# Pathways to Diagnosis of Endometriosis among Women of Different Socioeconomic Statuses and Races

> **NIH NIH F31** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $35,012

## Abstract

PROJECT SUMMARY/ABSTRACT
An estimated 5-10% of reproductive age women have endometriosis. Despite the profound negative effects of
this chronic condition on individual functioning and quality of life, diagnosis can take years or decades. During
this time of delayed diagnosis, women suffer from chronic pelvic pain, menstrual irregularity, pain with
intercourse and infertility among other physical symptoms. They also report psychological suffering in the form
of social isolation, anxiety and depression. These overwhelming symptoms affect their work productivity and
result in high medical costs and substantially diminished quality of life. The high bar for definitive diagnosis,
surgical assessment with histological confirmation, leaves women without access to care with longer delays in
diagnosis. Women of lower SES and minority races have been conspicuously underrepresented in
endometriosis research. Although there have been studies to examine the experiences of women with
endometriosis and delay in diagnosis, there is a large gap in the literature regarding the diagnostic pathways
women travel and the pre-diagnostic period especially among lower SES and non-white women in the United
States. This study will apply a life course perspective to a diverse sample of women to examine patient
behavioral and environmental factors influencing symptom recognition, health maintenance and help-seeking
to better understand the pathways to diagnosis experienced by women with endometriosis. Aim one proposes
to map pathways to diagnosis using qualitative interviews and analysis informed by a life course perspective
through two sub-aims. This will be accomplished by (1) describing pathways and experiences of the women’s
symptom recognition, appraisal and management and (2) identifying differences in pathways and experiences
among a socio-economically and racially diverse group of women. Furthermore, this study is innovative in
considering the perception of women with regard to the time to diagnosis and its implications for their lives. Aim
two will determine the factors and symptoms shared among women who perceived the time to diagnosis as
timely and to those who perceived the time as delayed. Understanding pathways to diagnosis across SES and
race for women in the United States is vital to helping them to recognize symptoms and seek help for a timely
diagnosis.

## Key facts

- **NIH application ID:** 9985607
- **Project number:** 5F31NR018786-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Martha Grace Cromeens
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $35,012
- **Award type:** 5
- **Project period:** 2019-08-01 → 2021-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985607

## Citation

> US National Institutes of Health, RePORTER application 9985607, Pathways to Diagnosis of Endometriosis among Women of Different Socioeconomic Statuses and Races (5F31NR018786-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9985607. Licensed CC0.

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