This blog article is based on the WORK180 DEI Knowledge Share: Endometriosis at Work — What Employers Need to Know live session, featuring Alyssa Mills, Education and Awareness Lead Facilitator at Endometriosis Western Australia.
One in seven. That’s the number of women living with endometriosis in Australia. If you have seven women on your team, statistically, one of them is managing this condition right now — possibly in pain, possibly exhausted, and possibly saying nothing about it at all.
In April, WORK180 hosted a DEI Knowledge Share with Alyssa Mills, Education and Awareness Lead Facilitator at Endometriosis Western Australia. Alyssa holds a Bachelor of Biomedical Science and a Masters of Medical Science Research, with her thesis focused on endometriosis. She also lives with the condition. Over the course of the session, she covered what every employer should understand — the science, the workplace reality, and what good support actually looks like.
Here’s a summary of the most important things.
It’s not just a period problem
Most people, if they know anything about endometriosis, think of it as a bad period. That’s the first thing to understand: it isn’t.
Endometriosis is a chronic disease in which tissue similar to (but not the same as) the uterine lining grows outside the uterus. These lesions can occur on organs such as the ovaries, bowel, bladder, and diaphragm, and in rare cases, the brain. Unlike the uterine lining, this tissue does not behave in the same controlled way and can lead to inflammation, the formation of scar tissue (adhesions), and, over time, it can cause damage to surrounding organs.
It affects people of diverse gender identities — not only women. And while it’s often described as a reproductive condition, that framing misses how widely it can impact the body.
Why diagnosis takes so long
On average, it takes 7 to 11 years from the onset of symptoms to receive a diagnosis of endometriosis. That’s years of pain, medical appointments, and being told it’s “just a bad period.”
The reasons for this are largely systemic. From 1977 to 1993, women were excluded from clinical trials entirely. Today, only around 1% of medical research funding goes to female-specific conditions beyond cancer. The result is that endometriosis is chronically understudied — and the tools available to diagnose it are unreliable for most people.
There’s no diagnostic blood test. Ultrasounds and MRIs can detect it in some cases, but for around 80% of people with endometriosis, those tools won’t pick it up. Lesions can be clear, red, or white — not the dark spots typically shown in textbooks — so even during surgery, they can be missed if the surgeon hasn’t had advanced training. Endometriosis can also present microscopically, making it invisible even in the operating theatre.
Many patients also face invalidation in healthcare settings: being told their pain is genetic, or that severe pain is simply part of having a period. Alyssa was direct about the impact of that: going back and forth to a doctor for years, asking for help and being dismissed, is exhausting in a way that goes beyond the physical.
What it feels like at work
Because endometriosis affects so many systems in the body, the symptoms that show up in the workplace are varied and often invisible to anyone looking in from the outside.
Period pain is the most commonly known symptom. But many people with endometriosis also develop what’s called central sensitisation — after years of severe, recurring pain, the brain becomes so efficient at building pain pathways that a low-level ache becomes the constant baseline, even between flare-ups.
Other symptoms include:
- Fatigue — not tiredness, but a heaviness that makes it difficult to move. Alyssa described it as fatigue that has “taken over your whole body.”
- Brain fog — losing a train of thought mid-conversation, struggling to find words, or blanking on the name of an object you use every day.
- Bloating — known as “endobelly,” it can be severe enough that someone looks visibly pregnant. For people also managing infertility, this is particularly distressing.
- Bladder symptoms — frequency, urgency, and pain often mistaken for recurrent UTIs.
- Depression, nausea, leg pain, and headaches — all commonly reported.
Someone at a team meeting could be managing all of this and you’d have no way of knowing. That invisibility is part of what makes endometriosis so difficult to support — and why creating a workplace where people feel safe raising it matters so much.
The workplace numbers
Researchers from Western University, in partnership with Endometriosis Australia, surveyed people living with endometriosis about their experience at work. The findings are stark.
- 65% said they take unpaid leave to manage their symptoms. Standard sick leave runs out quickly when you’re managing a chronic condition — and people still need time off.
- 64% reported feeling burdened or judged when trying to hide their symptoms from employers.
- 40% feared losing their job because of their endometriosis.
- 1 in 3 had been passed over for a promotion.
- 1 in 7 had lost their job entirely as a result of the condition.
Alyssa made a point that should stay with any employer:
“If you let someone go because managing endometriosis was affecting their attendance, the next person you hire has roughly a 1 in 7 chance of having the same condition. The problem doesn’t leave when the employee does. It’s the workplace that needs to adjust.”
What good support looks like
The adjustments that make a meaningful difference aren’t complicated or expensive. Most of them come down to flexibility and trust.
Alyssa outlined several practical measures that employers can put in place:
- Access to a power point for a plug-in heat pack — a small thing that makes a significant difference during a flare.
- Working from home on difficult days, without needing to justify it each time.
- Ergonomic seating — prolonged sitting in an uncomfortable position can aggravate pelvic pain significantly.
- Additional or modified breaks to allow movement, which can help manage symptoms.
- A quiet or rest space for breathing exercises or physiotherapy stretches.
- Adjusted deadlines where possible, with regular check-ins.
- An overarching letter from a treating practitioner, rather than requiring a new medical certificate for every absence — given that each certificate visit can cost $40 to $50.
Flexibility runs through all of it. As Alyssa put it: “We know it works because we did it in COVID.” The capacity to work differently was always there.
How to have the conversation
If someone on your team comes to you about endometriosis — or if you’ve noticed someone who seems to be struggling — the approach is straightforward.
Start by acknowledging what they’ve told you. For people who’ve spent years being dismissed by medical professionals, being heard goes a long way. Listen without cutting them off. Ask what support would help, and involve them in finding solutions. If they’re unsure what to ask for, you can ask what adjustments might help them meet the requirements of their role, or whether their treating practitioner could provide some guidance on limitations and recommendations.
Keep the focus on capacity and function, not medical detail. That protects the employee’s privacy and keeps the conversation within appropriate boundaries for a manager. And what’s shared in that conversation should stay confidential.
Where to begin if you haven’t yet
If your organisation doesn’t have a reproductive or women’s health leave policy, Alyssa’s advice was simple: start by having the conversation. Create conditions where people feel safe raising it.
Then look honestly at what flexibility already exists in your workplace — and whether it’s actually accessible to the people who need it. Policies that exist on paper but require difficult conversations to activate aren’t really flexible at all.
Endometriosis Western Australia offers workplace education programmes — from a foundational session covering the basics of endometriosis and workplace support, to a deeper masterclass on policies, processes, and building an endometriosis-inclusive environment. Sessions are available online and in person. If you’d like to be connected, reach out to your WORK180 account manager.
Why this matters
WORK180’s What Women Want 2026 report identified women’s health across life stages as one of the two standout themes from respondents this year. Women consistently described the same experience: work was not designed with the reality of living in a female body in mind.
Endometriosis is one of the most visible examples of that gap. 1 in 7 people at work are managing it. The knowledge to support them better exists. The adjustments needed are largely about flexibility and trust.
The question isn’t really whether your workplace can afford to support people with endometriosis. It’s whether it can afford not to.
