Exploring delay to diagnosis of endometriosis, a healthcare professional perspective

TL;DR

This study explores why endometriosis diagnosis is delayed, focusing on healthcare professionals' perspectives in the UK.

Contribution

The study provides new insights into healthcare professionals' perceptions of diagnostic delays in endometriosis.

Findings

Three themes emerged: symptom masking, the role of a witness in diagnosis, and barriers to reaching a diagnosis.

The presence of a third party, often a male partner, can legitimize symptoms and influence diagnostic decisions.

Healthcare professionals should reflect on their biases and the influence of others during consultations.

Abstract

Delay to diagnosis of endometriosis is an increasing problem. As it stands, the mean delay to diagnosis time is nine years. There is limited research exploring the perceptions of healthcare professionals regarding the diagnosis and respective delay to diagnosis of endometriosis in the United Kingdom. This study aims to explore this further.

This study used an interpretive qualitative approach involving healthcare professional perspectives on reasons for delay to diagnosis of endometriosis. A series of focus group interviews with 15 healthcare professionals (General Practitioners (GP), gynaecologists and nurses) were conducted to explore their experiences of (the pathway to) diagnosing endometriosis. The data were analysed using reflexive thematic analysis.

Three main themes were identified: (1) masking and unmasking the symptoms, (2) power of the witness in diagnosis and (3) experiences that hinder the threshold to diagnosis. The presence of the patient alone is not always enough to facilitate a diagnosis, and as such, the presence of another individual, quite often a male partner enables the threshold to referral and diagnosis to be crossed.

Healthcare professionals in this study described how endometriosis is often masked or rendered invisible, and how the presence of another person—most often a male partner—can legitimise symptom severity and influence referral decisions. Healthcare professionals should consider reflecting on how another individual in a consultation influences their thinking process regarding the diagnostic journey of an individual with suspected endometriosis. They should also consider their own preconceptions of endometriosis as an illness to explore how best they can support individuals with suspected endometriosis. These practical suggestions can be used to reduce the delay to diagnosis of endometriosis and bring positive change to the diagnostic process of people living with endometriosis.

Not applicable.