Why Does It Take 7–10 Years for Women to Get an Endometriosis Diagnosis?

When I was a second-year doctor working in the emergency department, my senior turned to me and said, “The next patient is a reattender. She’s opiate-seeking for ‘period pain’”. It was said in that familiar, dismissive tone. The kind that suggests the story is already written before you’ve even met the patient. Opiate-seeking. Even now, that phrase is often shorthand for ‘addict’. I walked into the cubicle carrying that bias.

She told me she had endometriosis. I remember internally questioning it. How bad could period pain really be? If her scans were normal, how severe could this disease actually be? I didn’t say those thoughts out loud. But I had them.

Years later, after working in women’s health and listening to hundreds of stories like hers, I think about that encounter often. She wasn’t drug-seeking. She was exhausted. She was in pain. She wanted someone to take her seriously. How many years had it taken for her symptoms

On average, it takes 7–10 years to diagnose endometriosis, despite affecting 1 in 10 women of reproductive age. That number still stops me. Why does it take so long?

Endometriosis is common. But it doesn’t present neatly.

Symptoms vary. Severe period pain. Chronic pelvic pain. Pain during sex. Pain opening bowels. Fatigue that flattens you. Difficulty conceiving. Some women are bed-bound for days every month. Others push through work and childcare, then collapse quietly at home.

There isn’t a simple blood test. No screening tool we can reliably use in primary care. Imaging helps sometimes, but not consistently. And layered on top of that is something harder to measure: how we’ve been taught to think about period pain.

Many women grow up hearing the same messages:

“Periods are supposed to hurt”

“It’s just part of being a woman”

“Everyone gets cramps”

“You’re probably just sensitive”

So they normalise it.

Missing school every month becomes routine. Vomiting from pain becomes “unlucky”. Fainting is brushed off. Being unable to stand upright is framed as dramatic.

But when pain is minimised early in life, women often delay seeking help. And when they do seek help, they sometimes underplay it. Clinicians - influenced by the same cultural messaging - may unintentionally do the same.

Prescribe the pill. Try stronger pain relief. See how it goes. If symptoms improve a little, the search often stops. If they don’t, patients are passed between specialties - gastroenterology, urology, emergency care - before someone considers endometriosis seriously.

Then there’s imaging. One of the most difficult conversations I have in clinic is explaining that a normal scan doesn’t rule it out. Standard pelvic ultrasound frequently misses superficial disease. MRI is better for deep infiltrating endometriosis in experienced hands, but it isn’t definitive. The gold standard remains laparoscopic surgery - and surgery isn’t something patients walk into lightly.

So women are left in this strange space: severe symptoms, normal results.

That gap can do real psychological harm. I’ve had patients tell me they started wondering if they were imagining it. Some were told it was IBS. Or stress. Or anxiety.

When tests are reassuring but life is not, people begin to doubt themselves.

If you suspect endometriosis and you’ve been told everything is normal, don’t ignore what your body is telling you. Keep a record of symptoms. Write down how many days of work you miss. Note bowel or bladder pain, pain during sex, how often you rely on strong analgesia. Patterns matter more than isolated appointments.

Ask for referral to a gynaecologist, ideally someone with a specific interest in endometriosis. Not all clinicians see it regularly. That isn’t a criticism - it’s just reality. And be clear about impact. Pain scores are useful, but “I can’t function for three days a month” is often more powerful than “it’s an eight out of ten”.

I think back to that woman in the emergency department. I don’t remember every clinical detail. I remember her expression though - tired, defensive, used to not being believed. I wonder how many years it took for her to be heard.

Seven to ten years is not just a statistic. It’s years of education disrupted. Careers slowed. Relationships strained. Fertility plans complicated. Confidence eroded.

Endometriosis is common. The delay in diagnosis shouldn’t be. As women, we must challenge the narrative that severe period pain is ‘normal’. As a society, we must stop trivialising women’s symptoms. And as doctors, we must agree that a normal scan does not equal a normal life.

And finally, I’d like to dedicate this to Sarah Fraichit, for the strength and resilience you show every day.

// Dr. Tamara Aldawery

Acting Director of Dubai Hills Clinic, Primary Care Physician. American Hospital Dubai