Endometriosis is a chronic, often debilitating condition affecting an estimated 1 in 10 women and people assigned female at birth. Symptoms can include severe pelvic pain, fatigue, heavy bleeding, gastrointestinal issues and, in many cases, significant disruption to daily activities. For many employees, this means that work can be greatly affected.
It is important to understand that endometriosis is a common, often painful chronic condition where tissue, similar to the lining of the uterus (endometrium) grows outside it, typically on pelvic organs like ovaries and fallopian tubes. These patches behave like the uterus lining, breaking down and bleeding during menstruation, but have no way to exit the body, causing inflammation, pain, scar tissue and potential infertility.
Many people have not heard of the condition, partly given the taboo of discussing menstrual problems which some people still find difficult to discuss. However, March is Endometriosis Awareness Month and is a great opportunity for employers to reflect on how well they support affected employees and whether policies, culture, and management approaches align with best practice and their legal obligations.
Here we set out what employers need to know from an employment law perspective, and the practical steps HR and managers can take to create a healthier, more inclusive workplace.
Why employers should pay attention
While endometriosis isn’t automatically deemed a disability, many employees meet the definition under the Equality Act 2010 if their symptoms have a “substantial” and “long-term” adverse effect on their ability to carry out normal day‑to‑day activities. When this threshold is met, employers are legally required to make reasonable adjustments to remove or reduce workplace disadvantages and to ensure an employee does not suffer from discrimination in their treatment.
As endometriosis is a gynaecological condition that predominantly affects women, employers should also be mindful of the risk of sex discrimination when managing related issues. Endometriosis can also contribute to fertility problems, and while infertility treatment itself does not attract pregnancy‑related protections, employees undergoing IVF will have pregnancy discrimination protection from the point of embryo transfer onwards. These matters should therefore be handled sensitively and in accordance with your legal obligations.
Practical examples of support can include:
- Understanding your employee’s condition. Consider a sensitively handled meeting to understand your employee’s condition and how it affects them. Everyone is different and you need to understand how endometriosis affects your employee. You can ask them how they can be supported? How have they been supported in other jobs? What can you do to assist them?
- Reasonable adjustments and flexible working. Do consider with the employee any support that may need to be offered, such as modified duties, frequent rest breaks, or home‑working arrangements. This could also include hybrid or home working during flare‑ups. Employers should consider an occupational health referral for tailored recommendations.
- Sickness Absence. Employees suffering from endometriosis may also suffer with increased long‑term or intermittent sickness absence. Employers will need to manage these issues with sensitivity. This can include considering adjusted attendance triggers within absence policies resulting from this medical condition.
- Work Environment. Under the Health and Safety at Work Act, employers must ensure the working environment does not exacerbate an employee’s condition. This extends to workstation set‑ups, rest facilities and ensuring employees can access bathrooms easily if experiencing severe pain or bleeding.
- Communication Plan. It can be helpful to work with your employee to create a ‘communication plan’ understanding if they feel happy to share some information or not, as they decide, remembering your data protection obligations. It can also help with agreeing flexibilities or working arrangements that co-workers will support where these may, in some cases, occur monthly.
Supporting employees with endometriosis shouldn’t just be looked at as a legal obligation. When this arises, businesses should also consider that supporting employees with such health issues, can also assist the business in:
- Lower sickness absence;
- Higher retention of skilled employees;
- Improved morale and engagement;
- Reduced grievances and risk of tribunal claims; and
- A reputation as an inclusive employer
Given the prevalence of endometriosis, most organisations will inevitably have affected employees, whether they disclose it or not. Therefore, creating a workplace where people feel safe to talk about their health conditions benefits everyone and being aware of symptoms and reasonable adjustments that can be offered can greatly assist.
HR best practice: what employers should be doing
Many employees do not disclose endometriosis due to a fear of being dismissed, penalised, or disbelieved. Employers can foster openness by training teams and managers on the following:
- Handling sensitive health disclosures;
- Equality Act obligations, reasonable adjustments and disability discrimination; and
- Respect at work: creating inclusive and supportive team environments.
While a standalone endometriosis policy is not essential, many employers can choose to include it within:
- Women’s health or reproductive health policies;
- Long‑term health conditions guidance;
- Menstrual health policies; and
- Flexible working frameworks.
Policies should cover reasonable adjustments and how employees can request help.
A supportive employer should aim to:
- Acknowledge endometriosis as a legitimate and serious health condition;
- Provide clear pathways for disclosure and support;
- Ensure policies are inclusive and flexible;
- Individualise support through personalised adjustments; and
- Monitor and review changes regularly.
Creating a workplace where employees feel understood and supported helps them stay productive, loyal, and engaged.
How we can help
Endometriosis is common, often misunderstood, and frequently invisible but its impact on employees can be profound. By understanding your obligations and adopting a supportive approach, you can make a real difference. And you don’t have to navigate it alone.
We’re here to help you build a workplace that is inclusive, compliant, and genuinely supportive for employees living with endometriosis. Let us know if you would like to discuss any employment issues, our in-house training offers or employer policies.
Do get in touch with Paula Squire on 03452091200 or paula.squire@clarkewillmott.com to discuss the above.
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