For thousands of women across the UAE, severe period pain, chronic pelvic discomfort, and unexplained fertility struggles often become part of daily life long before they receive a diagnosis.
Multiple clinical reviews and consensus statements from bodies, such as the American Society for Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE), suggest that 25-50 per cent of women with infertility are estimated to have endometriosis, highlighting the need for earlier intervention.
Medical experts say endometriosis — a condition in which tissue similar to the lining of the uterus grows outside it — continues to be significantly under-recognised, leaving many women suffering in silence for years.
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The issue has taken on greater urgency as healthcare providers across the UAE report increasing awareness of women’s reproductive health concerns.
Yet despite advances in treatment and diagnosis, endometriosis remains one of the most commonly missed gynecological conditions, with symptoms frequently mistaken for other disorders.
Diagnostic delays can stretch beyond a decade
“Endometriosis remains one of the most under-recognized conditions in gynecology. A landmark study of 512 Arab patients found that the average diagnostic delay was 11.61 years, a figure that escalates to 15.81 years in females who are not married,” said Dr Khulood Ali Al Suwaidi, consultant Obstetrics and Gynecology at Burjeel Medical Center, Al Falah.
Pointing to research involving Arab patients that revealed lengthy delays before diagnosis, Al Suwaidi explained that several factors contribute to these holdups. She noted that definitive confirmation traditionally requires laparoscopic surgery, while the disease itself can be difficult to identify because symptom severity does not always match the extent of the condition.
She added that cultural attitudes towards menstrual pain can also prevent women from seeking help early. “Studies note that period-related pain is often culturally perceived as something women must simply cope with rather than a reason to seek medical care, which delays presentation in the first place.”
Symptoms often mistaken for other conditions
One of the biggest challenges clinicians face is that endometriosis symptoms frequently overlap with other gynecological and gastrointestinal disorders.
Ramya Raj, specialist Obstetrician and Gynaecologist at International Modern Hospital Dubai, said the condition can resemble adenomyosis, uterine fibroids, pelvic inflammatory disease, irritable bowel syndrome, and interstitial cystitis.
She noted that during menstrual pain, young women are frequently treated with pain relief or hormonal therapy without further investigation. In some cases, imaging scans may also fail to detect the disease.
“Ultrasound may appear normal in women with superficial endometriosis, creating false reassurance if clinical suspicion is low.”
Raj stressed that women should not ignore symptoms that interfere with their daily lives. “Importantly, persistent pelvic pain that affects education, work, daily activities, or quality of life should never be considered a normal part of menstruation.”
New approaches could speed up diagnosis
Healthcare specialists say the global medical community is increasingly moving towards earlier, symptom-based diagnosis rather than relying solely on surgery.
Dr Soha Abdelgadir Yassin Nasr, consultant Obstetrics and Gynaecology at NMC Royal Hospital Abu Dhabi, said recent international guidelines encourage clinicians to make a presumptive diagnosis based on a patient’s history, symptoms and examination findings.
“Recent guidelines from the American College of Obstetricians and Gynecologists and other major medical societies now recommend that clinicians shift from relying solely on surgical findings to establishing a presumptive clinical diagnosis.”
She said this approach allows women to access treatment sooner and recognises endometriosis as a chronic condition requiring long-term management.
For the UAE, Dr Nasr believes improvements could include enhanced physician training, symptom-based clinical pathways, faster referral systems to specialists and greater public awareness campaigns.
She added, “Raising public awareness through health campaigns to reduce menstrual stigma and encourage earlier care-seeking.”
Source: Khaleej Times