Impact of the early COVID-19 era on endometriosis patients: Symptoms, stress, and access to care

Abstract

Introduction: Monitoring the impact of natural disasters such as pandemics on health and wellbeing is a public health priority. Stress is proven to affect pain intensity and quality of life of endometriosis patients. A cross-sectional study was conducted to determine whether the measures implemented to mitigate COVID-19 infections had a substantial impact on risk behaviors, endometriosis symptoms, stress, and access to healthcare. Methods: Electronic questionnaires that measured COVID-19 impact and peri-traumatic stress were disseminated through social media over June–September 2020 and completed by 82 adult patients with endometriosis living in Puerto Rico. Descriptive data analysis and correlations were done in quantitative data and systematic analysis of free text was done on qualitative responses. Results: Participants self-reported worsening of endometriosis symptoms and high levels of peri-traumatic stress, as well as changes in risk behaviors (exercise, nutrition, sedentarism, sleep) during the pandemic in comparison to the previous months. They also reported substantial barriers in access to medical appointments, scheduled procedures, and prescriptions. Electronic health modalities (telemedicine, mobile apps) were considered acceptable alternatives for gynecologic care during natural disasters. Conclusion: The COVID-19 pandemic negatively impacts the health and wellbeing of endometriosis patients while imposing substantial restrictions on access to health care. These timely insights will guide the development and implementation of plans to address barriers to health care and minimize long-term detrimental effects of natural disasters on the health of those living with stress-related disorders such as endometriosis.

Endometriosis and COVID-19: A Systematic Review and Meta-Analysis

“…The four studies not included in the meta-analysis were based on qualitative data [ 10 , 11 , 12 , 13 ]. In addition, four studies [ 3 , 14 , 15 , 16 ] appear in both the meta-analysis on the prevalence of SARS-CoV-2 in endometriosis patients as well as the meta-analyses on the health impacts of COVID-19 in endometriosis patients.…”

“…A total of six studies [ 3 , 9 , 14 , 15 , 16 , 17 ] comprising 4555 patients were included in the meta-analysis. Figure 2 illustrates the forest plot of the prevalence of COVID-19 in endometriosis patients, and the risk of COVID-19 infection in endometriosis patients.…”

“…The pooled prevalence was 7.5% (95% CI [4.5–10.5]; I 2 = 92.6%; p < 0.001). The prevalence of individual studies ranged from 1.2% [ 15 ] to 22.9% [ 17 ]. Only two studies [ 9 , 17 ] had available data to estimate the odds ratio.…”

A systematic review and meta-analysis on alcohol consumption and risk of endometriosis: an update from 2012

“…Moreover, alcohol could be implied in the vicious circle "pain-stress-inflammation" 9,54 . In 2021, one of the early effects of COVID-19 pandemic was an increase of alcohol consumption for 29.2% endometriosis patients 55 . Notably, psychiatric disorders (bipolar, depressive, anxiety, and stress-related syndromes) and endometriosis may be intertwined [56][57][58] so that endometriosis patients may more likely suffer of these conditions 59 .…”

Serum Chemokines and Quality of Life among Patients with Endometriomas and Teratomas

“…Patients suffering from endometriosis, regardless of pathogenesis [36], experience pain every day [8][9][10][18][19][20] and often require immediate consultation, planned surgeries, or even emergency surgical interventions. SARS-CoV-2 pandemic has significant negative consequences for endometriosis patients worldwide, including postponed surgeries [37][38][39], reduced quality of life [40], worsened access to care [41], difficulties in repeating painkiller or hormone prescriptions, and missed appointments [42]. Clinicians should remember that patients suffering from endometriosis or its symptoms, especially pain, need longterm treatment and consultation with doctors.…”