Endometriosis Management Patterns Among Women in the National Survey of Family Growth (2017-2019) [A98]

INTRODUCTION: Endometriosis is a common gynecologic condition among women of reproductive age. Optimal treatment should be utilized, especially among those who have not completed childbearing. METHODS: We described the prevalence of endometriosis and treatment patterns among reproductive-aged women from the National Survey of Family Growth (NSFG, 2017-2019), focusing on treatments received by individuals reporting a desire for future childbearing. We conducted weighted bivariate analyses using t-tests and chi-square tests as appropriate. RESULTS: Endometriosis was diagnosed in 5.7% (n=314/6,141) of reproductive-aged women, of whom 43.6% reported a current diagnosis. Women with endometriosis were aged 38 years, commonly identified as non-Hispanic White (7.3%), and nearly all (92.7%) had health insurance (65% from private insurance). Reported treatments included: non-narcotic medicines (58.5%), hormonal medicines (47.7%), narcotics (34.6%), hysterectomy (30.1%), and progesterone-releasing intrauterine devices (IUDs) (12.2%); 11.2% never received any treatment. Treatments received did not vary by race and ethnicity, education, income, marital status, or insurance coverage. Prior to hysterectomy among 74 women, 56.7% received non-narcotic medicines, 54.7% hormonal medicines, 47.0% narcotics, and 26.1% progesterone-releasing IUDs. Twenty women (15.5%) who underwent hysterectomy reported a desire for future childbearing. Among these, 81.8% received narcotics, 76.2% received hormonal medicines, 73.0% received non-narcotic medicines, and 23.1% received a progesterone-releasing IUD prior to hysterectomy. CONCLUSION: Nearly one-third of reproductive-age women with endometriosis underwent a hysterectomy, among whom approximately 16% had not completed childbearing. Narcotics are overutilized and progesterone-releasing IUDs underutilized among individuals receiving hysterectomy prior to completion of childbearing.