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The Pain Gap: Working With Period Pain, Endometriosis and the Conditions Nobody Talks About

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Hello and welcome to this week's WOOT blog. This one is for every woman who has sat at her desk in genuine pain and said nothing. Who has taken three times the recommended dose of ibuprofen just to get through a meeting. Who has booked annual leave on the days she knew would be worst, not for a holiday, but just to be able to lie down.

 

It is for the woman who has been told by a doctor, more than once, that what she is experiencing is normal. And for the one who finally got a diagnosis after years of being dismissed, only to find that the workplace was barely better equipped to support her than the GP surgery had been.

 

And it is for anyone who has never spoken about this at work because she could not quite figure out how to start that conversation, or whether she should, or what it would cost her if she did.

 

The Numbers That Should Not Still Be This Bad

 

•       Endometriosis affects approximately 1.5 million women in the UK, around 1 in 10 of those of reproductive age.

•       The average time to diagnosis in the UK is eight years. During that time, most women are told repeatedly that their pain is normal.

•       Women with endometriosis can lose between 1.9 and 15.8 working hours per week managing symptoms in workplaces that do not accommodate them.

•       27% of women with endometriosis have missed out on promotions as a direct result of their condition. 54% have experienced income reductions. 1 in 6 have left the workforce entirely.

•       The total economic cost of menstrual health conditions including endometriosis, fibroids and adenomyosis is estimated at £11 billion per year in the UK alone.

•       Nearly 60% of women say their period pain is severe. 47% say their workplace does not take them seriously in relation to their periods.

 

These are not statistics about a niche condition. They are statistics about a significant proportion of the women in every workplace, in every sector, managing something debilitating in silence because the alternative has historically felt worse.

 

What Endometriosis Actually Is

 

Endometriosis is a chronic condition in which tissue similar to the lining of the womb grows in other parts of the body, including the ovaries, fallopian tubes, bowel and bladder. Every month, this tissue behaves as the womb lining does during a period: it thickens and bleeds. But unlike a period, it has nowhere to go. The result is inflammation, scar tissue, adhesions and, for many women, pain that is severe enough to be genuinely disabling on certain days.

 

Symptoms vary widely and can include chronic pelvic pain, extremely heavy periods, back and leg pain, digestive issues, profound fatigue, brain fog, depression and, in some cases, infertility. The condition is unpredictable and the severity fluctuates, which makes it particularly difficult to manage within the rigid expectations of most workplaces.

 

There is currently no cure.

 

The Workplace Problem Is Not Just About Absence

 

The most visible impact of endometriosis at work is absence. But the less visible impact is arguably larger. Women with the condition describe an enormous amount of invisible effort that goes into simply showing up: concealing symptoms to avoid stigma, overcompensating by working additional hours to make up for time lost to pain, managing medication side effects whilst maintaining professional performance, and planning obsessively around their cycle in ways that consume significant mental energy.

 

"Women with endometriosis are not asking for special treatment. They are asking for fair, informed, flexible workplaces."

 

That is the whole ask. And it is entirely reasonable. The research is clear that flexible working arrangements, the ability to start later on bad pain days, to work from home when symptoms are severe, to take breaks when needed, do not reduce productivity. In many cases they increase it, because the alternative is a woman spending her entire energy budget on managing her condition rather than doing her work.

 

What the Law Now Says

 

The Employment Rights Act 2025 introduced several changes that are directly relevant to women managing menstrual health conditions, the most significant of which came into force in April 2026:

 

•       Statutory sick pay now applies from the first day of illness, with no waiting period and no earnings threshold. This is significant for women with fluctuating conditions like endometriosis, who previously could not access sick pay for short-term absences caused by acute pain.

•       Flexible working requests must now be considered properly, with employers required to provide specific written reasons for any refusal on genuine business grounds.

•       From 2027, employers with 250 or more employees will be required to publish gender equality action plans. Guidance from the Office for Equality and Opportunity explicitly states that actions taken to support employees experiencing menopause may also benefit those with endometriosis.

 

Endometriosis may also qualify as a disability under the Equality Act 2010 if it has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities. If it does, your employer has a legal duty to make reasonable adjustments. This is worth exploring with a solicitor or ACAS if you believe it applies to your situation.

 

The UK government has not yet introduced statutory menstrual leave, despite a parliamentary petition and debate on the subject in April 2026. Spain and Portugal have introduced paid menstrual leave for those with diagnosed conditions. The UK position remains that existing employment rights should be sufficient. Many women's experience suggests that gap between policy and reality remains significant.

 

What Can Actually Help at Work

 

Understanding your options before deciding whether to disclose

 

Whether to tell your employer about endometriosis or a menstrual health condition is entirely your decision. There is no legal obligation to disclose. The case for doing so is that it may enable more tailored support and reasonable adjustments. The risk is that it changes how you are perceived, and not always in the ways you would want. Many women find it useful to speak to HR or occupational health in general terms first, to get a sense of the culture and what support exists, before deciding how much to share with a line manager.

 

Making a flexible working request

 

You do not need to cite endometriosis or any medical condition to make a flexible working request. You can request a change to your hours, location or working pattern on any grounds. Your employer must consider it seriously and provide a specific business reason in writing if they refuse. If a pattern of working, such as starting later on certain days or working from home when needed, would genuinely help you manage your condition, a formal request creates a record and an obligation to respond properly.

 

Knowing what reasonable adjustments might look like

 

If your condition qualifies as a disability under the Equality Act, reasonable adjustments could include: amended hours or flexible start times, the ability to work from home on acute symptom days, access to a private rest space during the day, relaxed absence management policies that do not penalise frequent short-term absences, and time off for medical appointments without it counting against your attendance record. These are not extraordinary requests. They are the kinds of adjustments that make the difference between a woman being able to sustain her career and not.

 

Tracking your symptoms and their impact

 

Keeping a record of your symptoms and how they affect your work is useful for several reasons. It helps you see patterns that can inform both your medical care and your conversations with your employer. It provides a factual basis for any request you make or any formal process you need to engage with. And it counters the tendency, which many women with endometriosis describe, to minimise their own experience because they have been told so many times that the pain is normal.

 

Finding support and community

 

Endometriosis UK runs an endometriosis-friendly employer scheme and has resources for both individuals and organisations. Their support groups and online community connect women who are managing the condition in work and can provide both practical advice and the kind of solidarity that comes from being genuinely understood. The Womeniverse™ is also a space where conversations about health, work and the real experience of managing both can happen honestly.

 

A Note on Period Pain More Broadly

 

Not every woman experiencing significant period pain has endometriosis. Conditions including adenomyosis, fibroids, PCOS and dysmenorrhoea can all cause debilitating pain that affects a woman's ability to work. The same principles apply: the pain is real, it has a workplace impact, it deserves to be taken seriously, and there are adjustments that can help.

 

The fact that period pain has historically been minimised, both medically and in workplace contexts, does not mean it is minor. It means the systems around it have failed to take it seriously. That is changing, slowly. In the meantime, knowing your rights and knowing what to ask for matters more than waiting for the culture to catch up.

 

A Final Word

 

Eight years. That is how long it takes, on average, to get a diagnosis of endometriosis in the UK. Eight years of pain. Eight years of working with period pain. Eight years of being told it is normal. Eight years of managing it alone, often in workplaces that were not designed with your health in mind.

 

If that is your experience, or something close to it, your pain was never normal in the sense of being acceptable or something to simply endure. It was normal in the sense of being common, which is a different thing entirely. Common does not mean fine. Common means there are millions of women navigating exactly what you are navigating, and the more we talk about it, the harder it becomes to ignore.

 

You deserved to be taken seriously from the beginning. You still do.

 

Ready to go further? Discover the Womeniverse™ Today

 

If this blog has made you think, question, reflect or simply feel a little less on your own, the Womeniverse™ is here for more of that.

 

Inside, you will find practical guides, honest conversations, expert insight, online events, resources, podcasts and a space designed to support women through work, life and everything in between.

 

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Join the Womeniverse™ today and find your space for Connecting. Growing. Belonging.



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Working With Period Pain, Endometriosis and the Conditions Nobody Talks About – Frequently Asked Questions 

Q. I think I might have endometriosis but I have not been diagnosed. What should I do?

A. Start with your GP and be specific about your symptoms, including how severe your pain is, how it affects your daily functioning and your work, and how long you have been experiencing it. If you are dismissed or told it is normal, ask for a referral to a gynaecologist. Endometriosis UK has a symptom checker and resources to help you prepare for medical appointments and advocate for yourself within the healthcare system.

Q. My employer has an absence management policy that penalises frequent short absences. My condition means I sometimes need a day off at short notice. What can I do?

A. If your condition qualifies as a disability under the Equality Act, your employer may need to make reasonable adjustments to how they apply their absence policy to you. This could include discounting condition-related absences from your attendance record. Document your absences and their cause. Speak to HR about whether a reasonable adjustment can be made. If your employer refuses to consider this, ACAS can advise on your options.

Q. I have been managing this for years and I am tired of it affecting my career. Is there anything that actually changes things?

A. The honest answer is that the most consistent improvements come from a combination of finding the right medical management for your specific symptoms, securing workplace adjustments that reduce the energy cost of managing the condition at work, and being in community with other women who understand what you are dealing with. None of those things makes the condition go away. Together, they can make it significantly more manageable.

Q. I am worried that if I ask for adjustments, my employer will see me as unreliable or a problem.

A. That concern is widely shared and reflects a real stigma that still exists around menstrual health conditions. What tends to help is framing a request around what you need to do your best work, rather than around what the condition prevents you from doing. You are not asking to do less. You are asking for the conditions in which you can contribute fully. Whether your employer responds well to that depends on the individual and the culture, but you are entitled to make the request regardless.

Q. Where can I find more information and support?

A. Endometriosis UK (endometriosis-uk.org) has comprehensive resources including a helpline, support groups and an endometriosis-friendly employer scheme. ACAS (acas.org.uk) provides free advice on employment rights. The Equality Advisory and Support Service can advise on disability discrimination under the Equality Act. And the Womeniverse™ community is a space where you can connect with other women navigating work and health challenges without having to explain yourself from scratch.


 
 
 

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