Endometriosis has a ‘significant’ impact on women’s ability to earn and work, according to a unique new study. L360 investigates the reasons why, and what workplaces can do to support employees.
Recent data from the Office for National Statistics (ONS) has laid bare a shocking reality: women with endometriosis earn an average of £130 less per month within four to five years of their diagnosis.
This financial gap isn’t just a statistic — it’s a symptom of a much larger issue.
Endometriosis, a chronic and often debilitating condition, continues to be misunderstood, underdiagnosed and inadequately addressed in workplaces across the UK.
The result? Women forced to choose between their careers and their health.
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What is endometriosis?
GP Dr Kandi Ejiofor explains, “Endometriosis is a chronic, often debilitating condition that affects approximately one in 10 women of reproductive age. It occurs when tissue similar to the endometrium (the inner lining of the womb) grows outside the uterus, leading to inflammation, scarring and adhesions”
Symptoms include chronic pelvic pain, severe menstrual cramps, painful sex, fatigue and even infertility.
Dr Ejiofor highlights that despite its severity, endometriosis is still widely misunderstood. “Many women struggle for years before receiving a diagnosis — on average, it takes seven to 10 years. In that time, they may face misdiagnosis, dismissal of symptoms and worsening health, all of which impact their ability to work and progress in their careers.”
Read more: The truth about premenstrual dysphoric disorder (PMDD)
The workplace struggles of women with endometriosis
For women managing endometriosis while holding down a job, every workday can feel like an uphill battle. The pain, fatigue and unpredictability of symptoms mean that concentration and productivity can be severely impacted.
Michaella Mazzoni, a Cambridge-based hormone health nutritionist, recalls a harrowing experience: “I was sitting at my desk towards the end of a consultation when a huge wave of pain hit me. I finished the appointment holding back tears and went straight to A&E, where I needed emergency surgery. Running my own business, I had to take unexpected time off and cancel speaking engagements. The financial impact was immediate.”
Natasha, a businesswoman, echoes this sentiment. “I was misdiagnosed for eight years before finally receiving my diagnosis at 29. The delays in care meant I needed multiple surgeries, each requiring time off work. Internally, my bowel, womb and ovary are stuck together, causing persistent pain. Even though my surgeries have helped, I’m still dealing with the long-term effects every day.”
The unpredictability of endometriosis makes it difficult for women to commit to rigid workplace schedules. Many feel forced to overcompensate, pushing through pain and exhaustion to avoid being seen as unreliable.
“The guilt of having to take time off, combined with the fear of being overlooked for promotions, is immense,” says Dr Ejiofor. “Women are dealing with presenteeism — showing up to work while unwell — because they fear the consequences of taking time off.”
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The financial toll of endometriosis
The ONS research examined employees, self-employed individuals and those not in paid work. It found that women’s monthly income declined in the first three months after diagnosis but returned to pre-diagnosis levels from four to 12 months. However, their income then decreased on average each year, reaching a reduction of £130 per month within four to five years post-diagnosis.
For employees, average monthly pay fell by £56 within five years of diagnosis, indicating that women may be shifting to lower-paying jobs or reducing their working hours. Additionally, the likelihood of being in paid employment decreased by 2.7% following an endometriosis diagnosis.
The initial decline in salary may be linked to the diagnostic process, as endometriosis requires a laparoscopy — a type of keyhole surgery — necessitating time off work. While the procedure can remove endometriosis tissue and temporarily alleviate pain and menstrual symptoms, the tissue eventually grows back.
Beyond lost wages from time off, endometriosis can lead to significant out-of-pocket medical expenses. Treatments, surgeries and fertility treatments (such as IVF) can place an overwhelming financial burden on those affected.
Natasha shares, “The financial impact of endometriosis has been huge for me. My condition meant I needed IVF, which is expensive. I wish I’d been encouraged to check my fertility earlier in life.”
For Michaella, working for herself has provided flexibility, but at a cost: “If I’m recovering from surgery or a miscarriage, I have to turn down work. That’s lost income and lost opportunities.”
Read more: Stories of women who went through early menopause in their 30s
What workplaces can do to support women with endometriosis
Despite its challenges, there are ways employers can make a real difference. Dr Ejiofor suggests simple but effective workplace policies, including:
- Flexible working arrangements: Remote work or adjusted hours can help women manage their symptoms without sacrificing their careers.
- Access to rest areas: A quiet space to recover from sudden pain can make a huge difference in day-to-day comfort.
- Increased awareness: Training managers on the realities of endometriosis can foster empathy and prevent stigma.
- Reasonable adjustments: Offering additional sick leave and accommodating medical appointments can ensure that women don’t have to choose between their health and their job security.
Michaella advises women to advocate for themselves: “If your workplace doesn’t understand, get a note from your GP explaining why flexibility is necessary. It adds credibility and protects you from HR-related repercussions.”
Endometriosis UK estimates one in six women with the condition leave the workforce. The charity’s chief executive, Emma Cox, says more needs to be done by employers and the government to support people with chronic health conditions to remain in the workforce: “Those with endometriosis symptoms shouldn’t have to worry about losing their job, having to change career or feel restricted in the types of work they can do.
“We need employers to understand endometriosis and overcome myths and embarrassment about periods and menstrual health, and to support their employees.”
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Advice for young women navigating work and endometriosis
Both Natasha and Michaella have strong messages for young women facing endometriosis in the workplace.
Natasha urges, “Get diagnosed as soon as possible. Don’t let your symptoms be dismissed. And check your fertility early — I wish I had.”
The latest data from the Royal College of Obstetricians and Gynaecologists shows that there are over 760,000 people on waiting lists for gynaecological conditions. The report found that over three-quarters of women waiting for care reported worsening mental health and over two-thirds reported being unable to take part in daily activities including work.
Michaella adds, “Set boundaries. It’s hard, but necessary. In 10 years, you won’t remember the meetings you missed, but you will still be living in your body.”
The ONS data is a wake-up call: endometriosis isn’t just a health issue — it’s a workplace issue, a financial issue and a gender-equality issue. It’s time for employers to step up, for healthcare systems to speed up diagnoses and for women to feel empowered to demand the support they need. No one should have to choose between their career and their wellbeing.
If we want a workforce where women thrive, we must ensure that chronic conditions like endometriosis are recognised, accommodated and treated with the seriousness they deserve.
