O-29 Suffering in silence: endometriosis and the Caribbean research gap

Methods: A scoping review was conducted to identify literature published between 2015 and 2025 exploring endometriosis, mental health, stigma, and quality of life in Caribbean populations. Google Scholar was searched using the terms “endometriosis,” “Caribbean,” “Latin America,” “quality of life,” “mental health,” “pain,” and “stigma.” Seventy-three records were screened, 16 underwent full-text reviews, and 4 primary studies (three cross-sectional surveys and one crosscountry analysis) met inclusion criteria.

Results: Most studies combined Caribbean participants with larger Latin American cohorts, limiting regional inference. Across studies, the most commonly reported symptoms were chronic pelvic pain, dysmenorrhea, dyspareunia, and fatigue. Depression was substantially more prevalent among individuals with chronic pain (up to 86%) compared to those without pain 38%. Endometriosis-related stigma was independently associated with poorer quality of life and lower self-esteem, and was linked to worse psychological outcomes among individuals experiencing pain. Longer diagnostic delays, unemployment,, and poorer self-rated health were consistently associated withreduced emotional and social well-being. Aggregated data also highlighted a substantial burden of endometriosis on fertility and chronic pain, with persistent disparities across socioeconomic contexts. However, the reliance on cross-sectional designs, selfreported data, and aggregated regional data limited the ability to draw Caribbean-specific conclusions.

Conclusion: Endometriosis contributes significant morbidity through chronic pain, infertility, and psychological distress, often independent of pain severity. In the Caribbean, menstrual stigma and delayed care exacerbate distress and hinder illness acceptance. Given endometriosis’ global classification as a leading cause of disability, multidisciplinary, culturally responsive care models, integrating gynecologic management, mental health screening, and anti-stigma initiatives, are urgently needed. Expanded