Endometriosis affects an estimated 10% of reproductive-age women with symptoms ranging from painful experiences such as dysmenorrhea, dyschezia, dyspareunia and may also lead to infertility [1,2]. In fact, studies report that up to 50% of infertile women are affected by endometriosis [3]. The relationship between infertility and endometriosis remains incompletely understood, but it is thought to be linked to various mechanisms, including distorted pelvic anatomy, endocrine imbalances and ovulatory dysfunction, all of which can adversely impact embryo implantation [4]. These symptoms significantly affect the quality of life for women, particularly in terms of work, intimate relationships, mental health [5,6], and are associated with substantial direct and indirect healthcare costs [7].

The natural history of endometriosis is challenging to predict. In many women, without appropriate hormonal treatment, endometriotic lesions, such as deep infiltrating nodules and endometriomas are likely to progress over time [8]. One of the main challenges in managing endometriosis is reducing the diagnostic delay, which is essential to prevent endometriosis progression. Currently, the diagnosis of endometriosis is often delayed by an average of 7 years, with studies across different countries reporting screening intervals ranging from 4 to 12 years [[9], [10], [11], [12]].

In response to these issues, a National Endometriosis Public Health Plan was implemented by our government in February 2022, in collaboration with women’s patient networks. This initiative aims to raise awareness among both healthcare professionals and women, while optimizing the overall management of women's health [13]. Several factors contribute to the prolonged diagnostic delays of endometriosis including the lack of specialized practitioners, the costs associated with consultations, and radiological examinations [14]. Our public healthcare system provides full coverage for these medical services, ensuring universal access, which offers hope for reducing diagnostic delays.

The objective of our study was to evaluate the time frame from symptom onset to the diagnosis of moderate and severe endometriosis and comparing this delay before and after the implementation of a National Endometriosis Public Health Plan.