BARREIRAS NO DIAGNÓSTICO E TRATAMENTO DA ENDOMETRIOSE: uma revisão de escopo no período de 2020 a 2025

BARRIERS IN THE DIAGNOSIS AND TREATMENT OF ENDOMETRIOSIS: a scoping review from 2020 to 2025 DOI: https://doi.org/10.66104/cfpvg125Keywords: Endometriosis, Clinical Diagnosis, Therapeutics.Abstract Endometriosis is a chronic estrogen-dependent inflammatory disease characterized by the presence of endometrial tissue outside the uterine cavity. Diagnosis combines clinical history, physical examination, and, in some cases, specific imaging tests; despite all these techniques, diagnosis often occurs late, resulting in an unfavorable outcome due to progressive inflammatory changes. Treatment aims at pain control, although there are delays in access to diagnosis, underestimation of complaints, financial impact, and difficulty in establishing differential diagnoses. OBJECTIVE: To describe the barriers in the diagnosis and treatment of endometriosis. METHODOLOGY: This is a scoping review based on the analysis of articles published between 2020 and 2025, selected from SciELO, PubMed, and LILACS databases through the combination of descriptors, registered in DeCS, combined using the Boolean operators "and" and "or", in Portuguese and English, freely available, that relevantly addressed the barriers/limitations/challenges in the diagnosis and/or treatment of endometriosis. The process was based on the guiding question "What are the barriers to the diagnosis and treatment of endometriosis in resource-limited regions?". After applying the inclusion and exclusion criteria, 17 articles were selected. The data were organized according to PRISMA-ScR and presented in tables/charts. RESULTS: Through the articles included in the results, it was observed that among the main limitations and difficulties found are the delay in diagnosis and the choice of an appropriate treatment according to the individualities of each patient. The normalization of symptoms, sociocultural and economic aspects, and the availability of imaging examinations are also identified as important factors. CONCLUSION: Observing its chronic inflammatory characteristic and different presentations, endometriosis shows a high level of complexity. Thus, strategies aimed at health education for both patients and professionals, expanding access to diagnostic tests, and multidisciplinary treatment should be the core of management for women with endometriosis.Downloads References ALLAIRE, Catherine; BEDAIWY, Mohamed A.; YONG, Paul J.. Diagnosis and management of endometriosis. Canadian Medical Association Journal, [S.L.], v. 195, n. 10, p. 363-371, 13 mar. 2023. CMA Impact Inc. http://dx.doi.org/10.1503/cmaj.220637. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC10120420/. Acesso em: 31 ago. 2025. DOI: https://doi.org/10.1503/cmaj.220637 ALMEIDA, Nathália Carvalho de et al. Desafios para o diagnóstico e tratamento da endometriose e consequências do diagnóstico tardio. Brazilian Journal Of Health Review, [S.L.], v. 5, n. 5, p. 19169-19179, 20 set. 2022. South Florida Publishing LLC. http://dx.doi.org/10.34119/bjhrv5n5-129. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/52287. Acesso em: 05 set. 2025. DOI: https://doi.org/10.34119/bjhrv5n5-129 Associação Brasileira de Endometriose e Ginecologia Minimamente Invasiva, 2024. Disponível em: https://sbendometriose.com.br/endometriose-causas-sintomas-e-tratamentos/. Acesso em: 30 ago. 2025. BARROSO, Antonia Tamires Rodrigues; SILVA, Tayla Raianne Brandão da; LOPES, Graciana de Sousa. ENDOMETRIOSE: dificuldades no diagnóstico precoce e seu impacto na vida das mulheres que convivem com a doença. Revista Contemporânea, [S.L.], v. 3, n. 11, p. 23487-23510, 24 nov. 2023. Brazilian Journals. http://dx.doi.org/10.56083/rcv3n11-171. Disponível em: https://ojs.revistacontemporanea.com/ojs/index.php/home/article/view/2352/1643. Acesso em: 30 ago. 2025. DOI: https://doi.org/10.56083/RCV3N11-171 CAMARGO JÚNIOR, Raimundo Nonato Colares et al. Revisão integrativa, sistemática e narrativa - aspectos importantes na elaboração de uma revisão de literatura. Revista Acb: Biblioteconomia em Santa Catarina, Santa Catarina, v. 28, n. 1, p. 1-15, 2023. Disponível em: https://brapci.inf.br/v/224932. Acesso em: 05 set. 2025. CARDOSO, Jéssica Vilarinho et al. Epidemiological profile of women with endometriosis: a retrospective descriptive study. Revista Brasileira de Saúde Materno Infantil, [S.L.], v. 20, n. 4, p. 1057-1067, dez. 2020. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/1806-93042020000400008. Disponível em: www.scielo.br/j/rbsmi/a/VvLYZ9XdYDsLjYvYgh9GmgG/?format=pdf&lang=pt. Acesso em: 26 ago. 2025. DOI: https://doi.org/10.1590/1806-93042020000400008 CERVANTES, Graziele Vidoto et al. Sexual Function of Patients with Deep Endometriosis after Surgical Treatment: A Systematic Review. Revista Brasileira de Ginecologia e Obstetrícia. v. 45, n. 11, p. 729-744, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38029775/. Acesso em: 10 fev. 2026. DOI: https://doi.org/10.1055/s-0043-1772596 CORTE, Pauline de et al. Time to Diagnose Endometriosis: current status, challenges and regional characteristics⠴a systematic literature review. Bjog: An International Journal of Obstetrics & Gynaecology, [S.L.], v. 132, n. 2, p. 118-130, 7 out. 2024. Wiley. http://dx.doi.org/10.1111/1471-0528.17973. Disponível em: https://pubmed.ncbi.nlm.nih.gov/39373298/. Acesso em: 10 fev. 2026. DOI: https://doi.org/10.1111/1471-0528.17973 DANTKALE, Ketki s; AGRAWAL, Manjusha. A Comprehensive Review of the Diagnostic Landscape of Endometriosis: assessing tools, uncovering strengths, and acknowledging limitations. Cureus, [S.L.], vol. 16, n.3, 2024. Springer Science and Business Media LLC. http://dx.doi.org/10.7759/cureus.56978. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC11045176/. Acesso em: 31 ago. 2025. DOI: https://doi.org/10.7759/cureus.56978 FEBRASGO, Federação Brasileira das Associações de Ginecologia e Obstetrícia. Endometriose. São Paulo: FEBRASGO, 2021 (Protocolo FEBRASGO-Ginecologia, n. 78/Comissão Nacional Especializada em Endometriose). Disponível em: https://sogirgs.org.br/area-do-associado/Endometriose-2021.pdf. Acesso em: 05 set. 2025. FEBRASGO, Federação Brasileira das Associações de Ginecologia e Obstetrícia. Endometriose/Endometriosis. Femina, v.53, n. 6, 2025. Disponível em: https://docs.bvsalud.org/biblioref/2025/09/1619916/femina-2025-536-853-858.pdf. Acesso em: 18 fev. 2026. DOI: https://doi.org/10.61622/0100-7254536202511 FERREIRA, Emilli Fraga et al. Avaliação do perfil clínico e aspectos da ressonância nuclear magnética de pacientes com suspeita de endometriose no sul de Santa Catarina. Revista da AMRIGS, v. 66, n. 1, p 226-233, mar. 2022. Disponível em: https://docs.bvsalud.org/biblioref/2023/03/1424991/39_2542_revista-amrigs.pdf. Acesso em: 10 fev. 2026. IMPERIALE, Ludovica et al. Three Types of Endometriosis: pathogenesis, diagnosis and treatment. state of the art. Journal Of Clinical Medicine, [S.L.], v. 12, n. 3, p. 994-000, 28 jan. 2023. MDPI AG. http://dx.doi.org/10.3390/jcm12030994. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC9918005/#sec3-jcm-12-00994. Acesso em: 07 jun. 2026. DOI: https://doi.org/10.3390/jcm12030994 LEGATTI, Julia Nascimento; OLIVEIRA, Rúbia Carla. A ESTREITA RELAÇÃO ENTRE ENDOMETRIOSE E INFERTILIDADE FEMININA. Coletânea de Trabalhos Acadêmicos do Grupo Estudantil de Ensino, Pesquisa e Iniciação Científica (GEEPIC) do Centro Universitário de Patos de Minas (Unipam), [S.L.], p. 80-89, 30 out. 2022. Amplla Editora. http://dx.doi.org/10.51859/amplla.cta822.1122-9. Disponível em: https://books.google.com.br/books?hl=pt-BR&lr=&id=xMWZEAAAQBAJ&oi=fnd&pg=PA80&dq=endometriose+%C3%A9+infertilidade&ots=Ggq6c2NEXj&sig=KgHaq2rUtdRjCKrYxpeDyyUm0LI#v=onepage&q=endometriose%20%C3%A9%20infertilidade&f=false. Acesso em: 31 jul. 2025. LI, Wenwei; FENG, Huiyan; YE, Qingjian. Factors contributing to the delayed diagnosis of endometriosis - a systematic review and meta-analysis. Front. Med, p 1-14, 2025. Disponível em: https://pubmed.ncbi.nlm.nih.gov/40766070/. Acesso em: 10 fev.2026. MICK, Ido et al. Comprehensive endometriosis care: a modern multimodal approach for the treatment of pelvic pain and endometriosis. Sage Journals, v. 18, p 1-23, 2024. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC11457249/. Acesso em: 23 fev. 2026. DOI: https://doi.org/10.1177/26334941241277759 MOURA, Alessandra Isabella Santiago Silva; GURGEL, Sylvia Pereira; CHAGAS, Luccas Melo. Métodos de diagnóstico e tratamento da endometriose: uma revisão baseada em evidências científicas. Revista Jrg de Estudos Acadêmicos, [S.L.], v. 7, n. 15, p. 1-16, 14 out. 2024. Revista JRG de Estudos Academicos. http://dx.doi.org/10.55892/jrg.v7i15.1456. Disponível em: https://revistajrg.com/index.php/jrg/article/view/1456. Acesso em: 05 set. 2025. DOI: https://doi.org/10.55892/jrg.v7i15.1456 MUNN, Zachary et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. Bmc Medical Research Methodology, [S.L.], v. 18, n. 1, p. 1-7, 19 nov. 2018. Springer Science and Business Media LLC. http://dx.doi.org/10.1186/s12874-018-0611-x. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30453902/. Acesso em: 29 ago. 2025. DOI: https://doi.org/10.1186/s12874-018-0611-x MUTTA, Danielle et al. Avaliação da espessura endometrial e sintomas de dor em mulheres com endometriose profunda usando dienogeste: coorte retrospectiva. Brazilian Journal Of Pain, [S.L.], v. 8, p. 1-5, 2025. Sociedade Brasileira para o Estudo da Dor. http://dx.doi.org/10.63231/2595-0118.20250042-pt. Disponível em: https://www.scielo.br/j/brjp/a/gLgRvS5cXkr7n7WgTvnPWxb/?format=html&lang=pt. Acesso em: 22 fev. 2026. DOI: https://doi.org/10.63231/2595-0118.20250042-pt NUNES, Bibiana Carneiro Monteiro et al. Abordagem multidisciplinar no manejo da endometriose: desafios no diagnóstico e tratamento. Brazilian Journal Of Implantology And Health Sciences, [S.L.], v. 7, n. 2, p. 213-222, 3 fev. 2025. Brazilian Journal of Implantology and Health Sciences. http://dx.doi.org/10.36557/2674-8169.2025v7n2p213-222. Disponível em: https://bjihs.emnuvens.com.br/bjihs/article/view/5106. Acesso em: 05 set. 2025. OLIVEIRA, Hillary Gabriela dos Santos et al. Prevalência dos sintomas dolorosos em mulheres com endometriose em uma capital do nordeste brasileiro. Revista Brasileira de Enfermagem - Universidade Estadual do Rio de Janeiro, v. 32, p 1-7, out. 2024. Disponível em: https://www.e-publicacoes.uerj.br/enfermagemuerj/article/view/80769/52134. Acesso em: 18 fev. 2026. DOI: https://doi.org/10.12957/reuerj.2024.80769 OLIVEIRA, Inês Jerónimo; PINTO, Pedro Viana; BERNARDES, João. Noninvasive Diagnosis of Endometriosis in Adolescents and Young Female Adults: A Systematic Review. Journal of Pediatric & Adolescent Gynecology, v. 38, n 2, p 124-138, abr. 2025. Disponível em: https://pubmed.ncbi.nlm.nih.gov/39098544/. Acesso em: 10 fev. 2026. DOI: https://doi.org/10.1016/j.jpag.2024.07.005 PANNAIN, Gabriel Duque et al. Perfil Epidemiológico e Assistência Clínica a Mulheres com Endometriose em um Hospital Universitário Público Brasileiro. Femina, Juiz de Fora, v. 50, n. 3, p. 178-183, jan. 2022. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1367572. Acesso em: 30 ago. 2025. PODGAEC, Sérgio et al. Endometriose. Femina, São Paulo, v. 48, n. 4, p. 233-237, 2020: Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo); 2018. (Protocolo Febrasgo – Ginecologia, nº 32/Comissão Nacional Especializada em Endometriose). Disponível em: https://docs.bvsalud.org/biblioref/2020/05/1096077/femina-2019-484-233-237.pdf. Acesso em: 05 set. 2025. PRUDÊNCIO, Aline de Oliveira Menck et al. TRATAMENTOS DA ENDOMETRIOSE E SUA DISPONIBILIDADE NO SISTEMA ÚNICO DE SAÚDE REVISÃO INTEGRATIVA. Saúde da Mulher - Edição XI, [S.L.], p. 235-244, 30 jul. 2023. http://dx.doi.org/10.59290/978-65-6029-013-6.25. Disponível em: https://sistema.editorapasteur.com.br/uploads/pdf/publications_chapter/TRATAMENTOS%20DA%20ENDOMETRIOSE%20E%20SUA%20DISPONIBILIDADE%20NO%20SISTEMA%20ÚNICO%20DE%20SAÚDE%20REVISÃO%20INTEGRATIVA-7430cad6-31b2-44c2-88b5-3a409cc4d20b.pdf. Acesso em: 29 ago. 2025. QUADROS, Bárbara Ferreira et al. Perspectiva epidemiológica da morbidade hospitalar por endometriose em mulheres brasileiras de 2019 a 2023. Brazilian Journal Of Implantology And Health Sciences, [S.L.], v. 6, n. 7, p. 1263-1275, 13 jul. 2024. Brazilian Journal of Implantology and Health Sciences. http://dx.doi.org/10.36557/2674-8169.2024v6n7p1263-1275. Disponível em: https://bjihs.emnuvens.com.br/bjihs/article/view/2527. Acesso em: 25 ago. 2025. DOI: https://doi.org/10.36557/2674-8169.2024v6n7p1263-1275 RANGI, Sabrina et al. Fertility Preservation in Women with Endometriosis. Journal of Clinical Medicine, v. 12, n. 13, jun. 2023. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC10342469/. Acesso em: 23 fev. 2026. DOI: https://doi.org/10.3390/jcm12134331 . RIBEIRO, Victoria Régia Ferreira da Silva et al. AVANÇOS NO DIAGNÓSTICO PRECOCE DA ENDOMETRIOSE: métodos e desafios. Brazilian Journal Of Implantology And Health Sciences, [S.L.], v. 6, n. 7, p. 3281-3291, 31 jul. 2024. Brazilian Journal of Implantology and Health Sciences. http://dx.doi.org/10.36557/2674-8169.2024v6n7p3281-3291. Disponível em: https://bjihs.emnuvens.com.br/bjihs/article/view/2742/2947. Acesso em: 05 set. 2025. SILVA, Julio Cesar Rosa et al. Endometriose - Aspectos Clínicos do Diagnóstico ao Tratamento. Femina, Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO), Ribeirão Preto, São Paulo, v. 49, n. 3, p. 1-68, mar. 2021. Disponível em: www.febrasgo.org.br/media/k2/attachments/FeminaZ2021Z49Z-Z3.pdf. Acesso em: 25 ago. 2025. SILVA, Carla Marins et al. Experiências das mulheres quanto às suas trajetórias até o diagnóstico de endometriose. Escola Anna Nery, [S.L.], v. 25, n. 4, p. 1-9, fev. 2021. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/2177-9465-ean-2020-0374. Disponível em: https://www.scielo.br/j/ean/a/NTzvkB8pddYxGKX5xq5ywJb/?format=html&lang=pt. Acesso em: 27 ago. 2025. DOI: https://doi.org/10.1590/2177-9465-ean-2020-0374 SOMBRA, Mirella Pascoal Pereira; SILVA JÚNIOR, José Antonio; NASCIMENTO, Ellany Gurgel Cosme do. A endometriose e sua realidade epidemiológica no Nordeste Brasileiro. Medicina (Ribeirão Preto), [S.L.], v. 57, n. 2, p. 1-13, 13 dez. 2024. Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais. http://dx.doi.org/10.11606/issn.2176-7262.rmrp.2024.214123. Disponível em: https://revistas.usp.br/rmrp/pt_BR/article/view/214123. Acesso em: 18 fev. 2026. DOI: https://doi.org/10.11606/issn.2176-7262.rmrp.2024.214123 The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2015 edition. Disponível em: https://reben.com.br/revista/wp-content/uploads/2020/10/Scoping.pdf. Acesso em: 29 ago. 2025. TOCZEK, Jakub et al. Endometriosis: new perspective for the diagnosis of certain cytokines in women and adolescent girls, as well as the progression of disease outgrowth. International Journal Of Environmental Research And Public Health, [S.L.], v. 18, n. 9, p. 4726, 29 abr. 2021. MDPI AG. http://dx.doi.org/10.3390/ijerph18094726. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33946650/. Acesso em: 29 jan. 2026. DOI: https://doi.org/10.3390/ijerph18094726 TRONCON, Júlia Kefalás et al. Importance of an Interdisciplinary Approach in the Treatment of Women with Endometriosis and Chronic Pelvic Pain. Revista Brasileira de Ginecologia e Obstetrícia / Rbgo Gynecology And Obstetrics, [S.L.], v. 45, n. 11, p. 635-637, nov. 2023. Federação das Associações de Ginecologia e Obstetrícia. http://dx.doi.org/10.1055/s-0043-1777001. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38029764/. Acesso em: 29 jan. 2026. DOI: https://doi.org/10.1055/s-0043-1777001 TSAMANTIOTI, Eleni S.; MAHDY, Heba. Endometriosis. StatPearls, Ilha do Tesouro (FL), 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33620854/. Acesso em: 05 set. 2025. WAHL, Kate et al. Does Menstrual Health and Endometriosis Education Affect Knowledge Among Middle and Secondary School Students? A Cluster-Randomised Controlled Trial. Journal of Obstetrics and Gynaecology Canada, v. 46, n.8, p 1-8, ago. 2024. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38871121/. Acesso em: 16 jan. 2026. DOI: https://doi.org/10.1016/j.jogc.2024.102583 WANG, Peng-Hui et al. Endometriosis: part i. basic concept. Taiwanese Journal Of Obstetrics And Gynecology, [S.L.], v. 61, n. 6, p. 927-934, nov. 2022. Elsevier BV. http://dx.doi.org/10.1016/j.tjog.2022.08.002. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36427994/. Acesso em: 10 fev. 2026. DOI: https://doi.org/10.1016/j.tjog.2022.08.002 YOUNG, Steven L. Nonsurgical approaches to the diagnosis and evaluation of endometriosis. Fertility and Sterility, 2024. Elsevier BV. Disponivel em: https://pubmed.ncbi.nlm.nih.gov/38103884/. Acesso em: 29 jan. 2026. Downloads Published Issue Section License Copyright (c) 2026 Thainara Monique Rodrigues Barboza, Amanda Namíbia Pereira Pasklan, Jomar Diogo Costa Nunes, Rosana Maria Paixão Castello Branco, Kezia Cristina Batista dos Santos This work is licensed under a Creative Commons Attribution 4.0 International License. Authors who publish in this journal agree to the following terms: Authors retain copyright and grant the journal the right of first publication, with the work simultaneously licensed under the Creative Commons Attribution License, which permits the sharing of the work with proper acknowledgment of authorship and initial publication in this journal; Authors are authorized to enter into separate, additional agreements for the non-exclusive distribution of the version of the work published in this journal (e.g., posting in an institutional repository or publishing it as a book chapter), provided that authorship and initial publication in this journal are properly acknowledged, and that the work is adapted to the template of the respective repository; Authors are permitted and encouraged to post and distribute their work online (e.g., in institutional repositories or on their personal websites) at any point before or during the editorial process, as this may lead to productive exchanges and increase the impact and citation of the published work (see The Effect of Open Access); Authors are responsible for correctly providing their personal information, including name, keywords, abstracts, and other relevant data, thereby defining how they wish to be cited. The journal’s editorial board is not responsible for any errors or inconsistencies in these records. PRIVACY POLICY The names and email addresses provided to this journal will be used exclusively for the purposes of this publication and will not be made available for any other purpose or to third parties. Note: All content of the work is the sole responsibility of the author and the advisor.