New research reveals Associations between several sociodemographic factors and endometriosis symptoms

Endometriosis is overlooked and underdiagnosed reflected by
a prevalence of hospital-diagnosed endometriosis in Denmark. In addition, the
time from symptom presentation to diagnosis can be 7–10 years. This could be
due to women’s inaccurate pain perceptions, societal normalization of pain,
stigma around menstrual issues, insufficient knowledge and normalization of
symptoms among physicians

The pathogenesis of endometriosis is related to multiple interwoven
processes, involving genetic and epigenetic predisposition. This could partly
explain why the prevalence of hospital-diagnosed endometriosis has been found
to vary based on sociodemographic factors such as age, socioeconomic status,
race/ethnicity, and geographic region. Whether this can be explained by actual
differences in the prevalence of endometriosis and/or disparities in diagnostic
access due to healthcare systems, awareness of symptoms, and personal resources
is still unknown.

Investigating the prevalence of endometriosis symptoms and
indicators, and their distribution across sociodemographic factors may therefore
bring new insights that can help guide future interventions aimed at decreasing
underdiagnosis and diagnostic delay. Therefore, a study aimed to estimate the
prevalence and sociodemographic distribution of endometriosis symptoms and
indicators in Denmark.

The study used data from the CYKLUS-survey; a women’s health
survey sent to 63,199 Danish women aged 16 to 51 in 2023. Self-reported
information on endometriosis symptoms and indicators was linked to Danish
register data on sociodemographic factors. Age-standardized prevalence of six
endometriosis symptoms and indicators were estimated for each of the nine
different regions of residence and for the whole country. In addition, logistic
regression analysis was used to estimate the association between sociodemographic
factors and the six endometriosis symptoms and indicators.

11,407 women were included in the study. Age-standardized
prevalence of symptoms showed little variation across Danish regions. However,
younger age, lower socioeconomic status, and non-Danish origin were found to be
associated with higher prevalences, and higher education was found to be
associated with lower prevalences.

This study did not find regional differences in the
prevalence of endometriosis symptoms in Denmark, as the distribution of
symptoms across regions only showed small, non-significant differences. Yet,
several sociodemographic factors were associated with the prevalence of
endometriosis symptoms explored. Women with higher educational levels were less
likely to report symptoms, except difficulties becoming pregnant. The odds of
reporting all symptoms were higher among women of younger age and of lower SES.
Associations between endometriosis symptoms and parity, origin, and household
composition were also found, but with a mixed pattern.

Several sociodemographic factors were associated with
endometriosis symptoms and indicators. Younger women were more likely to report
symptoms compared to older age groups. Women with lower education, lower SES,
and immigrants and descendants of immigrants, had higher odds of reporting
various symptoms and indicators. Contrary to regional disparities in the
incidence of hospital-based diagnoses of endometriosis across Denmark, no major
differences were observed in the geographical distribution of symptom
prevalence. Altogether these findings suggest an inequitable sociodemographic
burden of endometriosis symptoms, warranting further investigation into these
disparities.

Source: M. Josiasen et al.; European Journal of Obstetrics
& Gynecology and Reproductive Biology 307 (2025) 109–120