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Open Access
CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2026; 86(02): 189-200
DOI: 10.1055/a-2765-4322
GebFra Science
Review

Barriers and Facilitators Affecting the Care of Patients with Endometriosis: A Scoping Review

Artikel in mehreren Sprachen: English | deutsch

Autor*innen

  • Selina Bayrak

    1   Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany

  • Alena Allak

    1   Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany

  • Till Neugebauer

    1   Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany

  • Siegrun Pardon

    1   Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany

  • Yüce Yilmaz-Aslan

    1   Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany

  • Sven Schiermeier

    2   Faculty of Health, School of Medicine, Gynaecology and Obstetrics, Witten/Herdecke University, Witten, Germany
    3   Department of Gynaecology and Obstetrics, Marien-Hospital Witten, Witten, Germany

  • Claudia Kiessling

    4   Universität Witten/Herdecke Fakultät für Gesundheit, Witten, Germany (Ringgold ID: RIN235785)

  • Sven Schmiedl

    5   Faculty of Health, School of Medicine, Clinical Pharmacology & Center for Clinical Trials, Witten/Herdecke University, Witten, Germany
    6   Philipp Klee-Institute of Clinical Pharmacology, Helios University Hospital Wuppertal, Wuppertal, Germany

  • Christoph Dockweiler

    7   Department of Social Sciences, Faculty of Arts and Humanities, University of Siegen, Siegen, Germany

  • Patrick Brzoska

    1   Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany

Gefördert durch: Universität Witten/Herdecke Interne Forschungsförderung
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Abstract

Background

Endometriosis affects around 10–15% of women of reproductive age worldwide. Despite its prevalence and the considerable pain and psychological stress associated with the disease, the care of those affected is associated with numerous challenges. A central problem is the often delayed diagnosis, which takes 6–10 years on average. However, early diagnosis is essential for appropriately targeted therapeutic approaches. The specific barriers that contribute to delayed diagnosis and inadequate care have not yet been comprehensively identified. The aim of this scoping review was therefore to systematically identify existing barriers and facilitators to derive approaches for improving diagnosis and doctor–patient communication in Germany.

Methods

A systematic search of international studies was conducted in accordance with the PRISMA-ScR guidelines to identify relevant German- and English-language publications in the period from 2014 to 2024. The search was conducted in various scientific databases. Empirical studies on barriers and facilitators in endometriosis care were included. After screening and selection, 39 relevant publications remained, based on which eight main categories were inductively derived.

Results

Primary barriers include delays in diagnosis, stigmatization of menstrual pain, emotional distress such as shame and fear, inadequate pain management, and structural barriers. The findings suggest that effective interdisciplinary collaboration and patient-centered communication between doctors and patients are essential to reduce diagnostic delays and optimize care. Furthermore, individual studies suggest that digital technologies have the potential to encourage patients to document and communicate their symptoms.

Discussion

The results of the study suggest that the stigmatization of endometriosis significantly complicates its care in the health care system. Consequently, interdisciplinary care models, targeted training of medical professionals, and measures to strengthen doctor–patient communication are key approaches for patient-centered and early care.

Keywords

endometriosis - barriers - facilitators - health care - scoping review


Publikationsverlauf

Eingereicht: 16. Juni 2025

Angenommen nach Revision: 02. Dezember 2025

Artikel online veröffentlicht:
11. Februar 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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