Incidence and burden of endometriosis among U.S. active component service women, 2017-2024

Endometriosis is a complex gynecological condition affecting nearly 10% of reproductive-aged women. This report updates a 2017 MSMR report of gynecological conditions, including endometriosis, from 2012 through 2016 among U.S. active component service women. The current report utilized medical encounter data from 2017 through 2024 to assess the incidence of endometriosis and its health care burden among U.S. active component service women. Factors related to co-occurring gynecological conditions, deployment, parity, and contraceptive use were also examined. Crude incidence rates and incidence rate ratios with 95% confidence intervals were calculated. The overall crude rate of endometriosis was 32.8 cases per 10,000 person-years and increased approximately 42.0% from 2017 to 2024. Incidence rates increased with age and were higher among nulliparous and never-deployed service women. Additionally, obese and underweight service women had higher incidence rates. Menorrhagia was the most common co-occurring condition, with oral birth control the most common form of contraceptive among incident cases. Identification of at-risk service women may help formulate targeted policies for earlier diagnosis to improve both quality of life and military readiness. Incidence of endometriosis increased during the surveillance period, from 28.7 cases per 10,000 person-years in 2017 to 40.7 cases per 10,000 person-years in 2024, coincident with a general increase of medical encounters for endometriosis, from 2,740 medical encounters in 2017 to 3,864 medical encounters in 2024. Service women who were older, obese or underweight, nulliparous, and never deployed had higher incidence rates.