Differences in Clinical Management and Outcomes of American Indian and White Women Diagnosed With Endometriosis

  • Alessandra Spagnolia Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
  • James R Beal Department of Family and Community Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
  • Abe E Sahmoun Mail Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
Endometriosis, Race, Rural, Management, Outcomes, Epidemiology


Objective: Endometriosis is a chronic, painful disease that can be disabling. There is a scarcity of research on the clinical management and outcomes of endometriosis in American Indian (AI) women. The aim of this study was to determine whether there are discrepancies between AI and White women in symptoms at presentation, initial diagnosis methods, clinical management, and long-term outcomes of endometriosis, in a rural state. Materials and methods: This retrospective study described and compared the clinical management and long-term outcomes of AI and White women diagnosed with endometriosis. All statistical tests were two-tailed with p-value < .05 considered to be significant.
Results: 110 women diagnosed with endometriosis were included in the study, with 50% (n = 55) AI and 50% (n = 55) White. White women were more likely to have private insurance (80% vs. 42%; p < 0.001). AI women were more likely than White women to report abdominal pain at diagnosis (20.3% vs. 9%; p = 0.010), and be diagnosed with mild endometriosis symptoms at the initial visit, (44.4% vs. 10%; p = 0.051). White women were more likely to report a reduction or cessation of pain compared to AI women (63.3% vs. 34%; p = 0.004). Conclusion: We found the majority of women continue to report pain long after endometriosis diagnosis. AI women were less likely to report a reduction or cessation of pain. Future research should investigate why pain is more persistent in AI women.


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How to Cite
Spagnolia A, Beal J, Sahmoun A. Differences in Clinical Management and Outcomes of American Indian and White Women Diagnosed With Endometriosis. J Fam Reprod Health. 14(2):74-80.
Original Articles