Endometriosis can end patient’s careers and hamper their education – time to wake up and recognize it as a potential chronic disability said Dr. Vimee Bindra – Fertility Enhancing Surgery Specialist| Endometriosis Excision Surgery Specialist |Gynecologist |Laparoscopic and Robotic Surgeon | Co-Founder ENDOCRUSADERS

Endometriosis affects more than 170 million women worldwide and up to 10% of women of reproductive age, with a higher prevalence in women with painful periods/dysmenorrhea (40–60%), subfertility (21–47%), and/or pelvic pain (71–87%)

Endometriosis may cause a deterioration of daily functioning due to related symptoms such as pain, fatigue, and psychological distress. Accordingly, endometriosis may jeopardize workability, as suggested in mainly survey-based case-control studies.

Patients with endometriosis often describe their pain as “stabbing” pain during their period, back pain, pain during bowel movements, and pain going to the toilet and during sex.

They might have stomach pain, vomiting and diarrhea, headaches, muscle aches, and tiredness. Have you ever imagined dealing with this every single day at work and you do not know when symptoms might strike?

How do patients with endometriosis struggle at work?

Patients with endometriosis may find difficulty focusing at work because of unpredictable symptoms, side effects of strong painkillers, and frequent trips to the toilet.

They may find it difficult to explain this to their colleagues or boss at work and they may find it to be embarrassing. They may feel like it may interfere with their career opportunities and sharing such things may make them feel like an invasion of privacy.

They may not be left with sick leave and may feel pressured to work while being sick.

Emma Watkins, the former Yellow Wiggle, went public with her battle to balance endometriosis and work. Ongoing pain and the need for surgery to treat it forced Emma to pull out of the 2018 Wiggles national tour.

Endometriosis can take years to be diagnosed

Many patients with endometriosis start to see symptoms when they are teenagers but they are officially diagnosed only in their thirties. On average, it may take 7-10 years to be diagnosed. It happens because of the normalization of symptoms and dismissing patients’ complaints.

Given that endometriosis usually occurs during the same years as an education and career-building, career development may be affected.

A Danish case-control study showed that women with endometriosis aged 26–35 years reported poorer work ability and more sick days than women without endometriosis.

Concerning employment status, cross-sectional case-control studies suggest that women with endometriosis are less likely to be employed and practicing their desired profession.

A longitudinal case-control study in the USA evaluated endometriosis-related exits from the workforce and found increased risks of sick leave and short-term disability.

Women with endometriosis more often reported over 10 days’ sickness absenteeism during the previous year. The women/patients with endometriosis had on average 10 more disability days compared with unaffected women/patients. Endometriosis and sickness absenteeism and poorer work ability were aggravated by fatigue, pain, depression, and long intervals between symptom onset and diagnosis

How can we support endometriosis patients to stay at work?

This includes offering flexibility in the workplace – whether that’s through job modifications and time off in lieu, flexible work hours, or working from home.

Creating a supportive workplace culture is also important. Non-judgemental responses to patients’ experiences with endometriosis are also key.

Additional days of sick leave for patients with endometriosis may also help to manage the demands of their job and symptoms.

These are great starts for women already in work, but we need to do more, and start earlier.

Girls and women need flexibility early in their education to cope with the unpredictable nature of endometriosis.

Virtual classrooms could help minimize missed days at school, and college.

Flexibility and allowing them to complete their education over a longer period could help.

For healthcare practitioners, we encourage recognition of the problem, early diagnosis, avoiding normalizing symptoms, and the relevance of organizing timely care for endometriosis patients to promote workability.

About the author- Dr. Vimee Bindra – Fertility Enhancing Surgery Specialist| Endometriosis Excision Surgery Specialist |Gynecologist |Laparoscopic and Robotic Surgeon | Co-Founder ENDOCRUSADERS