By Alicia Collinson, Rebecca Shah & Maisie Watson
A Growing Workplace Issue That Can No Longer Be Ignored
Endometriosis is a chronic inflammatory condition that can cause severe pain, fatigue, organ complications and fertility difficulties. It affects roughly 1 in 10 women and people assigned female at birth, that equals about 190 million people globally – making it almost as common as diabetes.
Adenomyosis, a related condition affecting the uterine muscle wall, can produce similarly debilitating symptoms. Both conditions are fluctuating, unpredictable and often long-term. People with these conditions may experience recurring flare-ups, require surgery and face extended recovery periods.
These are not short-term health issues. They are fluctuating, unpredictable and often lifelong, yet they remain insufficiently acknowledged or understood by employers.
The Human Reality Behind the Legal Risk – Case Study
For many women, this does not start at work. It starts at puberty, with pain that feels wrong, with bleeding that is heavy, persistent, and incapacitating. Women being told it is “normal”. I was one of those girls.
I knew early on that something wasn’t right. I was a county swimmer, it was my passion and my pride, and yet it became impossible because my periods were too heavy and too debilitating. School, social life, and education were all quietly affected. I was repeatedly told by my GP that it was “growing pains”.
At 19, after years of worsening symptoms, I underwent what was meant to be a 45-minute exploratory procedure. It lasted four and a half hours. When I woke, I learned that my endometriosis was so severe that my organs had adhered together and my right ovary had been removed. Years of dismissal had led to one irreversible outcome.
My recovery was long. University exams were taken with medication lined up on my desk but this was only the beginning.
Over the next two decades there were further surgeries, anaemia, migraines, fertility decisions made against surgical advice timelines, and the quiet management of pain around performance expectations.
This is what often walks into workplaces unnoticed. Endometriosis is not “just a bad period”. It is:
- Working through exhaustion and brain fog
- Sitting in meetings while managing internal pain
- Recovering from invasive surgery and returning before you’re ready because you feel there is no flexibility.
- Planning pregnancy around both medical urgency and maternity pay qualification
- Absorbing throwaway comments about “women’s troubles”.
It is cumulative, invisible and frequently masked. This is due to cultural stigma surrounding menstrual health, lack of clinical awareness, and the historical underfunding of women’s health research have all contributed to delayed recognition and treatment.
Why this is now a legal issue
Endometriosis is widely recognised as a condition that remains significantly underdiagnosed and under-researched. Individuals typically experience an average diagnostic delay of seven to ten years, with symptoms frequently dismissed as normal menstrual pain, stress-related discomfort, irritable bowel syndrome, or exaggerated period symptoms.
The condition is also considered medically complex and understudied due to its still largely unknown causes, variable presentation between individuals, and limited long-term research investment. By the time a diagnosis is confirmed, the condition is often advanced, as shown by the case study.
Against this backdrop, for many employees, speaking openly about chronic gynaecological conditions remains daunting. Individuals frequently report fears of job loss, stigma or professional disadvantage.
Ensuring fair treatment is not simply a compliance exercise – it is a fundamental workplace right and a key driver of inclusion, retention and employee wellbeing.
Parliamentary Momentum: Paid Menstrual Leave Under Consideration
A significant policy development is currently gathering momentum.
A UK petition calling for up to three days of paid menstrual leave for individuals living with endometriosis and adenomyosis has now passed 100,000 signatures, triggering consideration for parliamentary debate within the UK Parliament.
Campaigners argue that paid menstrual leave would:
- Recognise the severity of disabling menstrual pain
- Reduce pressure on employees to work through debilitating symptoms
- Limit reliance on unpaid leave or sickness absence
- Encourage open workplace conversations around reproductive health
While the proposal is not yet law, this signals growing political recognition of menstrual health as a workplace equality issue. Employers should view this as part of a broader shift toward increased legislative and regulatory scrutiny.
Tribunal Precedent: Disability Protection and Endometriosis
A further landmark development is a January 2026 employment judgment involving claims against Accenture.
The ruling has been widely described as establishing an important precedent by:
- Confirming that endometriosis can meet the definition of disability under UK equality legislation
- Considering what could arise from that disability, including absence linked to treatment and recovery
- Highlighting failures in workplace support mechanisms
The judgment reinforces that employers must carefully assess whether chronic gynaecological conditions meet disability thresholds rather than treating them as short-term health concerns.
Common Workplace Failures Identified
Recent legal commentary and employee testimony have highlighted recurring areas of employer risk. These include:
- Failure to Listen to Medical Evidence
Employees report that symptoms and treatment requirements are frequently dismissed or minimised, despite clinical evidence.
- Inadequate Assessment of Workplace Impact
Employers may underestimate the substantial effect of endometriosis on day-to-day functioning, including recovery following surgery or treatment.
- Failure to Make Reasonable Adjustments
Adjustments are often overlooked or treated as discretionary rather than a statutory obligation where disability thresholds are met.
- Misuse of Disciplinary or Capability Procedures
Rigid attendance or performance frameworks can lead to unlawful treatment where absence or performance concerns arise from disability.
- Dismissal Risk
Dismissals linked to sickness absence, without proper assessment or adjustment consideration, are increasingly subject to tribunal challenge as they may amount to disability discrimination, regardless of length of service.
Behind each of these failures is a human being who has often already fought for years to be believed.
The Legal Risk Landscape for Employers
Employers must recognise that chronic reproductive health conditions can trigger legal protections where the impact has:
- A substantial adverse effect on normal day-to-day activities
- That adverse effect is long-term or of a recurring nature
Where this threshold is met, employers must:
- Consider and implement reasonable adjustments
- Not take any unlawful action which is because of the disability
- Avoid policies that indirectly disadvantage affected employees
- Ensure disciplinary or capability processes account for disability-related absence
Failure to do so may result in claims involving discrimination, failure to make reasonable adjustments, or unfair dismissal.
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Looking Ahead: More than just compliance
Endometriosis is not niche. It affects high performers. Future leaders. Trainees. Senior executives. Mothers. Women navigating fertility. Women who have lost organs at 19 after being told nothing was wrong.
For many, the only eventual “cure” offered is hysterectomy.
This cannot remain a policy footnote. We have learned to understand neurodivergence, migraines, chronic pain and mental health. Reproductive health deserves the same recognition and support.
Endometriosis is not only a medical condition; it is an equality, wellbeing and workforce sustainability issue.
When employers get this wrong, the cost is legal, cultural and deeply personal but when they get it right, the impact is transformative.
How Thrive Law Can Support Employers
Employers should consider reviewing existing policies, adjustment frameworks and absence procedures to ensure compliance with emerging legal expectations.
Get in touch at enquiries@thrivelaw.co.uk and let’s explore how we can help you and your workplace thrive.
