Diagnostic Delays and Economic Burden in Japanese Women with Endometriosis: A Cross-Sectional Analysis

Background: This study investigates the association between diagnostic delay (DD) and clinical and behavioral variables among Japanese women with endometriosis, and explores an optimal cut-off point distinguishing short and long DD. Methods: a cross-sectional online survey was conducted among 220 Japanese women aged 18–49 diagnosed with endometriosis. Data on healthcare behaviors, economic expenditures, and disease-specific outcomes were analyzed by stratifying participants based on DD length. Multivariate logistic regression models were applied. Results: the mean age at initial symptom onset was 24.3 years, and at diagnosis, 27.7 years. The median DD was 1.5 years, with significant differences between short and long DD groups ( p < 0.001). Longer DD was significantly associated with greater use of over-the-counter (OTC) pain medication ( p = 0.008) and a higher proportion of Stage IV endometriosis ( p = 0.022). Conclusions: diagnostic delays longer than 1.5 years may contribute to disease progression and reliance on self-management, potentially postponing medical consultation. Early intervention strategies, including screenings and public awareness, may promote timely healthcare-seeking behavior. Future studies should prioritize clinical assessments and early diagnosis to reduce the burden of advanced disease.