Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, often on the ovaries, fallopian tubes, or other pelvic organs. It affects about 1 in 10 women worldwide and can cause a range of symptoms, including severe menstrual pain, fatigue, bloating, infertility, and pain during intercourse or bowel movements. According to the American College of Obstetricians & Gynecologists, many women face delays of a decade or more in receiving a diagnosis, often because symptoms are mistaken for normal menstrual discomfort or other health issues. Zoë Armstrong, now 31, was diagnosed with endometriosis at age 29 after experiencing symptoms since she was 11. She described the diagnosis as a relief after years of struggling with severe pain, nausea, heavy periods, and ruptured ovarian cysts. An ultrasound eventually revealed an endometrioma, a type of cyst linked to endometriosis, confirming her condition. Armstrong’s journey highlights the challenges many women face in getting an accurate diagnosis. Experts say delayed diagnoses often occur because period pain is frequently dismissed or normalized, and symptoms can overlap with other conditions. Dr. Megan Billow of the Cleveland Clinic recommends that patients track their symptoms in a diary, noting the location, intensity, and frequency of pain to help doctors make a more accurate diagnosis. In some countries outside the U.S., new diagnostic tests are being used to detect endometriosis more quickly. EndoSure is a test that takes about 30 minutes and uses sensor pads on the abdomen to measure electrical signals in the gut, potentially indicating endometriosis. Another test, Endotest, analyzes a saliva sample for specific microRNAs linked to the condition, with results available in two to three weeks. In the United Kingdom, draft guidelines suggest using these tests for three years while more data is gathered on their effectiveness. Dr. Mark Noar, who founded EndoSure in Maryland, is working to get the test approved by the U.S. Food and Drug Administration (FDA), while a French company, Ziwig, is seeking to offer Endotest to U.S. patients through certified labs without FDA approval. Dr. Andrew Spiers of Ziwig emphasized that these tests are not a substitute for other diagnostic methods but can serve as a starting point. Treatments for endometriosis vary and may include pain medications, hormone therapy, or surgery to remove lesions and scar tissue. Armstrong, who underwent excision surgery, continues to manage her condition with pelvic floor therapy and educates others about women’s health. Dr. Drorit Or of Mount Sinai West stressed that while endometriosis can be challenging, effective management and relief from pain are possible with the right care.