ENDOMETRIOSIS AND YOUR CAREER
Why endo affects careers, income, and progression, and what you can actually do about it.
By Katie Rice | Accredited Naturopath & Nutritionist | Her Herbs Founder
You've taken sick leave and felt guilty about it. You've pushed through a day at your desk in pain because you couldn't afford another absence. You've turned down a project or a promotion because you couldn't guarantee you'd be reliable enough. You've called in with a migraine when the truth was you couldn't move from the pain.
If any of that sounds familiar, you are not failing at your career. You are managing a serious chronic condition in a workplace that was not designed with you in mind.
The Career Impact Is Real and Documented
This is not anecdotal. The research now clearly supports what women with endometriosis have been describing for years.
A landmark 2025 study by the Office for National Statistics in England, using anonymised data from over 55,000 women, found that in the four to five years following an endometriosis diagnosis, average monthly earnings fell and the likelihood of being employed dropped measurably. Endometriosis UK reports that around one in six women with the condition are compelled to leave the workforce altogether. Many more move to lower-paid roles, reduce their hours, or shift to self-employment to gain the flexibility their workplace won't offer.
An earlier matched case-control study found around 40 percent of women with endometriosis reported impaired career growth, and around 50 percent experienced a decreased ability to work. A 2025 cross-sectional study found employment status was directly associated with quality of life in endometriosis, reinforcing that this isn't just an economic issue. It affects identity, purpose, and mental health too.
The economic argument for taking this seriously is clear. Unsupported flares have been estimated to reduce workplace productivity by around 65 percent. Supportive workplaces don't just help the individual. They retain skilled, experienced people who would otherwise be lost.
Why Work Gets So Hard
The symptoms of endometriosis don't clock off at 9am. Chronic pelvic pain, fatigue, heavy bleeding, brain fog, bladder symptoms, and the unpredictability of flares don't fit neatly into a standard attendance system or a performance framework built around continuous, consistent output.
Pain is unpredictable. A Tuesday that felt manageable becomes a Wednesday where you can't sit at a desk. Heavy bleeding during a work day is not a minor inconvenience. Fatigue that doesn't respond to rest makes sustained concentration genuinely difficult, not a matter of trying harder.
A 2026 qualitative study identified the structural features of workplaces that make endometriosis particularly difficult to navigate: rigid attendance policies, performance systems that assume able-bodied consistency, lack of flexibility, stigma around reproductive health, and cultures where disclosure feels risky. These aren't personal failings. They are systemic barriers that disproportionately affect women with conditions like endometriosis.
Why Women Don't Disclose
This deserves to be said plainly. Most women with endometriosis do not tell their employer what's actually going on.
The fear of being seen as unreliable, of being passed over, of having a reproductive health condition used as evidence of some kind of professional limitation, is real and it is rational given how these conversations often play out. So women use annual leave for flares. They call in sick with vague explanations. They manage their symptoms invisibly while their colleagues have no idea what they're carrying.
That silence has a cost. It means no adjustments are made, no accommodations are offered, and the structural mismatch between the condition and the workplace never gets addressed. Women end up managing the gap entirely on their own.
What You Can Actually Ask For
You don't have to disclose your diagnosis to request reasonable adjustments, though in some contexts a diagnosis can support a formal request. What matters is identifying what would actually make work sustainable for you, and asking for it specifically.
Flexible start and finish times. Pain and fatigue are often worse at particular times of day or cycle. Flexibility around when the work happens, rather than exactly when you're at your desk, can make an enormous difference.
Remote work options. Working from home during a flare means the difference between a productive day and no day at all. If remote work is possible in your role, it's a reasonable thing to ask for during symptom-heavy periods.
A quiet or comfortable workspace. Access to a private space, a supportive chair, or the ability to use a heat pack without explanation is not a luxury.
Flexibility around medical appointments. Endometriosis requires ongoing medical management. Appointments with gynaecologists, physiotherapists, and other specialists should not require exhausting your annual leave or being made to feel like a burden.
Adjusted absence policies. Standard sick leave policies often penalise frequent short absences, which is exactly the pattern endometriosis produces. If your workplace has a formal process for adjusting how absences are counted for chronic conditions, it's worth understanding and using it.
How to Have the Conversation
There is no single right way to disclose, and the decision about whether and how much to share is yours entirely. Some women find naming the condition directly opens doors. Others prefer to frame it around functional impact without going into detail.
A practical approach is to focus on what you need rather than what you have. "I manage a chronic condition that causes unpredictable pain and fatigue. I'd like to discuss some flexible arrangements that would help me be consistent and productive." That framing keeps the conversation practical and removes some of the vulnerability of full medical disclosure.
If your workplace has an HR department, an occupational health service, or an employee assistance programme, these can be useful entry points for formalising adjustments without having to navigate the conversation with your direct manager alone.
The Naturopathic Piece
Managing endometriosis well enough to sustain a working life requires more than medical treatment alone. From a naturopathic perspective, supporting the body's ability to function through the demands of a working day means addressing the underlying inflammatory and hormonal picture, not just managing symptoms reactively.
An anti-inflammatory dietary approach reduces the systemic inflammation that drives pain and fatigue. Supporting sleep quality, even when cycles disrupt it, helps maintain the cognitive and physical capacity that work requires. Nervous system regulation, through movement, breathwork, and stress management, reduces the overall burden on a body that is already carrying a significant physiological load.
Herbal and nutritional support can be genuinely useful for pain, fatigue, and hormonal balance during the working week, but what's appropriate is individual. Working with a naturopath means support is tailored to your specific symptom pattern rather than generic.
Track Your Symptoms to Support Your Case
If you are considering requesting workplace adjustments, or if you want to have an informed conversation with a GP about your capacity to work, having documented symptom data behind you makes a significant difference. Patterns of pain, fatigue, and flares across cycles give a clearer picture of what you're actually managing than a verbal description in a ten-minute appointment.
The Her Herbs Endometriosis Companion App tracks pain, fatigue, mood, bladder symptoms, and cycle data daily, and generates a clinical export you can bring to appointments. That data can support conversations not just with practitioners, but with employers and HR if needed.
DOWNLOAD THE HER HERBS ENDOMETRIOSIS COMPANION APP
A Note From Katie
"The women I saw in clinic who were struggling with work were often holding an enormous amount of shame about it. Feeling like they should be able to manage better, like other people coped so why couldn't they. The research says clearly that this is not a coping problem. It is a structural mismatch between a serious chronic condition and workplaces that were not built for it. You are not failing. You are navigating something genuinely hard, and you deserve support for that, at work and beyond it."
-Katie Rice, Naturopath & Founder, Her Herbs
This content is for educational purposes only and does not constitute medical advice. Please consult your healthcare provider regarding your individual health concerns.
