Impact of Endometriosis on Fatigue and Productivity Impairment in a Cross-Sectional Survey of Canadian Women

Abstract

Objective: To evaluate fatigue burden and productivity impairments in Canadian women with a self-reported diagnosis of endometriosis (DxE). Methods: From December 2018 to January 2019, Canadian women aged 18À49 years completed an online survey assessing fatigue via the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 6a questionnaire. Fatigue T-scores were compared between women with and without a DxE, by age and endometriosis symptom severity, using t tests. Women with a DxE completed the Work Productivity and Activity Impairment − Specific Health Problem (WPAI-SHP) questionnaire. The effects of age and hallmark endometriosis symptoms on productivity impairments were assessed via analysis of variance. Results: Survey data included 2004 women with and 26 528 women without a DxE. Mean fatigue T-scores were 58.5 § 10.1 in women with a DxE and 59.2 § 10.1 in women with hallmark endometriosis symptoms (i.e., menstrual or non-menstrual pelvic pain/cramping, dyspareunia) versus 55.2 § 9.4 in women without a DxE (both P < 0.001). Women with moderate or severe endometriosis symptoms had a mean T-score of 61.2 § 9.4 versus 55.9 § 10.1 for women with mild symptoms (P < 0.001). Women with moderate or severe hallmark endometriosis symptoms had mean T-scores of 59.6−62.9 versus 57.0−58.2 for women with mild or no symptoms (all comparisons P < 0.01). Women with a DxE reported 17.1% of work time missed, 41.8% impaired work ability, 46.5% overall work impairment, and 41.4% activity impairment per the WPAI-SHP. Women with a DxE aged 30−34 and 35−39 years consistently experienced the greatest effects of fatigue and productivity impairments. Conclusions: Canadian women with a DxE experience a substantial fatigue burden and significant productivity impairments.

Endometriosis Is Undervalued: A Call to Action

“…Fatigue is more common among endometriosis patients, than in control populations ( 62 ). In a 2021 Canadian study on fatigue, endometriosis patients reported substantial impairments to their work productivity with 46.5% overall work impairment due to endometriosis-related symptoms ( 63 ). These findings were like a 2013 Danish study that found that patients with endometriosis had significantly more pain than controls, were in more pain when using their sick days and used more sick days ( 64 ).…”

Endometriosis: A Disease with Few Direct Treatment Options

“…Endometriosis impacts different aspects of life, and one of them is the economic aspect. A large multicentre study carried out between Europe, UK, and the USA showed that the total cost per woman with endometriosis per year was approximately EUR 9579.00, with most of the costs (EUR 6298.00) caused by the absence or reduction of effectiveness at work resulting from the symptoms of the disease [11,12]. Medical care costs (EUR 3281.00) were mainly due to surgeries (29%), monitoring exams (19%), hospitalization (18%), and medical visits (16%) [13].…”

Characterizing the impact of menstrual and pelvic health disorders in a convenience sample of women in Barbados

“…The WPAI used has been validated for use in similar studies. 14,54–56 By limiting recall to the past 7 days in the questionnaire we expected low recall bias. Limitations of this study included uncertainty of methods used in diagnosing respondents and reliance on their self-reported diagnoses; these problems are inherent to studies employing surveys dependent on patient recall.…”