Contemporary Challenges in the Diagnosis of Endometriosis: A Literature Review

Contemporary Challenges in the Diagnosis of Endometriosis: A Literature Review | Author | Affiliation | |---|---| Gorbunova, Ana | | Date | Start Page | End Page | |---|---|---| 2026-03-27 | 110 | 110 | Objectives Endometriosis is a chronic gynecological disease with a significant negative impact on quality of life, reproductive health and long-term clinical outcomes. Diagnostic delay remains a major clinical issue, with many patients experiencing years between symptom onset and definitive diagnosis. The objective of this literature review is to synthesize current evidence on the challenges in diagnosing endometriosis and to highlight key factors contributing to diagnostic delays. Methods A systematic literature review was conducted focusing on studies published since 2018 that report on time to diagnosis, diagnostic methods and barriers in endometriosis diagnosis. Databases searched included PubMed and Embase. Observational studies documenting diagnostic timelines, clinical practices and diagnostic modalities were included. Definitions of diagnostic delay and regional variations in diagnostic intervals were examined. Results Studies consistently showed prolonged diagnostic delays, with time between symptom onset and confirmed diagnosis frequently ranging from 0.3 to 12 years, depending on definitions and study populations. Many women see multiple healthcare providers before diagnosis, reflecting gaps in early recognition and referral to specialists. Diagnostic delay was driven primarily by clinician-related factors, such as low disease awareness and under-recognition of symptoms, as well as variability in access to imaging and specialist care. Traditional imaging techniques like transvaginal ultrasound and MRI improve detection of some endometriosis forms but have limitations, especially for superficial lesions. Laparoscopy with histological confirmation remains the gold standard despite its invasiveness. Conclusions Despite improved clinical guidelines and increased awareness, endometriosis diagnosis still faces significant challenges, including substantial delays influenced by both healthcare provider and system-related factors. Standardized diagnostic criteria, enhanced educational efforts among clinicians, earlier use of appropriate imaging techniques and research into reliable non-invasive biomarkers are crucial to shorten diagnostic pathways and improve patient outcomes.