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Symptom flares in endometriosis: burden, self-management and barriers to care in a cross-sectional survey

Abstract:
Objective: To explore the characteristics of symptom flares, individual experiences and behaviours during flares in people with endometriosis.

Design: Online questionnaire shared on patient support sites.

Setting: People with a confirmed or working diagnosis of endometriosis (a working diagnosis is given by clinicians based on symptoms/history, individuals may or may not go on to have further imaging/surgical investigations).

Population or Sample: A total of 236 responses collected.

Methods: Descriptive and comparative analysis of quantitative data, and thematic analysis of qualitative data.

Main Outcome Measures: The characteristics, triggers, treatments and strategies for symptom flares together with perceived predictability and self-efficacy in relation to flares, healthcare access during flare, advice received and overall endometriosis-related quality-of-life.

Results: We identified a wide variation in the characteristics and treatments/strategies. 31.2% stated that they were “not at all” confident coping with long flares, and around 1/3 of participants found flares “not at all” predictable. Only 35.3% reported receiving advice from a healthcare provider about flares. We developed 5 themes to suggest why participants did not contact healthcare providers: ‘what can they do?’, ‘I can cope, it will end’, ‘broken healthcare system’, ‘perceived dismissal and gaslighting’ and ‘symptoms stop me’.

Conclusions: Flares have a large impact on quality-of-life and are clinically very important. Individuals do not commonly receive advice from healthcare providers or contact healthcare providers during a flare. More research, in a more diverse sample, is needed to identify mechanisms underlying flares, as well as developing and disseminating management tools to prevent, manage and treat flares.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1111/1471-0528.70211

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Oxford college:
St Hugh's College
Role:
Author
ORCID:
0000-0003-0818-1240
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Role:
Author


Publisher:
Wiley
Journal:
BJOG: An International Journal of Obstetrics & Gynaecology More from this journal
Publication date:
2026-03-13
Acceptance date:
2026-02-25
DOI:
EISSN:
1471-0528
ISSN:
1470-0328


Language:
English
Keywords:
Pubs id:
2385858
Local pid:
pubs:2385858
Deposit date:
2026-03-06
ARK identifier:

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