Endometriosis in the workplace – what HR and business leaders need to know

March marks Endometriosis Awareness Month, a useful time to highlight this often-overlooked condition affecting 10% of women of reproductive age. Despite its prevalence, many women struggle for years before receiving a diagnosis, with the average time to diagnosis being around eight years.

Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the uterus (endometrium) grows outside of the uterus. This tissue can be found on the ovaries, fallopian tubes, bowel, bladder, and even in areas beyond the pelvis, such as the diaphragm or gallbladder. Unlike the normal endometrial lining, which sheds during a menstrual period, this misplaced tissue has no way to exit the body, causing inflammation, scarring, and intense pain.

Symptoms can vary widely but commonly include:

• Chronic pelvic pain – often worsening during menstruation.
• Painful periods (dysmenorrhoea) – sometimes severe enough to cause fainting or vomiting.
• Pain during or after sex (dyspareunia).
• Gastrointestinal issues – including bloating, constipation, diarrhoea, or bowel pain.
• Fatigue and low energy levels.
• Urinary problems – such as pain when passing urine or blood in urine.
• Heavy menstrual bleeding – leading to anaemia and requiring medical intervention.
• Infertility issues – endometriosis is a leading cause of infertility.

The workplace impact

Endometriosis can have profound effects on employees, leading to:

• Reduced productivity due to chronic pain and fatigue.
• Increased absenteeism from severe symptoms, frequent medical appointments, and surgical procedures.
• Limited career progression if employees feel unsupported or unable to manage their symptoms effectively at work.
• Mental health strain due to the emotional burden of coping with pain, infertility concerns, and societal stigma.

A study from the Office for National Statistics (ONS) found that women diagnosed with endometriosis often experience a drop in earnings following their diagnosis, with this financial impact persisting over time. This suggests that many women reduce their working hours or take on less demanding roles to cope with their condition. Without adequate workplace support, businesses risk losing valuable talent.

The challenges of diagnosis and treatment

One of the biggest challenges with endometriosis is its delayed diagnosis. Many women report that their symptoms are dismissed as “just bad periods”, or they are misdiagnosed with conditions such as irritable bowel syndrome (IBS) or urinary tract infections (UTIs). Due to these misdiagnoses, women may go years without receiving the correct treatment.

The gold standard for diagnosing endometriosis is laparoscopy, a surgical procedure that allows a doctor to look inside the pelvis and confirm the presence of endometriosis. However, given the long NHS waiting lists, many women face significant delays in getting this diagnosis. In the meantime, treatment options may include:

• Pain relief – such as ibuprofen, naproxen, or stronger painkillers like codeine or tramadol.
• Hormonal therapy – including the combined contraceptive pill, progesterone-only treatments, or hormone-releasing intrauterine devices (IUDs) like the Mirena coil.
• Surgery – excision surgery can remove endometrial tissue, but in severe cases, a hysterectomy (removal of the uterus) may be suggested.
• Lifestyle and holistic approaches – including dietary changes, pelvic physiotherapy, yoga, and mindfulness.

How HR and business leaders can provide support

To build an inclusive workplace and retain valuable talent, consider implementing the following strategies:

1. Raise awareness and break the stigma

Endometriosis remains under-discussed, often dismissed as “just bad periods.” Employers can foster awareness by providing educational sessions, sharing resources from organisations like Endometriosis UK, and encouraging open conversations around menstrual health.

Providing training to managers on how to support employees with chronic conditions like endometriosis is key. Many women report feeling unheard or dismissed when discussing their symptoms at work, so fostering an environment where employees feel safe to disclose their condition is essential.

2. Flexible work arrangements

Providing employees with flexible schedules, remote work options, or hybrid working models can make a significant difference for those managing chronic pain and fatigue. Having the option to work from home on difficult days can help employees stay productive while also managing their symptoms effectively.

3. Reasonable workplace adjustments

Employers can support affected employees by:

• Allowing more frequent breaks or providing a comfortable rest area.
• Reassigning tasks on particularly difficult days.
• Implementing ergonomic adjustments, such as providing supportive seating.
• Offering menstrual leave or additional paid sick leave where possible.

4. Comprehensive healthcare and benefits

Consider expanding workplace benefits to include:

• Access to specialist consultations through private healthcare plans.
• Support for mental health services, including counselling.
• Coverage for alternative therapies that help manage pain, such as physiotherapy and acupuncture.
• Funding for fertility treatments – as endometriosis can impact fertility, some workplaces are now offering fertility support as part of their benefits package.

5. Reviewing policies for fair treatment

Ensure your organisation’s policies recognise endometriosis as a long-term condition requiring workplace accommodations. This includes:

• Updating sick leave policies to allow for more flexibility.
• Considering endometriosis under disability protections where applicable.
• Providing access to occupational health reviews to assess necessary workplace adjustments.

Moving towards a more inclusive future

By acknowledging and addressing the impact of endometriosis in the workplace, HR and business leaders can help remove barriers to success for employees affected by this condition.

Building a culture of understanding and support not only improves employee well-being but also enhances overall workplace engagement and retention. Investing in awareness, flexibility, and tailored workplace accommodations will ensure that businesses retain diverse and talented workforces while contributing to a more inclusive and supportive professional environment.

For further resources, organisations such as Endometriosis UK provide valuable guidance on employer support and advocacy for menstrual health in the workplace. Now is the time to take action and create lasting change for those living with endometriosis.