Global variability in the clinical presentation of endometriosis: A scoping review

Abstract

Endometriosis affects approximately 10-15 percent of women of reproductive age, yet its clinical presentation remains inconsistently reported. This scoping review mapped the global spectrum of endometriosis-related symptoms and examined factors influencing symptom reporting. Following the JBI framework, studies were identified using two databases to identify studies published between 2004 to 2024. Of the 1286 articles initially screened, 95 articles were included. Studies reported on a range of symptoms (49 symptoms) involving multiple organ systems, with the most commonly reported symptoms being dysmenorrhea, pelvic pain and dyspareunia. Symptom assessment varied widely, with predominant use of numerical rating and visual analogue scales and limited uptake of endometriosis-specific tools. Symptom cyclicity was inconsistently reported, and minority populations were under-represented. Overall, the findings highlight substantial heterogeneity in symptom classification and measurement, contributing to an incomplete understanding of disease burden. These findings set a basis for the creation of standardized, culturally sensitive, and multidimensional symptom assessment frameworks necessary to improve diagnostic accuracy, equity, and global comparability in endometriosis research and care. Open Science Framework (OSF) registration: https://doi.org/10.17605/OSF.IO/6BWRE.