Interactive guide
Check your symptoms.
Build a list to bring to your provider, including other conditions they should rule out.
Open the guide →State by state
Endometriosis news where you live.
Pick any US state for local reporting from vetted outlets.
Choose a state →By the numbers
Endometriosis and reproductive health in numbers
Figures on prevalence, diagnosis and access to care.
190million
women and girls of reproductive age live with endometriosis worldwide, roughly 1 in 10.
Explore the endometriosis hub →Source: WHO fact sheet, updated 20257years
median wait from first symptoms to a confirmed endometriosis diagnosis, and up to a decade in many countries.
Learn the symptoms to name →Source: BJOG systematic review; RBMO, 202523%
of US women who saw a provider in the past two years say they were treated unfairly or with disrespect, more often than men.
Prepare for your appointment →Source: KFF Women's Health Survey, Mar 202541%
of US women of reproductive age, more than 31 million, live in the 22 states where abortion is banned or under threat.
Look up your state →Source: National Partnership for Women & Families, Jun 20251 in 10
women of reproductive age are affected by PCOS; up to 70% remain undiagnosed.
Read the WHO fact sheet →Source: WHO fact sheet, updated 20251 in 6
people of reproductive age experience infertility at some point in their lives.
Track fertility coverage law →Source: WHO first global infertility guideline, Nov 2025Access to care
Barriers to diagnosis and treatment
Clinic availability, legal restrictions and the response to reported pain affect access to care.
- 1
Lack of care
Clinic closures, specialist shortages and insurance gaps can make gynecologic care harder to find.
- 2
Loss of autonomy
State restrictions can limit the care patients and doctors may choose, including miscarriage care and fertility treatment.
- 3
Medical neglect
Women report being dismissed more often than men in healthcare settings. When pain is dismissed, patients may wait longer for evaluation and treatment.
Follow the policy →
The economic toll
What endometriosis costs, in plain terms
Years spent waiting for answers carry costs in lost work, lost income and interrupted careers.
$997every 6 months
added healthcare costs while endometriosis goes undiagnosed, for as long as the wait lasts.
Source: npj Digital Medicine US model, 2026 →
$6,829at diagnosis
estimated added cost of reaching an endometriosis diagnosis along the current US care pathway.
Source: npj Digital Medicine US model, 2026 →
$2,896for treatment
estimated added healthcare cost of treatment after diagnosis in the same US model.
Source: npj Digital Medicine US model, 2026 →
$1,392every 6 months
estimated productivity lost after diagnosis and treatment, per patient, in the same US model.
Source: npj Digital Medicine US model, 2026 →
Total, United States
$78 to $119 billiona year
Estimated annual US cost of endometriosis, combining healthcare and productivity losses, reaffirmed in the 2026 npj Digital Medicine model (npj Digital Medicine, 2026; Ellis, Munro and Clarke, 2022).
Per woman, Europe
€9,579a year
Average annual cost per woman across ten European countries, with productivity losses making up about two thirds (Simoens et al., Human Reproduction, 2012) and up to 75% of total costs in earlier reviews (Simoens et al., Human Reproduction Update, 2007).
Pregnancy loss
The costs continue after the long wait for a diagnosis. Across 28 studies, endometriosis carries a 31% higher relative risk of miscarriage (Wang et al., 2021). A Swiss study found a 35.8% miscarriage rate among pregnant women with endometriosis versus 22.0% without, rising to 50% among those who struggled to conceive (Kohl Schwartz et al., 2017). A Danish nationwide cohort links endometriosis to both pregnancy loss and recurrent pregnancy loss (Boje et al., 2023). Meta-analyses of assisted and spontaneous conceptions reach the same conclusion, though individual studies differ (Huang et al., 2020; Zullo et al., 2017).
The essay · Marigny deMauriac
$100 billionin estimated annual costs
The $100 Billion Blind Spot: endometriosis as an economic issue
Endometriosis costs the US economy an estimated $100 billion a year, yet it rarely enters conversations about women's pay, careers or retirement. A patient spends about $6,829 in the year of diagnosis alone, and roughly $1,392 in lost productivity every six months. Marigny deMauriac writes about those costs and her own wait for diagnosis and surgery.
Read the full essay →It starts early
Symptoms can begin before a first period.
Symptoms can appear before menarche. A published case documents cyclical pain beginning at age 8.
Age 8
Premenarcheal symptoms. Young patients can have pelvic pain and cyclical inflammation linked to endometriosis before periods begin; one confirmed case had cyclic pain from age 8.
Source: Ebert et al., Histological confirmation in a 9-year-old0 to 6 mo
Onset around the first period. Disease can develop at menarche or within the first months after, which is why severe early cramps deserve a closer look.
Source: Marsh & Laufer, Fertility and Sterility; Dessole et al., 201266%
of people with endometriosis report symptoms before age 20, and 21% before age 15.
Source: Endometriosis Association surveyFurther reading: Endometriosis in premenarcheal girls (Fertility and Sterility); Brosens et al., adolescent endometrioma.
The training gap
Doctors are not taught enough about endometriosis or menopause.
Part of the long wait for a diagnosis starts in medical training. Surveys of US residency programs show how little time goes to these conditions.
31%
of US OB-GYN residency programs have a menopause curriculum. 83 of 99 program directors said they need more teaching materials.
Source: Allen et al., Menopause, 202356%
of US family medicine residency directors say menopause teaching needs to improve. Class time is limited and what gets covered varies by program.
Source: O'Dwyer et al., Menopause, 202658.5%
of colorectal surgeons and surgery fellows surveyed had no formal training on bowel endometriosis.
Source: Rivera Ortiz & Mahnert, AJOG, 2024For context: in 2013, only 20.8% of OB-GYN residents said their program had a formal menopause curriculum (The Menopause Society). A decade later the figure had barely moved. Further reading: OB-GYN residents' comfort with endometriosis care (2023).
Latest stories
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Patient resources
Where to get help
- Patient support
Endometriosis Foundation of America
Patient education, surgeon directories and the annual medical conference archive.
- Patient support
Endometriosis Association
The oldest US patient organisation: support network, research funding and a long-running patient registry.
- Clinical
ACOG patient guidance
The American College of Obstetricians and Gynecologists' FAQ on diagnosis, pain management and surgery.
- Research
NICHD endometriosis research
Federal research summaries, causes, treatments and open studies.
- Pain management
International Pelvic Pain Society
US-based patient library on pelvic pain, physiotherapy and multidisciplinary care.
- Get involved
ClinicalTrials.gov
Every recruiting US endometriosis study, searchable by state.
Support groups
You don't have to do this alone
National networks, community groups and moderated online spaces for people living with endometriosis. Peer support is not medical advice.
- National
Endometriosis Association support
Long-running US patient network with education and peer support.
- National
EndoFound patient support
Support resources and connections from the Endometriosis Foundation of America.
- Online
Endometriosis.net community
Patient-written stories and an active community forum for questions and support.
- Community
Endo Black
Support and advocacy centering Black women and people living with endometriosis.
- Online
Nancy's Nook Endometriosis Education
Large moderated patient education group focused on excision surgery and informed care.
- Online
Inspire endometriosis community
Moderated online health communities where patients share experiences and questions.
Treatment guides
What good care looks like
The guidelines your clinician is working from, plus plain-language explainers on surgery, pain and fertility. Not medical advice, reading material for better appointments.
- Standard of care
ACOG diagnosis guideline
ACOG's 2026 recommendations for clinical, imaging and surgical evaluation of endometriosis.
- Standard of care
ASRM patient guide
The American Society for Reproductive Medicine's evidence summary on diagnosis, treatment and fertility.
- Surgery
Excision vs. ablation explained
What the two main surgical approaches actually remove, and the questions to ask a surgeon before consenting.
- Pain management
Pelvic pain physiotherapy
International Pelvic Pain Society patient library on physio, nerve pain and multidisciplinary care.
- Fertility
Fertility and endometriosis
ASRM's patient guide to conception odds, IVF timing and when surgery helps or hurts fertility.
Advocacy
Groups pushing for change
- Campaigning
Endometriosis Coalition
Awareness campaigning and a directory of patient-led groups across the US.
- Research funding
Endometriosis Association
The oldest patient organisation, funding research and maintaining a long-running patient registry.
- Policy
EndoFound advocacy
School-curriculum work and legislative pushes for earlier diagnosis in the US.
- Get involved
ClinicalTrials.gov
Where to find recruiting US studies if you want to take part in research.
Glossary
Endo terms, decoded
- Adenomyosis
- Endometrial-like tissue growing inside the muscular wall of the uterus. Often occurs alongside endometriosis and causes heavy, painful periods.
- Laparoscopy
- Keyhole surgery through small abdominal incisions. Still the only way to confirm many cases of endometriosis, and the route used to treat lesions.
- Excision
- Cutting lesions out at the root, including the tissue beneath. Generally associated with lower recurrence than burning the surface.
- Ablation
- Burning or vaporising the visible surface of a lesion. Faster than excision, but deeper disease can be left behind.
- Deep infiltrating endometriosis (DIE)
- Lesions penetrating more than 5mm below the peritoneum, often involving the bowel, bladder or ureters. Usually needs a specialist multidisciplinary team.
- Endometrioma
- An ovarian cyst filled with old blood, sometimes called a chocolate cyst. Can affect ovarian reserve, both from the cyst and from surgery to remove it.
- Peritoneum
- The thin membrane lining the abdominal cavity and covering the pelvic organs, the most common place lesions are found.
- rASRM staging
- A I to IV scoring system for how widespread disease is. Stage does not track pain: stage I can hurt more than stage IV.
- Dysmenorrhoea
- Painful periods, the classic presenting symptom, though many patients have pain throughout the cycle.
- Dyspareunia
- Pain during or after sex, frequently deep rather than at the entrance in endometriosis.
- GnRH agonists / antagonists
- Drugs that suppress ovarian hormones to shrink lesions, inducing a temporary medical menopause. Usually paired with add-back hormone therapy.
- Retrograde menstruation
- Menstrual flow moving backwards through the fallopian tubes. A long-standing theory of origin, but it does not explain every case.
- Diagnostic delay
- The gap between first symptoms and diagnosis, an average of seven to nine years in most studied countries.
- Multidisciplinary team (MDT)
- A specialist centre pairing gynaecology with colorectal, urology, pain and physio input for complex disease.
Vetted sources on this beat
The ledger fills as EndoUnfiltered pulls reporting from vetted outlets.