Honing in on earlier endometriosis diagnosis, with Hugh Taylor, MD

Endometriosis remains underdiagnosed despite its high prevalence and significant impact on patients’ quality of life, according to Hugh Taylor, MD, Chair, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine. At the 2026 American College of Obstetricians & Gynecologists (ACOG) Annual Clinical & Scientific Meeting, he emphasized that delayed recognition continues to hinder timely intervention and long-term outcomes.¹

“Endometriosis is a very common disease. It probably affects 10% of reproductive-age women, and it can be quite debilitating,” Taylor said. “Unfortunately, we don't diagnose it soon enough. There's an average of a 7- to 10-year delay² from the time someone first has classic endometriosis symptoms until we make the diagnosis and get them on effective treatment.”

Endometriosis diagnostic delays disrupt life trajectories

“[Those] 10 years [are] just too long. These are young women, often at very formative stages of their lives, sometimes in school, sometimes in their early careers, and they just miss out on opportunities,” he said. “They never achieve their full potential if they're not able to participate fully because of the pain.”

He noted that earlier recognition is achievable through clinical evaluation rather than reliance on invasive procedures.

“It's not hard to make the diagnosis. Often, these patients have progressive cyclic pelvic pain. Somebody who has dysmenorrhea, their menstrual pain is getting worse over the years, it's a clear sign of endometriosis, and we can make that clinical diagnosis and begin therapy right away,” Taylor explained.

Recent guidance from ACOG now supports a clinical diagnosis based on symptoms, physical examination, and imaging when needed, eliminating the historical requirement for surgical confirmation.

Normalizing pain delays diagnosis

A key barrier, Taylor said, is the normalization of menstrual pain, which can lead to dismissal by both patients and clinicians.

“If you think about it, dysmenorrhea, or menstrual pain, is the only pain we as human beings would ever consider normal,” he said. “Every other pain you may have anywhere in your body, you would assume something is wrong, get it checked out, figure out what's wrong, and try [to] fix it. Most of my patients, when they first tell their friends, family members, and sometimes, unfortunately, even their healthcare providers about their menstrual pain, it's dismissed,” Taylor said. “It's often not until they have debilitating pain, where they're not able to even go to school or work, that it's recognized as something abnormal.”

Taylor also highlighted the downstream effects of missed diagnosis, including unnecessary specialty referrals and procedures.

“This is really not necessary. Let's get back to focusing on one diagnosis, a single disease that is endometriosis, that encompasses many of the other problems, and get away from this expensive, inconvenient diagnostic odyssey that just delays the real diagnosis of endometriosis,” he said.

References:

1. ACOG. Contemporary OB/GYN. Accessed May 26, 2026. https://www.contemporaryobgyn.net/conferences/acog
2. Fitch J. Women with endometriosis or adenomyosis face 10- to 11-year diagnostic delays, study finds. Contemporary OB/GYN. Published February 16, 2026. Accessed May 26, 2026. https://www.contemporaryobgyn.net/view/women-with-endometriosis-or-adenomyosis-face-10--to-11-year-diagnostic-delays-study-finds