Endometriosis is a mild form of the disease of female reproductive organs. It is a chronic, oestrogen-related inflammatory disease characterised by the presence of the endometrium beyond the uterine cavity1,2,3. It is an exceptionally heterogeneous disease, which can cause minor symptoms among some women, and an agonising pain among others, which affects their professional life, social contacts or reproduction4,5,6. Also, the growing intensity of symptoms is often not correlated with the severity of the disease5–8. One of its most troublesome symptoms is the overwhelming pain, which can occur as nonmenstrual pain in the lesser pelvis (10%-50%), cyclic pain during menstruation (28%-80%), pain during sexual intercourse (12%-40%) or defecation1,3,6−11. Over time, the disease leads to infertility, which affects 30%-50% of women2,4,7,12. These symptoms affect the physical and emotional well-being of women, seriously disrupting the quality of their lives13,14,15.
It is assumed that endometriosis affects approximately 10%-15% of the population of women of childbearing age, which amounts to 176 million of women in the whole world3,7,9,11. Most data on this subject originates from American, British, Canadian and Australian epidemiological research1,5,8,10,15−18. So far, no wide research has been performed for the area of Poland. In the Ministry of Health’s statistics for 2018, there are only 14,000 women with endometriosis who have been treated in a hospital (3,560 women) or an outpatient clinic (10,461 women)19. However, it is discussed unofficially that in Poland the number may be as high as 2 million women20.
Due to the heterogeneity of symptoms, endometriosis is diagnosed with much delay. In the world, the average time of waiting for a proper diagnosis is currently 8–10 years, depending on the country3,4,8,10,14,18,21,22. Reasons for this are sought in ignoring its early symptoms, especially those related to menstrual pain4,8−11. For centuries, the menstrual pain was a taboo, an embarrassing problem and an element of a woman’s life. There is still a popular opinion that it is a kind of women’s ‘thing’ which does not require the implementation of diagnostics16,19, and women who complain are perceived as exaggerating the symptoms, or suffering from diseases of a psychosomatic nature3,23−26. On the other hand, in accordance with the recommendations of the European Society of Human Reproduction and Embryology (ESHRE), in each case of the occurrence of ailments related to the menstrual cycle, after the exclusion of their other causes, endometriosis is to be suspected2,27.
Endometriosis is also a costly problem of public health. The average annual cost of treatment per one patient was calculated in 10 countries at € 9,579. These costs result mainly from surgeries, monitoring examinations, hospitalisation, as well as medical visits, and they grow along with the increasing intensity of endometriosis1,8,13,21,28.
All over the world, actions are taken in order to build social awareness of endometriosis by various social campaigns and actions of the associations of sick women32. Since 2014, worldwide EndoMarches have been organised in March, the month of building this awareness, uniting over 60 countries in the world under one common objective: to eliminate the taboo and replace it with dialogue29. In 2019, for the first time Polish women also joined the rest of the world, believing that this march can be a good beginning of a change in the approach to women with endometriosis, including in Poland20.
Due to the scale of the problem, it is becoming a priority to increase social awareness about endometriosis. In the literature, there is available data related to the awareness of other diseases, but there are few papers related to the knowledge about endometriosis in the world, with the total absence of them in relation to Poland30–32. Seeing an enormous need for changes in this regard, the authors of the present paper committed themselves to assessing women’s level of knowledge about endometriosis.