Women living with endometriosis are forced to miss twice as much work and report poorer work ability, resulting in an average indirect cost of 1757 euros per year to society in Hungary, according to a new international study conducted in collaboration between researchers from the FEMaLe (Finding Endometriosis using Machine Learning) H2020 programme and Corvinus University of Budapest.

Endometriosis affects one in ten women of reproductive age. The pain, cramps, infertility and chronic fatigue associated with the disease not only reduce quality of life, but also impair work ability and productivity. A research team from Corvinus University of Budapest, Semmelweis University and St. John of God Hospital in Vienna has quantified the social cost of these effects. The study compared data from 566 women living with endometriosis with 447 control participants using the Lucy health mobile application. The findings were published in the journal Preventive Medicine Reports. 

According to the study, people living with endometriosis faced a significantly greater burden at work. Over a four-week period, they missed an average of 12.7 working hours for health-related reasons, compared with 5.7 hours in the control group. The absenteeism rate was 9.7 percent among those with endometriosis, compared with 5.8 percent in the control group. Based on Hungarian average wages, the researchers estimate that this represents an average annual cost of EUR 1,757, or around HUF 620,000, to society per affected person. Presenteeism, meaning when someone is at work but is less effective because of their symptoms, proved to be an even greater problem. Women with endometriosis reported difficulties of this kind at a rate of 47.2 percent, compared with 38.4 percent in the control group. 

“The impact of endometriosis goes beyond the individual, as it is also a social and economic issue. Flexible working arrangements, better-informed managers and targeted workplace support can help ensure that those affected are not pushed out of the labour market,” said Valentin Brodszky, one of the authors of the study and a researcher at the Department of Health Policy at Corvinus University of Budapest. 

Among women living with endometriosis, 42 percent classified themselves as having “poor” work ability, compared with 17.9 percent in the control group. This suggests that the disease may also threaten their ability to remain in work in the longer term. More than half of the participants said their employer had little or no knowledge of endometriosis. One-third of women living with endometriosis reported that they could not discuss the issue with their supervisor. 

When respondents were asked what forms of workplace support would be effective, they most frequently mentioned menstrual leave, flexible or remote working, a supportive managerial attitude, rest periods and employer-supported private healthcare. These measures can also serve a preventive purpose: they may help preserve work ability, reduce lost working time and protect the economic security of the women affected. 

Endometriosis is a common, chronic gynaecological condition that is often diagnosed only years after symptoms first appear, with the average time to diagnosis ranging from 4 to 11 years. Its economic consequences are significant: the total annual social burden in the European Union reaches EUR 30 billion, the largest share of which consists of work-related indirect costs.