specialty focus
Tackling the taboo
How we can better diagnose , treat and help people manage endometriosis .
Mike Armour interviewed by Eleanor Campbell
Recent research has told us that one in six women in Australia have lost their jobs due to endometriosis , with one in three being passed over for a promotion at work .
A national survey of 389 women diagnosed with the condition found a lack of flexible work arrangements and locations made it difficult for them to manage their symptoms .
The study ’ s co-lead author , senior research fellow in reproductive health from Western Sydney University , Dr Mike Armour , says there is still a stigma and a lack of understanding around the impacts of endometriosis .
“ One of the most important things is believing in people ’ s pain ,” he told Nursing Review .
“ On top of that , we still have the taboo about talking about menstruation .”
One in nine women have a diagnosis of endometriosis in Australia by the age of 44 , however many will experience delays in diagnosis .
Health practitioners and nurses play an important role in empowering women and helping them to believe in their symptoms and to not brush them off , said Armour .
“ We need to get past this idea that everyone ’ s period pain is the same ,” he said .
16 | nursingreview . com . au
Armour joined Nursing Review to discuss his co-research and the current state of endometriosis in Australia .
NR : How prevalent is endometriosis in Australia , and can you give us an idea of the kinds of symptoms that women and people who are gender diverse might experience when they ’ re suffering from this condition ? MA : Around 1 in 9 women in Australia has a diagnosis of endometriosis by the age of 44 . Our research has shown some really common symptoms , especially in the beginning , include severe period pain , and severe dysmenorrhea is the most common initial symptom and it tends to be the one that persists throughout the reproductive lifespan .
Sever , chronic fatigue is one that we ’ re really starting to understand more and more now as a characteristic symptom , and then very commonly pain on or before urination , pain on or before bowel motion , and pain either during or in the 24 hours after sexual intercourse .
On top of that gastrointestinal symptoms , which are often misdiagnosed as irritable bowel syndrome , are also really common .
And your most recent co-research surveyed 389 women who were diagnosed with endometriosis . Could you tell us how they spoke about how the condition affected them at work , and how they were treated by their colleagues ? We did some preliminary research on this a couple of years ago . As part of a much larger study we looked at the impact on work , and we noticed that a lot of people reported that they had been fired or passed over for promotion .
We also knew about the huge impact on work productivity , in having to take a lot of sick days .
The reason for this research was COVID , and it was the perfect experiment because , especially in the initial lockdown phase , a lot of people were working from home . We felt this was a good time to be able to see what those changes might have done to those with endometriosis in terms of their ability to manage their symptoms and their productivity .
We know from our previous research that around two-thirds said that they had to take unpaid leave to manage their endometriosis . On average , our previous work said it was about 4 to 4.6 sick leave days per month on average that people with endometriosis would take . You can imagine it doesn ’ t take a long time to exhaust all of your sick leave .
Well over half felt that they were judged when they were trying to manage their symptoms , or they felt like they had a burden of trying to hide being unwell at work . That judgement came from both employers and fellow employees .
I think the headline grabbing one is that 1 in 7 people with endometriosis reported that they had been fired as a result of managing their endometriosis . Even for those that weren ’ t fired , over a third said they missed out on a