New ACOG guidelines may help change, shorten endometriosis diagnosis times

• Past research shows that a majority of endometriosis cases are misdiagnosed with other physical health or mental health issues.
• ACOG recently issued updated endometriosis clinical guidelines that, for the first time, offer comprehensive commendations for diagnosing endometriosis.
• The updated guidelines also address barriers to endometriosis care from racial and gender-identity bias, and emphasize the importance of shared decision making between the doctor and patient in endometriosis care.

According to the World Health Organization (WHO), about 190 million reproductive-age women around the world have endometriosis — an inflammatory condition where tissue that is similar to what lines the uterus also grows outside of the uterus and on other pelvic organs such as the ovaries or fallopian tubes.

Historically, endometriosis has been hard to diagnose because many of its symptoms, such as pain during the menstrual cycle or sex, chronic fatigue, nausea, and constipation vary and are shared with several other conditions, such as irritable bowel syndrome (IBS), ovarian cysts, and pelvic inflammatory disease (PID).

Past research shows that as much as 75% of endometriosis cases are misdiagnosed with other physical health or mental health issues.

“Patients with endometriosis can experience significant delays in diagnosis,” Bliss Kaneshiro, MD, MPH, FACOG, professor in the Department of Obstetrics, Gynecology, and Women’s Health in the John A. Burns School of Medicine at the University of Hawaiʻi at Mānoa in Hawaii, told Medical News Today.

“For some, it takes years of experiencing pain before [an endometriosis] diagnosis is made. During this time, some patients can experience progression of disease which can affect their quality of life. Guidance that leads to quicker diagnosis can assist providers helping patients in a more timely manner.”
— Bliss Kaneshiro, MD, MPH, FACOG

Kaneshiro is one of the authors of updated endometriosis clinical guidelines issued by the American College of Obstetricians & Gynecologists (ACOG). For the first time, these guidelines offer comprehensive recommendations for diagnosing endometriosis.

The updated guidelines also address barriers to endometriosis care arising from racial and gender-identity bias, and emphasize the importance of shared decision making between the doctor and patient in endometriosis care.