Differences in Clinical Management and Outcomes of American Indian and White Women Diagnosed with Endometriosis

Alessandra Spagnolia, Spagnolia A, Beal JR, James R. Beal, Abe E. Sahmoun
Journal of family & reproductive health · 2020 · vol. 14(2) , pp. 74–80 · doi:10.18502/jfrh.v14i2.4348 · PMID:33603797 · PMC7865200 · W3092035068
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This study found that American Indian women with endometriosis were more likely to report abdominal pain at diagnosis and less likely to experience pain reduction compared to White women.

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This paper examined differences in clinical management and outcomes between American Indian and White women diagnosed with endometriosis, using a comparative study design to assess how care patterns and resultant outcomes varied by race/ethnicity. The authors report observed disparities in management and outcomes between the two groups. A key limitation is that the available information likely constrains causal interpretation and may be influenced by differences in access to care and other confounding factors not fully addressed in the dataset. This paper is centrally about endometriosis—specifically, racial differences in management and outcomes among American Indian versus White women.

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Abstract

Objective: Endometriosis is a chronic, painful disease that can be disabling. There is a scarcity of research on the clinical management and outcomes of endometriosis in American Indian (AI) women. The aim of this study was to determine whether there are discrepancies between AI and White women in symptoms at presentation, initial diagnosis methods, clinical management, and long-term outcomes of endometriosis, in a rural state. Materials and methods: This retrospective study described and compared the clinical management and long-term outcomes of AI and White women diagnosed with endometriosis. All statistical tests were two-tailed with p-value < .05 considered to be significant. Results: 110 women diagnosed with endometriosis were included in the study, with 50% (n = 55) AI and 50% (n = 55) White. White women were more likely to have private insurance (80% vs. 42%; p < 0.001). AI women were more likely than White women to report abdominal pain at diagnosis (20.3% vs. 9%; p = 0.010), and be diagnosed with mild endometriosis symptoms at the initial visit, (44.4% vs. 10%; p = 0.051). White women were more likely to report a reduction or cessation of pain compared to AI women (63.3% vs. 34%; p = 0.004). Conclusion: We found the majority of women continue to report pain long after endometriosis diagnosis. AI women were less likely to report a reduction or cessation of pain. Future research should investigate why pain is more persistent in AI women.
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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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