Non-Surgical Options for The Diagnosis of Endometriosis in Low-Resource Settings: A Comparative Study

Dina Marlina, Aditya Utomo, Megawati Al'badly Ponco Dewi Poernomo, Megawati Al’badly Ponco Dewi Poernomo, Putri Nadhira Adinda Adriansyah, Beni Samsul Amri, Artha Falentin Putri Susilo, Muhammad Alamsyah Aziz
International journal of women's health · 2025 · vol. Volume 17 , pp. 1445–1456 · doi:10.2147/ijwh.s507556 · PMID:40417644 · PMC12102738 · W4410502797
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found that dysmenorrhea, particularly when it begins more than three years after menarche, is significantly associated with endometriosis in a low-resource Indonesian setting.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper investigated clinical menstrual-cycle characteristics in a case-control design at Prof. Dr. Margono Soekarjo Provincial General Hospital, Indonesia, using patients registered from 2020 to 2024 to compare features between histopathologically confirmed endometriosis and misdiagnosed cases. The main finding was that dysmenorrhea was strongly associated with endometriosis (OR 17.5, 95% CI 4.75–64.4), and that dysmenorrhea onset occurring more than three years after menarche showed a smaller but significant association (OR 2.790, 95% CI 1.011–7.698). The explicit caveat is that the study’s symptom-based, non-surgical comparative approach depends on the accuracy of case definition and the study’s sampling from a single hospital/registry window. This paper is centrally about endometriosis — it identifies dysmenorrhea characteristics, including timing since menarche, as potential indicators for non-surgical diagnosis in low-resource settings.

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Abstract

PURPOSE: Endometriosis, a chronic estrogen-dependent condition characterized by the implantation of tissue beyond the uterine cavity, impacts 10% of women of reproductive age. Endometriosis manifests through menstrual discomfort, chronic pelvic pain, dyspareunia, and cyclical digestive issues. It is additionally linked to infertility. Early diagnosis and effective treatment are crucial but remain limited in many settings. This study aims to identify specific clinical characteristics that could aid in the early diagnosis and treatment of endometriosis. PATIENTS AND METHODS: The study conducted at Province General Hospital Margono, Indonesia, involved endometriosis patients who had registered from 2020 to 2024. Some inclusion and exclusion criteria are applied in this study. Statistical analysis was performed to determine the rate, odd ratio and prevalence ratio. RESULTS: Our analysis indicates that women experiencing dysmenorrhea, particularly with an onset occurring more than three years after menarche, are significantly associated with endometriosis. Dysmenorrhea had nearly 17.5 times higher odds [OR 17.5, 95% CI 4.75-64.4, p-value 0.00] of being correlated with endometriosis, and the onset of dysmenorrhea more than 3 years after menarche had 1.67 times higher [OR 2.790; CI 95%; 1.011-7.698, p-value 0.045] of being associated with endometriosis. CONCLUSION: Multiple studies have shown that diagnosing endometriosis early is challenging due to its various symptoms. Our findings highlight the significance of dysmenorrhea characteristics, particularly its onset timing, as potential indicators of endometriosis. This findings suggest that incorporating dysmenorrhea onset into clinical assessments may enhance non-surgical diagnostic approaches, facilitating earlier detection and management of endometriosis.

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Outcome instruments

VAS-pain NRS-pain

Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareuniainfertility

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.

References (45)

SciLite annotations

chemicals 26
estrogen estrogen estrogen estrogen steroid leuprolide acetate danazol progestin dienogest androgen estrogen estrogen steroid prostaglandin progestin progestin prostaglandin progesterone estrogen estradiol testosterone estrone estradiol estrogen progestin
organisms 2
noordeloos 2009062 homo heidelbergensis

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