Endometriosis | Insight
Introduction
Endometriosis is a condition in which tissue similar to that which lines the womb begins to grow in other places, such as the ovaries and fallopian tubes. It affects an estimated one-in-ten women during their reproductive years, which equates to approximately 176 million women worldwide.
Endometriosis is a long-term condition which can have a significant impact on life. The cause is not known, but there are treatments that can help. It can be a difficult condition to deal with, both physically and emotionally. The symptoms can make working difficult - and it can affect productivity or cause absence from work.
Key takeaways for HR professionals:
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- One-in-ten women of reproductive age in the UK suffer from endometriosis
- As many as one-in-six women with endometriosis may be giving up work because of it - and 87% of sufferers believed the condition had impacted their long-term financial situation*
- The prevalence of endometriosis in women with infertility may be 30–50%
- Endometriosis is the second-most-common gynaecological condition in the UK, affecting 1.5 million women - similar to the number affected by diabetes
- On average it takes 7.5 years from onset of symptoms to get a diagnosis. The cause of endometriosis is unknown and there is no definite cure
- Endometriosis costs the UK economy £8.2bn a year in treatment, loss of work and healthcare costs
- Sufferers can find work challenging, and can be unable to carry out some usual tasks
- Its impact is felt both in absence from work and reduced productivity from sufferers
- Due to the long term and recurrent nature of symptoms, it may be considered a disability under relevant legislation
- Workplace adjustments can help individuals remain in work, and to be productive
*Source: Personnel Today
Condition overview
Endometriosis can be a chronic condition affecting women throughout their reproductive lives, and sometimes beyond.
It can be difficult to diagnose because symptoms can vary considerably - and many other conditions can cause similar symptoms.
Endometriosis can impact on a person’s life in a number of ways, including:
- Chronic pain
- Painful, irregular and heavy periods
- Fatigue/lack of energy
- Depression/isolation
- Problems with a couple’s sex life/ relationships
- An inability to conceive
- Difficulty in fulfilling work and social commitments
The symptoms of endometriosis can vary. Some women are badly affected, while others might not have any noticeable symptoms.
Endometriosis can cause pain that occurs in a regular pattern, becoming worse before and during the monthly period. Some women experience pain all the time but for others it may come and go. It’s important to remember that:
- Endometriosis is not an infection
- Endometriosis is not contagious
- Endometriosis is not cancer
Treatment
There is currently no cure for endometriosis, but there are treatments which can ease the symptoms and improve the quality of life for women living with the condition.
Treatment can be given to:
- relieve pain
- slow the growth of endometriosis tissue
- improve fertility
- help to prevent the condition returning.
Painkillers – such as ibuprofen and paracetamol
Hormone medicines - although this requires careful discussion with a doctor and may be not be suitable for everyone, due to significant or unacceptable side effects. It may take a few months of hormone treatment to gain the full benefit.
Surgery – which can be used to remove or destroy areas of endometriosis tissue, helping to improve symptoms and fertility. Laparoscopy (keyhole surgery) is the most-commonly used technique. Hysterectomy may also be considered in some cases. Surgery for endometriosis can also sometimes cause further problems - such as infections, bleeding or damage to affected organs. Endometriosis affecting the bladder or bowel can be difficult to treat and may require major surgery.
Some women find that lifestyle changes and natural remedies can help relieve some of the symptoms. Exercise, a healthy, well-balanced diet and the use of a hot water bottle or taking a hot bath are recommended.
Psychological therapies and counselling
Endometriosis can improve or disappear completely following treatment, only to return in the future – when further treatment.
Endometriosis at work
If Endometriosis prevents someone from carrying out their day-to-day tasks (even just sometimes), then the disability provisions in legislation such as the Equality Act may apply.
However, each case needs to be carefully evaluated on the basis of the individual’s experience – as some cases are not considered severe enough. An occupational health assessment can provide guidance regarding the impact of the condition on function.
Each person with the condition will experience it differently. Therefore, understanding the specific needs of the individual is important. Holding a meeting with the member of staff to discuss what can be done to help them is a good way to explore this. You may find it helpful to start by:
- Finding out more about the condition and its typical effects on someone at work – the sources of additional information below may help
- Finding out what makes their Endometriosis symptoms better or worse at work
- Considering what could be changed to make a positive difference.
Adjustments made for employees with Endometriosis might include:
- Flexible working such as working from home, reduction in hours, adjusted shift patterns or relief from some responsibilities, to prevent having to take time off sick
- Time off to attend medical appointments (including for infertility treatment)
- Flexible rest breaks, with a quiet place for the person to work or take time out
- Allow the person to wear loose clothing (if there is a uniform policy)
- Easy access to washrooms and drinking water.
- Review the employee’s workstation and consider provision of an ergonomic chair and adjustable desk to help with lower back and pelvic pain
- Signposting to services such as Employee Assistance Programme to support mental wellbeing
- Supporting a phased or gradual return to work activity, limiting tasks such as manual handling during recovery from abdominal surgery.
Further sources of information
Good support and advice is available online. Some of the best sources are listed below: