Important Notice
This article provides evidence-based commentary and research drawn from publicly available sources, legislation, case law and official reports as of 2026. It is intended for informational and educational purposes only. It does not constitute legal, medical or professional advice. Individuals should consult qualified medical practitioners, employment or clinical negligence solicitors, or specialist support organisations for advice tailored to their circumstances. Reliance on this content is at the reader’s own risk.
Introduction
Menstrual disorders such as endometriosis, adenomyosis, polycystic ovary syndrome (PCOS), fibroids and premenstrual dysphoric disorder (PMDD) affect a substantial proportion of women of working age. Endometriosis and adenomyosis each affect around one in ten women; PCOS is similarly prevalent; fibroids are common and symptomatic in many; PMDD affects a smaller but significant minority with severe psychological and physical symptoms.
A 2023 survey of more than 2,000 women aged 18–60 who had menstruated while in employment found that 79% experienced symptoms. Among those with symptoms, 69% reported a negative impact at work; this rose to 81% for women with a diagnosed menstrual condition. Over half (53%) had been unable to attend work at some point because of symptoms, though only a small minority (4%) every month. Many described abdominal cramps, fatigue, bloating, low mood, irritability and difficulty concentrating.
These are not trivial inconveniences.
For some women the pain, heavy bleeding, fatigue or mood disturbance can be debilitating for days each cycle or more persistently. The cumulative effect across a working life – from early career through potential fertility challenges, pregnancy loss or perimenopause – is often under-recognised.
Women frequently describe having to “push through”, hide symptoms or give a different reason for absence out of embarrassment, fear of being seen as unreliable, or concern about career progression.
In the same survey, 49% of those who took time off did not tell their manager the real reason.
Your legal position
Under the Equality Act 2010, a physical or mental impairment that has a substantial and long-term adverse effect on normal day-to-day activities may amount to a disability. Menstrual disorders can meet this definition in individual cases, particularly where symptoms are severe, persistent or recurrent.
The Employment Appeal Tribunal in Ms S Pal v Accenture UK Ltd [2026] EAT 12 emphasised that tribunals must properly examine medical evidence, the impact on daily functioning (including when symptoms are cyclical), the likelihood of recurrence, and the position without treatment.
The case was remitted for rehearing, but it provides important authority that endometriosis, and by extension comparable conditions, can constitute a disability where the statutory test is met.
If your condition qualifies, your employer has a duty to make reasonable adjustments to remove or reduce substantial disadvantages you face at work.
Adjustments are assessed case-by-case and may include flexible or adjusted hours (especially around predictable cycle patterns), working from home during flare-ups, modified duties or targets, additional rest breaks, access to quiet or rest facilities, phased returns after absence, referral to occupational health, or adjustments to uniform or facilities.
You also have protection against discrimination arising from disability (section 15) and harassment related to sex or disability.
Even where the strict disability definition is not met, employers owe a general duty of care and must not treat you less favourably because of your sex.
Unfavourable treatment linked to menstrual symptoms can amount to sex discrimination or harassment.
Practical steps
Keep a simple symptom diary noting dates, severity, impact on work tasks and any medical appointments or treatment. This can support conversations with your GP, occupational health or employer.
Request adjustments or flexible working in writing, explaining the link to your health.
You can ask a GP or specialist for a supporting letter (though employers are not obliged to accept it as conclusive).
If concerns arise about absence management, performance processes or dismissal, seek early advice from ACAS, a trade union or a specialist employment solicitor.
Early conciliation is often a required first step before tribunal claims.
Specialist charities offer excellent information and peer support: Endometriosis UK, Verity (PCOS), the International Association for Premenstrual Disorders (IAPMD), and Fibroid Network.
For mental health impacts, Mind and similar organisations provide resources.
Citizens Advice can assist with benefits or workplace rights queries.
Looking ahead in your health journey
Menstrual disorders sit within a longer biological narrative. Symptoms can influence fertility, mental health, bone and cardiovascular risk, and overall functioning across decades.
Many women find themselves navigating between primary care, gynaecology, endocrinology, pain services and mental health teams while trying to maintain employment.
The renewed Women’s Health Strategy for England (2026) prioritises improved menstrual health pathways, community hubs and earlier education, which may gradually reduce diagnostic delays and improve joined-up care.
You are entitled to be heard and supported, not to have your reality minimised. Many adjustments are low-cost and straightforward once the conversation begins.
Linked Pages:
For the clinical perspective on how healthcare professionals can better support patients in work, see the linked Clinical article in this series.
For employer obligations and policy development, see the Governance article.
Mandatory Disclaimer
This article is for general information and discussion only. It is not medical or legal advice, nor a substitute for professional advice. To contribute evidence, ideas, or corrections, please email womenshealthproject@outlook.com. Please do not share personal data when emailing. Individual cases cannot be reviewed.
This project does not offer any form of legal service and cannot assist with complaints, claims or individual advocacy. This platform is independent and not affiliated with any law firm, regulator, inquiry or clinical body.
© 2026 Women’s Health Inquiry Project (WHIP). This article includes original analysis of material from publicly available national sources. It may not be reproduced without permission.
References
- CIPD (2023) Menstruation and support at work. Available at: https://www.cipd.org/uk/knowledge/reports/menstruation-support-at-work/
- Ms S Pal v Accenture UK Ltd [2026] EAT 12. Available via gov.uk Employment Appeal Tribunal decisions.
- Department of Health and Social Care (2026) Renewed Women’s Health Strategy for England.
- Parliament UK, Women and Equalities Committee (2024) Women’s reproductive health conditions.
- NHS information on endometriosis, heavy menstrual bleeding and related conditions (current as of 2026).
- Endometriosis UK and other specialist charity resources.