Maryam Moradi - Department of Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Azin Niazi - Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Melissa Parker - Endometriosis Centre, Canberra Hospital, Canberra, Australia
Anne Sneddon - Department of Obstetrics and Gynecology, School of Medicine, Griffith University, Gold Coast, Australia
Violeta Lopez - Chair Professor, School of Nursing, Hubei University of Medicine, Shiyan, China
David Ellwood - Department of Obstetrics and Gynecology, School of Medicine, Griffith University, Gold Coast, Australia

Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey. Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed using the STATA software (version ۱۴.۱). A total of ۹۰۳ respondents completed an online survey from September ۲۰۱۳ to October ۲۰۱۵. Results: Out of ۹۰۳, ۷۱.۱۰% were Australians and ۲۸.۹۰% were Non-Australian, with a self-reported diagnosis of endometriosis confirmed by surgery. Out of the participants, ۸۶.۵% completed the online survey. Delay in diagnosis was ۸.۱±۶.۲ years. There was no difference in the age range (P = ۰.۳۵), mean age of onset of the first symptoms (P = ۰.۹۳), and delay in diagnosis (P = ۰.۱۱) between both groups. Most common endometriosis-related symptoms that all respondents had experienced in their lifetime were period pain (۹۸.۱%), fatigue (۹۴%), bloating (۹۰.۷%), ovulation pain (۸۸.۷%), pelvic pain (۸۷.۳%), pain during and before/after sexual activity (۸۲.۷%), and heavy bleeding (۸۲.۲%). Treatments used by affected women included: pain killers (۹۶%), hormonal medication (۸۴.۷%), surgical treatments (۸۴.۵%), and delayed fertility (۳۷.۱%). Conclusion: Vast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be understood to try to shorten this delay. Besides pain, patients with endometriosis suffer from a variety of other symptoms; hence, any treatment must take into account the most prominent symptoms.

Diagnosis, Diagnostic Delay, Endometriosis, Symptoms