Endometriosis is a condition where tissue usually found in the uterus grows elsewhere, such as in the ovaries. It Is characterised by severe abdominal and period pain. The causes of endometriosis are not fully understood. 10% of women in the UK are living with endometriosis.
What are the signs and symptoms of endometriosis?
Endometriosis is predominantly characterised by pain in the stomach, however this pain can spread to other areas of the body, such as the back. The pain is particularly bad during menstruation.
Pain can also affect the person during or after sex and when going to the toilet during menstruation.
Periods can also be very heavy and difficult to manage, as well as involving nausea, constipation and diarrhoea.
People with endometriosis can also experience fertility problems and depression as a result of the significant impact the condition has on their lives.
How is endometriosis diagnosed and treated?
Endometriosis cannot be cured and can be difficult to diagnose. This is because period-type pain can be linked to bacterial infections and non-cancerous and cancerous tumours, so pelvic ultrasounds and vaginal examinations can help diagnose endometriosis and rule out other conditions.
The only way to definitively diagnose endometriosis is by examining the potential endometriosis tissue through an incision in the stomach. This is called a laparoscopy.
Contraception is sometimes recommended – such as the contraceptive pill – if the person’s period pain cannot be managed easily with painkillers. This method works by maintaining a thinner uterus lining, which reduces the severity of contractions.
Some people may have surgery to remove some of the endometriosis tissue. In more severe cases, they may have an affected organ – such as the uterus – removed.
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with endometriosis:
An employee may not disclose their endometriosis upfront, but if they do, questions regarding the nature of an employee’s endometriosis and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, extra breaks to prepare a hot water bottle during their monthly period.
- Even if the employee does not wish to disclose their endometriosis – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible for employees with endometriosis?
Employers have a legal duty to make reasonable adjustments for employees with endometriosis if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has one of these impairments. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of endometriosis:
- Flexible working hours to accommodate periods of increased absence or decreased productivity following a flare-up in symptoms, such as during menstruation. This may also be necessary following surgery or invasive investigations like a laparoscopy.
- Additional breaks if the person’s pain medication causes their concentration to lapse, or to prepare a heat pack which helps them manage their pain.
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one month to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
- Raising awareness so that colleagues understand the employee’s endometriosis and can help ensure the employee feels comfortable at work, for example, when taking additional breaks. This is also particularly important in the case of endometriosis, as periods and related health conditions still have stigma attached to them and many women will feel the need to keep quiet about their period-related symptoms, even if they are interfering with their ability to perform their usual duties at work, etc.
Endometriosis UK – charity working to improve quality of life for people living with endometriosis, including improving access to quicker diagnoses and better care and treatment, as well as to raise awareness of the condition among the general public (0808 808 2227).
Pain UK – charity working to change the perception of pain, including that experienced by people living with endometriosis, and to promote the idea that pain is an issue in its own right. It also provides services and support for people living with endometriosis.