Endometriosis symptoms, mental health worsened with pandemic stress

During the first months of the COVID-19 pandemic, people with endometriosis reported worse symptoms and negative effects on their mental health, according to survey results.

“We would recommend that health care professionals take a holistic approach to the assessment of people with endometriosis and understand that stressful events, such as the pandemic, may negatively affect symptoms and that a personalized treatment plan may be more effective,” Lysia Demetriou, PhD, a postdoctoral research assistant at the University of Oxford in England, said in a press release.

Between May and June 2020, Demetriou and colleagues analyzed data from 4,717 people with endometriosis who participated in a global online survey advertised through social media by endometriosis support groups or mentioned by health care providers and researchers. Multiple choice questions, which were not mandatory and allowed for some free responses, asked about current symptoms, such as pelvic pain, fatigue and bleeding patterns, mental health and pain catastrophizing and changes in those areas from 6 months earlier — before the pandemic. The survey also asked about the effects of the pandemic on respondents’ personal life, work and health care access.

Respondents were aged at least 18 years and had a mean age of 33.2 years; 67.9% were from Europe, 14.9% from North America and 9.1% from Latin America and the Caribbean.

Compared with 6 months prior, 39.3% of respondents reported worse endometriosis-associated pain (95% CI, 37.7%-40.5%), and 49.9% reported more tiredness or fatigue (95% CI, 48.4%-51.2%). Changes in bleeding patterns were reported by 39.6% of participants (95% CI, 38.2%-41%), with 17.4% reporting increased or more frequent bleeding and 15.2% reporting decreased or less frequent bleeding. Alterations in treatment plans and medication during the pandemic were reported by 78.4% of respondents.

Additionally, 38.6% of participants reported worse mental health compared with 6 months prior (95% CI, 37.2%-39.9%). Participants with a preexisting mental health diagnosis were more likely to report worse mental health. Of note, worse pain and tiredness or fatigue were associated with worse mental health (P < .001).

The researchers observed no significant association between changes in endometriosis symptoms and perceived stress.

“It is important for public health bodies to be aware of how a crisis may affect people with chronic conditions, like endometriosis, especially when access to health care is difficult,” Demetriou said in the release.

Future research includes evaluating the long-term impact of the pandemic on people with endometriosis to more thoroughly understand the relationship between stress and symptoms, according to the release.

References:

• Demetriou L, et al. Reprod Fertil. 2022;doi:10.1530/RAF-22-0028.
• Endometriosis symptoms worsened by COVID-19 stress. https://www.wkrn.com/business/press-releases/ein-presswire/599159035/endometriosis-symptoms-worsened-by-covid-19-stress/. Published Nov. 3, 2022. Accessed Nov. 3, 2022.