Seeing the Unseen: What Recent Case Law means for Employers and Endometriosis 

Endometriosis affects around one in ten women and people assigned female at birth, yet it continues to be one of the most misunderstood long‑term health conditions in UK workplaces. Its symptoms including chronic pelvic pain, fatigue, heavy bleeding and mobility difficulties, can have a significant effect on an individual’s ability to carry out their job. Despite this, many employees still find themselves facing stigma, disbelief or intrusive questioning when trying to explain how their condition affects them.  

In recent years, the legal landscape has shifted decisively. Although endometriosis is not automatically classified as a disability, case law confirms that it can amount to one where symptoms have a long‑term and substantial impact on day‑to‑day activities. A significant Employment Appeal Tribunal ruling in January 2026, Sanju Pal v Accenture (2026), illustrates this clearly. The EAT found that the original tribunal had failed to properly assess whether Ms Pal’s severe endometriosis met the Equality Act definition of disability. It had overlooked the real impact of her symptoms on her daily functioning and placed undue emphasis on credibility issues rather than the evidence she had provided about her condition. As a result, the decision was set aside and the case ordered to be reheard. The tribunal had also failed to consider whether the performance concerns raised by the employer were, in fact, consequences of her disability, and had incorrectly approached the question of what the employer knew or ought to have known about her condition. This ruling reinforces that employers must take a proactive approach when disability may be in play, asking the right questions, seeking appropriate medical advice and properly examining whether symptoms are affecting performance or attendance before taking any formal action. 

The wider circumstances of the case provide a stark illustration of how easily employers can mishandle health‑related issues. After surgery for severe endometriosis, Ms Pal returned to work while still experiencing significant pain, fatigue and bleeding. She kept HR informed, yet her employer continued to assess her strictly against a promotion‑based performance model without considering the impact of her health. This approach ultimately led to her dismissal. The EAT recognised that the tribunal had failed to explore whether reasonable adjustments could or should have been made and did not assess the condition’s disabling effects with the required level of care. For employers, the message is clear: when an employee’s performance changes, or when attendance becomes inconsistent due to a long‑term health condition, capability or disciplinary action should never be the starting point. Instead, employers must consider the medical context, seek occupational health input and assess whether the Equality Act duties are triggered. 

Other recent cases reinforce how critical it is to handle adjustments properly. In Ms PP v Spericle Ltd (2024), an employer that had previously agreed to home‑working for an employee with debilitating endometriosis abruptly withdrew the arrangement and even deleted records of it. The tribunal found that the employer’s actions left the employee with no choice but to resign, and it awarded compensation for unfair dismissal. This demonstrates that once adjustments are put in place, employers cannot arbitrarily change or remove them without sound justification. Similarly, in Lacatus v Barclays (2024), a claimant with chronic endometriosis symptoms and associated mental health difficulties succeeded in her claim because her employer failed to ensure she did not work beyond her contracted hours. Excessive workload aggravated her symptoms, and the tribunal found both a failure to make reasonable adjustments and a workplace culture in which inappropriate language towards female staff had contributed to the discriminatory environment. These cases highlight that adjustments to hours, workload and work patterns are not optional extras; they are legal obligations where disability is established or reasonably suspected. 

When viewed together, these cases send a consistent message: endometriosis can, and often does, meet the legal threshold for disability, and employers must act accordingly. Ignoring or minimising symptoms does not protect an organisation, tribunals increasingly find that awareness of an employee’s difficulties creates implied knowledge of disability. Reasonable adjustments such as hybrid working, flexible schedules, modified duties or time off for appointments should be implemented promptly and with genuine engagement. Withdrawing adjustments once they are in place is particularly risky and may amount to unlawful discrimination or unfair dismissal. At the same time, workplace culture remains an important factor. A dismissive or trivialising attitude toward menstrual or reproductive health issues can fuel discrimination claims and undermine an employer’s legal position. 

This year’s campaign “Go Yellow” encourages organisations to raise visibility and understanding of endometriosis, but the law now requires employers to go further. They must ensure managers are trained to recognise and respond appropriately to signs of chronic health conditions, review and update relevant policies, and document the steps they take to support affected employees. Above all, employers need to work collaboratively with individuals to understand their specific needs and identify meaningful, sustainable adjustments. In 2026, it is no longer acceptable, legally or culturally, to overlook or downplay the impact of endometriosis at work. Supporting employees properly is not only a matter of compliance; it is an investment in wellbeing, retention and an inclusive workplace where people can perform at their best.