{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:58:54Z","timestamp":1785463134090,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the characteristics of symptom flares, individual experiences and behaviours during flares in people with endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Online questionnaire shared on patient support sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population or Sample<\/jats:title>\n                    <jats:p>A total of 236 responses were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Descriptive and comparative analysis of quantitative data, and thematic analysis of qualitative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>The characteristics, triggers, treatments and strategies for symptom flares together with perceived predictability and self\u2010efficacy in relation to flares, healthcare access during flare, advice received and overall endometriosis\u2010related quality\u2010of\u2010life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified a wide variation in the characteristics and treatments\/strategies. 31.2% stated that they were \u2018not at all\u2019 confident coping with long flares, and around 1\/3 of participants found flares \u2018not at all\u2019 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: \u2018what can they do?\u2019, \u2018I can cope, it will end\u2019, \u2018broken healthcare system\u2019, \u2018perceived dismissal and gaslighting\u2019 and \u2018symptoms stop me\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Flares have a large impact on quality\u2010of\u2010life 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70211","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T02:04:18Z","timestamp":1773453858000},"page":"1731-1741","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom Flares in Endometriosis: Burden, Self\u2010Management and Barriers to Care in a Cross\u2010Sectional Survey"],"prefix":"10.1111","volume":"133","author":[{"given":"Lydia","family":"Coxon","sequence":"first","affiliation":[{"name":"Nuffield Department of Women's &amp; Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Evans","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's &amp; Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francine","family":"Toye","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Cox","sequence":"additional","affiliation":[{"name":"Endometriosis  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Vincent","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's &amp; Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0008-5"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000001305"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101769"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2631"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/RAF-23-0004"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17915"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"e_1_2_12_9_1","volume-title":"Guideline Scope Endometriosis: Diagnosis and Management. 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