Endometriosis becoming severe problem in working women

Endometriosis can end patient's careers and hamper their education – time to wake up and recognise it as a potential chronic disabilitysays 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 work ability, 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 diarrhoea, headaches, muscle aches and tiredness. Have u 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?

Patient with endometriosis may find difficulty in 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 thirties. On an average it may take 7-10 years to be diagnosed. It happens because of normalisation of symptoms and dismissing patients' complaints.

Given that endometriosis usually occurs during the same years as 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 in work?

This includes offering flexibility in the workplace – whether that's through job modifications and time off in lieu, or flexible work hours and 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 minimise missed days at school, college. Flexibility and allow them to complete their education over a longer period could help.

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

e Endometriosis takes 7-10 years to be diagnosed

e Women with endometriosis reported poorer work ability and more sick days than women without endometriosis

e Women with endometriosis are less likely to be employed and practicing their desired profession

e women with endometriosis more often reported over 10 days' sickness absenteeism during the previous year

e A Global study has found that women who had surgery for endometriosis were 85% more likely to be unemployed three years after their diagnosis than before it.