Endometriosis is often described as a “period problem”. It is not. It is a whole-body, inflammatory condition that affects the reproductive system, and its impact reaches far beyond the pelvis. Even NICE now recognises that endometriosis can affect multiple systems in the body and may need care from more than one specialist [1].

Around 1.5 million people in the UK live with endometriosis [2]. For many of them, the condition shapes everyday life: whether they can get to work, finish a course, keep up with friends or plan more than a day ahead. This November, we are looking at endometriosis as a disability, what the law says, and what real workplace inclusion looks like.

Endometriosis can bring chronic pain, fatigue, heavy bleeding, bowel and bladder symptoms, and the mental strain of living with all of these at once. Because symptoms fluctuate, someone can manage a full week one month and struggle to get out of bed the next.

The impact on working life is now backed by national data. In 2025, the Office for National Statistics published the first population-level analysis of how an endometriosis diagnosis affects work in England. It found that women aged 25 to 54 earned, on average, £130 less per month five years after diagnosis than in the two years before it [3]. The linked study, covering 55,920 women, also found that people were less likely to be in paid employment after diagnosis [4].

Research with employees tells a similar story. A 2025 qualitative study of women with endometriosis, adenomyosis and infertility described difficulty managing symptoms at work, extra pressure to perform, using up sick leave, and working less with a knock-on effect on career progression [5]. Endometriosis UK also hears from people who have been forced to change careers or give up their ambitions because of the disease [6].

Behind every one of these numbers is a person making hard choices about money, health and their future.

Under the Equality Act 2010, you are disabled if you have a physical or mental impairment that has a “substantial” and “long-term” negative effect on your ability to do normal daily activities [7]. In plain terms:

• Substantial means more than minor or trivial, for example a daily task taking much longer than it usually would [7].
• Long-term means 12 months or more [7].
• Fluctuating conditions have their own rules, so symptoms that come and go can still count [7]

Endometriosis is not automatically classed as a disability. Whether it counts depends on how it affects each person [8]. If it does meet the definition, you are protected from discrimination at work, and your employer has a legal duty to make reasonable adjustments [8]. The Act applies in England, Scotland and Wales, but not Northern Ireland [7].

This year, an important appeal case added weight to the legal picture. Ms Pal, a manager at Accenture, was dismissed after being judged not ready for promotion, and brought claims including disability discrimination and failure to make reasonable adjustments linked to her endometriosis [9].

The Employment Appeal Tribunal (EAT) found that the original tribunal’s analysis of whether her endometriosis was a disability had been “wholly inadequate”, and parts of the original judgment, including its findings on disability, are now void [10]. In doing so, the EAT confirmed several points that matter for our community [9]:

• Endometriosis can qualify as a disability under the Equality Act where symptoms are substantial and long term.
• Fluctuating or cyclical symptoms do not stop a condition from being a disability.
• A tribunal must consider the condition as it would be without the benefit of treatment.

That last point is important. If medication or surgery is helping to manage your symptoms, that does not automatically mean you fall outside the definition.

Endometriosis UK welcomed the ruling, while noting that it does not mean every case of endometriosis will automatically be treated as a disability [10]. It also highlighted that endometriosis is still not properly understood in the workplace or in the legal system [10].

Not everyone with endometriosis wants to describe themselves as disabled, and that is completely valid. Endometriosis UK points out that people may choose not to use the words “disabled” or “disability” about themselves or their condition [10].

The legal protection does not depend on the label you use. What matters is the effect the condition has on your daily life. You can use whatever words feel right to you and still ask for the support you are entitled to.

Keep a record. Note your symptoms, how they affect your work or studies, and any time off. This helps you explain what support would make a difference, and can be useful evidence if things become difficult.

Start the conversation when you are ready. You do not have to share every detail. Focus on what you find hard and what would help. Your GP or specialist may be able to provide a letter, and many employers can refer you to occupational health.

Think about adjustments that fit your symptoms. Every person is different, but examples to discuss could include:

• flexible start and finish times, or flexibility on days when symptoms flare
• the option to work from home some of the time
• easy access to a toilet, and breaks when you need them
• a comfortable chair, a heat pad, or a quiet space to rest
• recording endometriosis-related absence separately from general sickness absence
• a phased return after surgery

Look into Access to Work. This government scheme can pay for extra support to help you stay in work if a health condition makes parts of your job, or getting to work, difficult [11]. If you sometimes need to work from home, it may also help with adjustments there [11].

Get advice if things go wrong. If you feel you are being treated unfairly, Acas, Citizens Advice or your trade union can talk you through your options. Employment tribunal claims have strict time limits, so it is worth getting advice early.

Supporting employees with endometriosis is not only a legal duty in many cases. It also helps you keep skilled people who might otherwise reduce their hours or leave. A few practical starting points:

• Learn the basics. Endometriosis is common, fluctuating and often invisible. A colleague can look well and still be in significant pain.
• Do not wait for a diagnosis or a label. Focus on what the person is finding difficult and what would help, rather than on whether they meet a legal definition.
• Train your managers. The Pal case shows how costly a poor understanding of endometriosis can be. Make sure managers know how to have supportive, confidential conversations.
• Review your policies. Check that sickness absence, performance and promotion processes do not unfairly penalise people with fluctuating conditions.
• Make adjustments simple to ask for. A clear, low-pressure process means people ask earlier, before problems build up.Endometriosis UK runs an Endometriosis Friendly Employer scheme, which more than 150 employers have signed up to, committing to help employees with endometriosis thrive at work [12]. It is a useful place to start.

Living with endometriosis should not mean giving up on your career, your education or the life you want. Whether or not you call it a disability, the impact is real, and so is your right to support.

If you would like to talk about anything in this piece, or you are an employer who wants to do better for your team, please get in touch. We are here to help.

• Gov.UK: Definition of disability under the Equality Act 2010
• Access to Work
• Acas and Citizens Advice for free employment advice

This article is for general information and is not legal or medical advice. For advice about your own situation, please speak to your GP, Acas, Citizens Advice or an employment adviser.