September 28, 2022

The COVID-19 pandemic has had a significant impact on healthcare, affecting the speed of getting diagnoses and treatments.
If you have a chronic condition like endometriosis, such delays can be difficult to deal with.
Plus, it’s natural to feel concerned about whether COVID-19 can affect endometriosis or vice versa.
Here’s everything you need to know about navigating endometriosis care in the current climate.
Since the coronavirus that causes COVID-19 was first discovered, there’s been no strong evidence that endometriosis makes you more at risk of contracting the virus.
At first, researchers thought there was a potential link due to the inflammatory nature of both conditions.
And one 2022 study with 401 participants did find that people with endometriosis could be more susceptible to COVID-19.
But other researchers have found no difference in COVID-19 risk levels between people with endometriosis and people without.
There’s a caveat for people with thoracic endometriosis, a rarer type that affects the diaphragm and lungs.
People with thoracic endometriosis may be more at risk of developing COVID-19 or of becoming more severely ill, particularly if there’s scarring on the lungs that makes it easier to contract infections.
But there’s still no clear answer, so it’s possible the risk level remains similar.
“The pandemic has greatly affected all aspects of medical care,” says Greg Marchand, an OB-GYN at the Marchand Institute for Minimally Invasive Surgery in Mesa, Arizona.
The initial focus of the pandemic was on treating people with COVID-19. This means people with other conditions faced barriers to accessing medical appointments, prescriptions, and procedures. Appointments were regularly canceled or delayed.
“Many doctors changed from in-person to telehealth visits,” explains Marchand, “which greatly decreased the level of care for endometriosis as physicians had a limited ability to examine patients, and communication decreased as patient-doctor interactions were limited to what could be expressed through a small screen.”
Surgical treatments may have been delayed, too —particularly as endometriosis treatment may be considered “nonessential” in some areas.
“Some hospitals and surgery centers limited the number of patients that could receive surgery,” adds Marchand. That means potentially longer waits for treatment.
It’s not just care and treatment for people who already have a diagnosis of endometriosis who have faced issues. The diagnostic process may also be taking even longer than usual.
“Endometriosis is notoriously known to be a chronic disease with a very delayed time to diagnosis,” says Dan Nayot, MD, chief medical adviser at Bird&Be and a reproductive endocrinologist and infertility specialist.
One reason is that the “gold standard” diagnosis involves invasive laparoscopy surgery. Other reasons involve misdiagnosis due to symptoms being similar to those of other conditions and certain symptoms being dismissed as “normal”.
While the “gold standard” diagnosis requires surgery, symptoms, physical examinations, and imaging, such as ultrasound or MRI, can be used to make a “clinical” diagnosis.
There’s an issue with that type of diagnosis, too.
“Although telemedicine has overcome a lot of the in-person hurdles during the pandemic, it’s fair to assume it’s delayed any direct physical exam that might assist with a diagnosis,” says Nayot.
While it can be frustrating and concerning to face delays and cancellations, staying in touch with your primary care doctor or specialist team, if you have one, can help you stay informed.
They will be able to offer information on likely timelines and give you opportunities to reschedule when they arise.
And even though you may not be able to talk with a doctor or get treatment in person as easily as before the pandemic, telemedicine has opened up access.
“It’s allowed patients with endometriosis to still connect with their clinicians,” says Nayot. Plus, he adds, “a lot of treatment options can be offered in this manner.”
Think the likes of dietary and lifestyle advice, prescriptions for pain and hormonal medications, and recommendations for complementary therapies.
For some people, such medical treatment may be an effective alternative to surgery. “But this will not be an option for all patients,” notes Marchand.
Talking with a doctor or other healthcare professional over the phone or virtually can also be beneficial if you’re already taking hormonal or pain treatment and feel the dose or type may need to be adjusted.
If you’re unable to access a clinician or are facing a long wait for an appointment, there are some ways to ease symptoms at home.
Trying to get enough sleep and doing low intensity exercises, like yoga, can help, along with relaxation and mindfulness strategies.
When symptoms are particularly painful, hot water bottles, warm baths, and over-the-counter pain medications, like ibuprofen, may help relieve any discomfort.
You may also want to connect with others in the same position through online support groups.
Finally, keeping a diary of your symptoms can help a doctor or other healthcare professional prescribe the most appropriate course of treatment while you’re waiting for specialist help.
It’s natural to worry about the risk of COVID-19 if you do need to attend an in-person appointment.
As Marchand explains, “This is not nonsense — quite logically, going ‘to the doctor’ and ‘to the hospital’ is what sick people do, so essentially by definition the worst pathogens will be found there.”
But there are ways to reduce the risk by properly washing your hands and wearing a mask.
Medical offices will use thorough sanitation techniques. They may not allow people with flu-like symptoms to attend appointments, likely reducing the risk of COVID-19 even further.
Right now, there’s no evidence to suggest a link between endometriosis and COVID-19.
“It’s possible that the severe pain associated with endometriosis could limit someone’s activities and exercise to the point where it decreased their immune system,” says Marchand.
This could then make a person with endometriosis more susceptible to viral infections like COVID-19. But, he adds, “I would say this is a rare occurrence.”
The only exception is people with thoracic endometriosis. Since this type affects the diaphragm and lungs, a person with this condition may be more at risk of contracting the coronavirus or more serious illness from COVID-19.
There’s also currently no evidence that COVID-19 affects the development or progression of endometriosis.
A separate factor may need to be considered in this area, points out Marchand.
“The real or perceived fear of going places where medical care is given could lead to barriers to treatment of endometriosis,” he says.
“For example, you might put off your endometriosis surgery because you know you will have to go to the hospital to have it, and it is likely there will be sick people with COVID-19 at the hospital,” Marchand explains.
“There are no published studies that have explored these specific questions as it’s a complex scenario to study,” says Nayot. “So, in short, there’s no evidence to suggest that COVID impacts endometriosis specifically.”
But the pandemic’s effect on accessing healthcare may impact endometriosis symptoms.
In one study carried out during the early part of the pandemic, people reported worsening endometriosis symptoms.
It’s also known that stress and anxiety can have a negative impact on symptoms.
Similar to the above, so far “there’s no evidence to suggest that the COVID vaccines have a negative impact on endometriosis,” says Nayot.
But one 2022 study did find that people with endometriosis were slightly more likely to have heavier menstrual bleeding after being vaccinated.
Whether it’s diagnosis delays or canceled appointments, the pandemic has had a significant impact on several health conditions, including endometriosis.
It’s possible that the stress associated with this and the delays themselves may have worsened both physical and mental symptoms along with overall quality of life.
In some cases, the lengthy waiting times may have resulted in the progression of endometriosis, potentially leading to a need for more complex surgery.
While some regions may still have longer waiting lists for in-person appointments than usual, there may now be more options to access doctors via telehealth. Telemedicine can remove geographic barriers to healthcare and help people who limit or avoid travel due to pain get care.
If you have endometriosis or are waiting for a diagnosis, the COVID-19 pandemic has likely affected the level of healthcare you’ve received.
While there’s no evidence that endometriosis can increase your risk of COVID-19 or vice versa, you may still have experienced a worsening of existing endometriosis symptoms.
It may take some time for doctors and specialist teams to make their way through the lengthy waiting lists.
But telehealth can help you access experts who can provide ways to manage your symptoms while you wait for any necessary in-person appointments.
Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.
Last medically reviewed on September 6, 2022
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