Endometriosis in the early second quarter of the 21st century: paradigm shift

Mekan R. Orazov, Evgeny D. Dolgov
In: Clinical review for general practice · 2026 · vol. 7(5) , pp. 100–103 · doi:10.47407/kr2026.7.5.00848 · W7167257550
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This review examines the epidemiology, comorbidities, and risk factors of endometriosis, highlighting diagnostic delays and recent therapeutic advances such as dienogest and gonadotropin-releasing hormone antagonists in the early 21st century.

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This review examines the epidemiological landscape and diagnostic challenges of endometriosis, highlighting that approximately 10% of women of childbearing age are affected globally. The authors note a significant delay in diagnosis, ranging from five to twelve years, which stems from symptom heterogeneity, menstrual health stigma, and insufficient awareness among both patients and medical professionals. The paper outlines recent paradigm shifts in the early 21st century, focusing on advances in understanding risk factors, comorbidities, and emerging pharmacological treatments such as dienogest and gonadotropin-releasing hormone antagonists like Relugolix. This paper is centrally about endometriosis — specifically reviewing its epidemiology, diagnostic delays, and evolving treatment paradigms in the modern era.

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Abstract

Endometriosis remains a mysterious steadily progressing disease for reproductive medicine of the 21st century. About 10% of women (190 million) of childbearing age all over the world suffer from the disorder. Despite high prevalence, endometriosis is still diagnosed late. The time from first symptoms to the diagnosis varies between 5 and 12 years, depending on the geographic region. This is due to heterogeneity of symptoms and stigma of the issues related to menstrual health, as well as the lack of awareness about the disorder in both medical professionals and patients. In this regard, the review considers endometriosis retrospectively and notes the advances and paradigm shift in the early second quarter of the 21st century. Keywords: endometriosis, epidemiology, comorbidity, risk factors, diagnosis, dienogest, gonadotropin-releasing hormone antagonists, Relugolix.
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Abstract

Endometriosis remains a mysterious steadily progressing disease for reproductive medicine of the 21st century. About 10% of women (190 million) of childbearing age all over the world suffer from the disorder. Despite high prevalence, endometriosis is still diagnosed late. The time from first symptoms to the diagnosis varies between 5 and 12 years, depending on the geographic region. This is due to heterogeneity of symptoms and stigma of the issues related to menstrual health, as well as the lack of awareness about the disorder in both medical professionals and patients. In this regard, the review considers endometriosis retrospectively and notes the advances and paradigm shift in the early second quarter of the 21st century.

Keywords

endometriosis, epidemiology, comorbidity, risk factors, diagnosis, dienogest, gonadotropin-releasing hormone antagonists, Relugolix. For citation:Orazov M.R., Dolgov E.D. Endometriosis in the early second quarter of the 21st century: paradigm shift. Clinical review for general practice. 2026; 7 (5): 100–103 (In Russ.). DOI: 10.47407/kr2026.7.5.00848 All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

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