A Diagnostic Delay in Endometriosis and Its Association with Women's Health Literacy: A Narrative Review

Endometriosis is a chronic inflammatory disease associated with pelvic pain, infertility, fatigue, and impaired quality of life. Despite increasing awareness, many women continue to experience long delays between symptom onset and diagnosis. This narrative review examines the association between diagnostic delay in endometriosis and women’s health literacy. The review was based on studies concerning diagnostic pathways, symptom recognition, healthcare communication, stigma, and educational barriers. The research hypothesis assumed that lower health literacy contributes to delayed diagnosis because women may fail to recognize symptoms as abnormal, postpone medical consultation, and experience difficulties navigating healthcare systems. The reviewed evidence demonstrated that normalization of dysmenorrhea, menstrual stigma, inadequate reproductive health education, and insufficient physician awareness contribute to diagnostic delay. Women frequently reported repeated consultations before referral to specialists and often described feeling dismissed during clinical encounters. Higher health literacy improved symptom recognition, communication with healthcare professionals, and self-advocacy. Educational interventions and improved professional training may reduce diagnostic delay and improve patient outcomes.