April 9, 2020

Managing Endometriosis During the COVID-19 Pandemic

woman with pelvic pain sitting in her bed

By Lucy Erickson, PhD, SWHR Director of Science Programs

Disclaimer: The following is not medical advice. If you are concerned about endometriosis, COVID-19, or another health condition, please contact your doctor.

Endometriosis is a burdensome gynecological disease that can have a huge impact on women’s lives under normal circumstances. With a global pandemic disrupting life as we know it in dramatic ways, the current situation is anything but normal.

For women with endometriosis, the widespread stress and anxiety caused by the coronavirus pandemic may make managing their chronic disease even more challenging.

Generally, women with endometriosis should follow the same guidance as the general population in avoiding coronavirus: Take care of yourself as best as you can while minimizing physical contact with others and washing your hands frequently and thoroughly (for at least 20 seconds).

However, women with endometriosis may face additional health questions and challenges during this time given their chronic disease.

Endometriosis and COVID-19 Risk

Because this virus is new, we do not yet have any data on whether individuals with endometriosis are at higher risk for COVID-19. Endometriosis is not listed as a high-risk condition on the Centers for Disease Control and Prevention (CDC) website.

Patients with endometriosis in the chest cavity — thoracic endometriosis — may be at higher risk because COVID-19 infects the respiratory tract, and individuals with other conditions that affect the respiratory tract, such as asthma and lung cancer, are considered at higher risk. If you have thoracic endometriosis, handwashing and social distancing are still your best preventative options. In addition, if you can, it may be advisable to work from home and avoid contact with any individuals outside your immediate household.

Another group considered at higher risk of COVID-19 are people with weakened immune systems. Endometriosis is not an autoimmune disease, but it is an inflammatory disease. However, according to Dr. Stacey Missmer, ScD, a member of SWHR’s Endometriosis and Fibroids Network Member, scientific director at the Boston Center for Endometriosis, and professor of obstetrics, gynecology and reproductive biology at Michigan State University, “women with endometriosis do have an altered immune system marked by a chronic inflammatory state, and they also have been shown to be at higher risk for autoimmune diseases.”

Therefore, we do not yet know if women with endometriosis have a higher risk of infection with COVID-19 or are at higher risk of severe symptoms if infected. “We will need to analyze this closely in the future when widespread testing for infection and recovery are available,” Missmer said.

Using NSAIDs to Manage Pain

Although nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen have been in the news recently as agents that may potentially worsen symptoms of COVID-19, the Food and Drug Administration (FDA) issued a statement calling this into question. At present, according to the agency, there is a lack of evidence supporting these reports. FDA is monitoring the situation and will release further information as it becomes available.

If you need NSAIDs to manage your endometriosis pain but are worried, you should contact your doctor.

Managing Your Endometriosis During COVID-19

The burden placed on hospitals in many areas due to COVID-19 is immense, and there is a strong chance that this situation will impact the ability to schedule and keep health care appointments, procedures, and surgeries. Having endometriosis-related appointments or surgeries canceled may be difficult and add to the burden of your disease, but try to remember that health care professionals are doing their best to provide care in an incredibly difficult and stressful time.

As best you can, partner with your health care provider in the management of your disease during this time. Although in-person visits and procedures may be impossible, telehealth appointments may be an option to consult with your provider to develop a plan to manage your symptoms.

Some at-home remedies that may help you manage your symptoms include using a heating pad, taking a hot bath, and keeping up your exercise regimen as best as you can. Practicing yoga may be especially helpful, as some yoga poses are thought to help ease some pelvic pain associated with endometriosis.

Due to the situation with COVID-19, going to the emergency room should be a last resort if you cannot manage your symptoms. If you are concerned and exhaust your ability to manage your symptoms alone, you should call you doctor, 911, or go to the hospital.

Caring for Your Overall Health and Wellbeing

There is no doubt that this is a challenging time. Taking care of yourself as best as you can, including your mental health, is really important. Eating well, drinking a lot of fluids, avoiding alcohol and drugs, getting enough sleep, and practicing mindfulness strategies are key to minimizing stress and maintaining your wellbeing. Check out SWHR’s blog post, “Tips for Staying Healthy During a Pandemic,” for general guidance in these areas.

Although physical distancing is important right now because of the pandemic, this does not have to mean true isolation. Social support is key to managing your endometriosis, and there are many free tools such as Google Hangouts or Zoom that can help you stay connected with loved ones from a safe distance. Online support groups for endometriosis patients may also be a good source of support, empathy, and ideas on managing symptoms and well-being in this challenging time.

If you believe you have COVID-19 symptoms and are having difficulty breathing, you should call your doctor or 911, or go to the emergency room.