriosis in adolescents, finding knowledge gaps, normalization of pain, lack of research, and physician resistance were primary causes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This systematic review analyzed scientific literature from 1980 to 2020 to identify causes of diagnostic delay of endometriosis in adolescents and to evaluate how education and awareness could be improved. The authors searched MEDLINE/PubMed using terms for endometriosis, diagnostic delay, and adolescence, screened full texts for discussion of diagnostic-delay causes in adolescent populations, and performed a qualitative synthesis of 27 eligible manuscripts, extracting 32 delay reasons across six categories. The review found multiple drivers of delay, including physician and patient knowledge gaps, normalization of dysmenorrhea by both patients and clinicians, limited adolescent-focused endometriosis research, and physician resistance to performing laparoscopic evaluation, with additional issues such as atypical or variable symptom presentations and misdirected differential diagnoses. A stated limitation is that one potentially relevant article could not be obtained in full text, and overall included studies varied in risk of bias using NIH quality assessment tools. This paper is centrally about endometriosis — it specifically synthesizes adolescent-specific causes of diagnostic delay and educational awareness strategies for endometriosis diagnosis.

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Abstract

Endometriosis occurs in approximately 10% of adult women worldwide; however, it is commonly under- or misdiagnosed in adolescents. The purpose of this study was to analyze existing scientific literature for reasons for diagnostic delay of endometriosis and to determine how education regarding endometriosis could be improved. An integrative review was conducted based on articles published between December 1980 and December 2020. Suitable articles were identified from the MEDLINE/PubMed databases, using relevant terms. Eligible studies included discussion on potential causes of diagnostic delay of endometriosis in the adolescent population. Data were extracted from eligible publications and qualitative synthesis was used. The 27 articles included in the study revealed several primary reasons for the delay, such as a physician and/or patient knowledge gap, normalization by physician and patient, lack of research, and physician resistance. Strategies to lessen diagnostic delay of endometriosis in adolescents must include integrated actions by educators and healthcare providers to improve health literacy and awareness of common causes of pelvic pain in this age group.

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Condition tags

endometriosis

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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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