Azhar Z, Sadia Z, Siddiqui AN (2026) Endometriosis: A Silent Suffering for Women in Pakistan. Arch Palliat Care 7(1): 1020

Endometriosis is a chronic disease in which tissue similar to the uterine lining (endometrium) grows outside the uterus. It is found to be asymptomatic in some instances; however, in most cases, it results in chronic pelvic pain, dyspareunia, dysmenorrhea, fatigue, and infertility. These symptoms have a profound negative impact on patients’ mental health. Globally, 10% of women of reproductive age and girls under the age of puberty have been affected by the disease [1]. In Pakistan it constitutes 5% to 15% of gynecological patients, with higher rates being reported among infertile women [2]. Approximately, 22% of women in Pakistan have infertility [3]. Endometriosis is a commonly diagnosed condition among infertile women, with a mean prevalence of 23.29%. Studies indicate that endometriosis is most widely associated with primary infertility in over 53% to 78% of these cases as compared to secondary infertility which is only present in 21.74% to 33.3% of cases [4]. Delayed diagnosis, often ranging from 4 to 11 years after onset, is one of the most significant challenges posed by the disease, resulting in poor prognosis in Pakistan. This delay is due to a lack of awareness, normalization of symptoms, misdiagnoses, and cultural stigmas surrounding menstruation and reproductive health. This contributes to a cycle of suffering and majorly affects women’s quality of life. Given Pakistan’s current economic inflation and rapidly rising healthcare costs and resources, policymakers must address the socio-economic impact of endometriosis. Cost analyses are essential for identifying the determinants of diagnostic and treatment costs. This information can then be used in economic evaluations to determine the cost-effectiveness of earlier diagnosis and treatment techniques [5]. The financial impact of endometriosis is also substantial, mainly due to loss in productivity [5]. Addressing endometriosis in Pakistan requires a diversified approach to increase awareness and eliminate diagnostic delays. This includes creating educational programs for women, families, and healthcare providers, working with community leaders to reduce stigma, and offering specialized training for healthcare workers. Creating support groups can provide a secure area for women to discuss their stories and get crucial emotional support. Increased awareness and early intervention are critical to improving the quality of life for affected women.

1. Endometriosis, 2025.
2. Saad M, Rafiq A, Jamil A, Sarfraz Z, Sarfraz A, Robles-Velasco K, et al. Addressing the Endometriosis Knowledge Gap for Improved Clinical Care-A Cross-Sectional Pre- and Post-Educational-Intervention Study among Pakistani Women. Healthcare (Basel). 2023;11: 809.
3. Ali S, Sophie R, Imam AM, Khan FI, Ali SF, Shaikh A, et al. Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study. BMC Public Health. 2011; 11: 760.
4. Alsudairy SM, Alahmad A, Ateeyh RS, Mandura AS, Hassan AMB,Hariri F, et al. 4 Endometriosis and infertility: a systematic 5 review.
5. Simoens S, Dunselman G, Dirksen C, Hummelshoj L, Bokor A, Brandes I, et al. The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres. Hum Reprod. 2012; 27: 1292-1299.