Abstract
BACKGROUND: Symptoms of endometriosis often emerge during adolescence and intensify in early adulthood, critical periods for educational and career development. However, evidence on its impact on women’s broader life trajectories, particularly in education and work, remains limited. This study aimed to examine how endometriosis influences these trajectories and to identify the underlying factors and mechanisms involved. METHODS: This cross-sectional study was conducted online using Qualtrics. Participants were 971 women with a clinical or surgical diagnosis of endometriosis. Sociodemographic and clinical data were collected, along with measures of educational (6 items) and occupational (8 items) impact using two researcher-developed, disease-specific question sets. Items were rated on 5-point Likert scales, with a “not applicable” option included. Psychological health was assessed using the Hospital Anxiety and Depression Scale (HADS). Both descriptive and inferential statistical analyses were conducted. RESULTS: Endometriosis had a moderate to high impact on education for 17%-23% of women and on work for 22%-28%, with participants also reporting social injustices such as workplace discrimination and job downgrading. The greatest impact was observed among those with both adolescent symptom onset and diagnostic delay. The assessment tools used showed strong psychometric properties. Path analysis revealed the role played by younger age at symptom onset and diagnostic delay. Among women under 45, more severe physical and psychological symptoms were linked to greater disruption in education and work. CONCLUSION: Symptomatic endometriosis can significantly impact women’s education and careers, especially when symptoms begin in adolescence and diagnosis is delayed, with effects extending beyond health to broader life trajectories and social inequalities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40359-026-04112-5.