Self-help groups say practitioners delay making the diagnosis, often because they do not consider it a possibility. There is a typical delay of 7–12 years from symptom onset in affected individuals to professional diagnosis. There is a general lack of knowledge about endometriosis among primary care physicians. Half of general health care providers surveyed in a 2013 study were unable to name three symptoms of endometriosis. Health care providers are also likely to dismiss described symptoms as normal menstruation. Younger patients may also feel uncomfortable discussing symptoms with a physician. Race and ethnicity
Race and ethnicity may play a role in how endometriosis affects ones life. Endometriosis is less thoroughly studied among Black people, and the research that has been done is outdated. Black people with endometriosis may face barriers in receiving care due to misconceptions about how Black people feel pain. Since pain is the primary symptom of endometriosis, this makes it increasingly possible for doctors to dismiss pain symptoms when their patient is Black. An inaccurate diagnosis is also more likely since Black women are at a higher risk for other related conditions such as uterine fibroids.Cultural differences among ethnic groups also contribute to attitudes toward and treatment of endometriosis, especially in Hispanic or Latino communities. A study done in Puerto Rico in 2020 found that health care and interactions with friends and family related to discussing endometriosis were affected by stigma.
Despite multiple benefits, there are lot of things to consider before using AIs for endometriosis, as it is common for them to induce functional cysts as an adverse effects. Moreover, dosages, treatment length, appropriate add-back therapies and mode of administration is still being investigated. Progesterone receptor modulators like mifepristone and gestrinone have the potential (based on only one RCT each) to be used as a treatment to manage pain caused by endometriosis. Other Medicines
Melatonin, there is tentative evidence for its use (at a dose of 10 mg) in reducing pain related to endometriosis. Opioids: Morphine sulphate tablets and other opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called "endorphins". There are different long acting and short acting medications that can be used alone or in combination to provide appropriate pain control. Chinese herbal medicine was reported to have comparable benefits to gestrinone and danazol in patients who had had laparoscopic surgery, though the review notes that the two trials were small and of "poor methodological quality" and results should be "interpreted cautiously" as  better quality research is needed. Serrapeptase, a Digestive enzyme found in the intestines of silkworms. Serrapeptase is widely used in Japan and Europe as an anti-inflammatory treatment. More research is needed but serrapeptase may be used by endometriosis patients to reduce inflammation. Angiogenesis inhibitors lack clinical evidence of efficacy in endometriosis therapy.