What is endometriosis?
The tissue lining of the womb is called endometrium, and endometriosis is a condition where this lining tissue is found outside the womb in other parts of the pelvis. There can be patches on the ovaries, the fallopian tubes and even on the bowels or bladder.
We don’t fully know how many women suffer with endometriosis as there is a huge spectrum of symptoms. Often the condition can be mild and remain undiagnosed. It can happen at any age but is common between 25 and 40. There is still no consensus on what causes endometriosis. It can run in families and it probably has a hormonal or immunological cause.
Symptoms can vary depending on the size of the patch of endometrial tissue that is outside the womb and its location or locations. Symptoms include painful periods, pain during sex, and pelvic or lower abdominal pain before or during periods. It can also cause difficulties in getting pregnant. If the patches are on the bowels or bladder it can be painful to open the bowels or pass urine.
Further reading
Five steps to improve menopause support
Taboo health conditions stall women's workplace productivity
Allow women to attend cervical screenings during work
Why period pain is everybody's business
What does treatment actually entail?
Currently there is no cure for endometriosis. Employees with the condition should consult a GP who can assess their symptoms and take them through treatment options. These can range from simple painkillers to the hormonal contraceptive pill or coil. Treatment options can also include a small operation to remove patches of endometrial tissue that is outside the womb, which can be done through keyhole surgery these days.
Depending on the severity of the symptoms, female employees who suffer with endometriosis may take time off work cyclically, sometimes for prolonged periods of time. Relying on painkillers or the contraceptive option, while relatively simple, can be problematic for women with other medical problems or who wish to conceive. Laparoscopy (keyhole surgery) outcomes depend on the severity of the endometriosis and the extent of removal. In-patient stays range from one to five days depending on how much had to be removed and from where.
Sometimes women must have catheters put in and if they cannot successfully pass urine after their procedure they may be sent home with one. It would be unreasonable for employees to be expected to return to work in such circumstances. There are the scars themselves, which can be mildly painful and run the risk of infection. Vaginal bleeding and sluggish bowels are also known issues following laparoscopic surgery.
Naturally all of these treatment options could have an impact on a person’s performance at work.
Is it a disability and how can employers help?
While living with endometriosis can be extremely difficult this is not recognised as a disability in the UK. This is because endometriosis, much like many other chronic conditions, has such a varying degree of impact on individuals, who should be assessed on a case-by-case basis.
Charities and support groups such as Endometriosis UK do not want endometriosis recognised as a disability, arguing that women may be disadvantaged at the workplace by such recognition. Employers could discriminate against women by deeming them unable to carry out certain roles and duties.
While it can be debilitating for some, many women are actually able to function perfectly well at work and home. However, as with anybody with a chronic medical condition, those struggling with work because of endometriosis should be supported by HR and management.
One way to achieve this is by offering them the necessary time off work, followed by flexible working options, so they can undergo the necessary tests, treatment and then fully recover. Emotional support from another female employee in management or HR might also go a long way in making the employee with endometriosis feel valued and secure.
Employers must recognise endometriosis as a chronic and often extremely difficult condition to manage. It must never be trivialised and seen as a 'hormonally-difficult time' for the woman. It must be treated with sympathy, which can often be difficult in a male-dominated environment.
The support of a GP, Endometriosis UK and specialists is invaluable in ensuring employers have a full grasp of the gravitas of a chronic, often unpublicised condition such as endometriosis.
Preethi Daniel is a GP and medical director at London Doctors Clinic
