Reproductive health perception and understanding of endometriosis among young women in the Colombo District, Sri Lanka

Abstract

Endometriosis affects about 10% of women of reproductive age worldwide, and its prevalence continues to rise, creating a growing public health concern. Endometriosis disproportionately affects women in low-resource countries such as Sri Lanka due to limited awareness, restricted access to healthcare, and cultural taboos which often lead to diagnosis delays and a reduced quality of life. This study evaluates the knowledge and perception of young women regarding reproductive health and endometriosis within the Colombo District, Sri Lanka, and examines the factors that influence their knowledge. A quantitative cross-sectional survey involving 200 women from diverse socioeconomic, ethnic, and educational backgrounds was conducted. The survey questionnaire was developed based on the Endometriosis Health Profile-30 (EHP-30) to examine the reproductive health perceptions and understanding of endometriosis. The quantitative data collected through the survey were analysed using SPSS. Findings revealed a high level of unawareness, with only 80 respondents indicating awareness of endometriosis. The education level showed a statistically significant positive association with awareness level (p = 0.005). Women with postgraduate or undergraduate qualifications were more likely to be aware of endometriosis, whereas those with diploma or certificate-level qualifications demonstrated considerably lower awareness regarding both reproductive health care perception and endometriosis. Social media was identified as the main source of information, while healthcare professionals played a minimal role in raising awareness among young women. However, 60% (9 out of 15) of diagnosed women had initially been misdiagnosed. Logistic regression analysis indicated that women who had recently used health care services were 4-12 times more likely to have knowledge about endometriosis (p<0.001) compared to the women who had not recently accessed such services. The Mann-Whitney U test demonstrated that women diagnosed with endometriosis experienced significantly greater limitations in physical activity and emotional support (p<0.001) compared to non-diagnosed women. The research identifies gaps in the perception of reproductive health and endometriosis awareness among young women in the Colombo District, highlighting the need for specific awareness and educational programs on early consultations, proper diagnosis, and adherence to treatment, especially among women with lower education levels to improve the overall quality of life