Burden of Endometriosis: Infertility, Comorbidities, and Healthcare Resource Utilization.

Authors: Eisenberg VH., Decker DH., Chodick G., Shalev V., Weil C.

Publication: J Clinical Medicine (2022) 11(4):1133-1142.


The present study was designed to evaluate how common are health problems like infertility and illnesses co-occurring with endometriosis. The authors also compared the costs associated with caring for women with endometriosis and controls. To answer these questions, the authors collected data from women enrolled in a 2.1-million-member nationwide healthcare plan in Israel. In this study, women between the ages of 15 and 55 with a diagnosis of endometriosis were enrolled and matched 1:4 with women without endometriosis based on age and residence. Results of the study demonstrated that women with endometriosis were significantly more likely to have consulted a gynecologist or primary care provider in the year prior to the start of the study. It was noteworthy that almost 20% of women with endometriosis visited a gynecologist at least 5 times during the year, a rate that was 1.6 times higher than controls. Emergency room visits and hospital admissions were also significantly more common among women with endometriosis compared to controls. Infertility and chronic illnesses including cardiovascular disease, hypertension, irritable bowel syndrome, appendicitis, and inflammatory bowel disease were significantly more common in women with endometriosis. Medication use revealed that women with a diagnosis of endometriosis were significantly more likely to use pain medications and antidepressants. Healthcare resource utilization was also significantly higher among women with a diagnosis of endometriosis compared to the control group and direct medical costs were 1.75 times higher for women with endometriosis. The burden of illness was greater in younger women (15-24 years) than other age groups studied.

Take home message:

Endometriosis is a chronic illness that is linked with higher rates of infertility, cardiovascular and gastrointestinal disease. Symptoms of gastrointestinal disease overlap with those of endometriosis and thus can add to the difficulty in reaching a diagnosis. Endometriosis is associated with more frequent visits to health care providers and emergency room visits adding to the higher utilization of healthcare resources.