Factsheet – Gynaecological conditions

Factsheet – Gynaecological conditions

This resource is part of our Disability Essentials range. You can find the other free resources that are included in this range by clicking here.

Introduction

This factsheet covers some symptoms of and adjustments for gynaecological conditions. There are many conditions that fall into this category, and this factsheet aims to provide general advice about adjustments, support and legal duties for people with gynaecological conditions.

This factsheet also outlines three of the most common conditions. These are:

• polycystic ovarian syndrome (PCOS)
• endometriosis
• menopause.

The symptoms covered in this factsheet include many seen in other gynaecological conditions, and the adjustments suggested will also be relevant to different conditions. Equally, some employees with gynaecological conditions may need adjustments not mentioned here – there is no ‘one-size-fits-all’ approach.

Gynaecological cancers are not covered in this factsheet, but some of the suggested adjustments may be applicable. For general advice about workplace adjustments for employees with cancer, see our ‘Briefing – Employment adjustments for people with cancer’.

Common gynaecological conditions

Polycystic ovarian syndrome (PCOS)

This common chronic condition affects approximately 20 per cent of women. There is no cure, but some treatments can help the symptoms. The cause of PCOS is unknown, but abnormal hormone levels are a factor.

PCOS is often underdiagnosed. This increases the risk of serious health conditions, especially:

• Type 2 diabetes
• cardiovascular disease and high blood pressure
• infertility and pregnancy complications
• cancer
• mood swings and depression
• excessive hair growth or hair loss (both of these can be very embarrassing and affect self-confidence)
• irregular periods
• weight gain.

Endometriosis

Endometriosis is a condition that affects about one in 10 women. It is a chronic condition, and there is currently no cure. Its symptoms can significantly affect person’s life, and it can take several years to get a diagnosis.

It is not known what causes endometriosis. However, the symptoms are caused by tissue similar to that found in the womb growing outside of the womb, usually onto other gynaecological structures and the bowel, bladder, and stomach. This tissue reacts to the hormonal cycle. As a result, it can cause significant inflammation and scarring to any attached structures, causing intense pain.

The symptoms of endometriosis can be mild or severe and be challenging to cope with both emotionally and physically. Common symptoms include:

• painful periods that prevent normal activities
• very heavy and irregular periods
• pain in the abdomen and lower back which is usually worse during a period
• long-term fatigue due to anaemia and blood loss
• fertility problems
• problems and pain with the urinary system and bowels
• migraines.

Menopause

The menopause occurs when a person stops having periods, usually between the ages of 45-55. About one per cent of people who experience menopause will experience it early (before 40), including some people in their 20s. It is caused by changes in the balance of the sex hormones. The process can last several years, up to 12 in some cases.

Some people will have very few symptoms, but there will be others who will have severe symptoms. These can include:

• heavy periods with ‘flooding’
• fatigue due to sleep disturbances and possible anaemia
• hot flushes
• night sweats
• difficulty sleeping
• mood swings and anxiety
• headaches and migraines
• difficulty concentrating and remembering things
• loss of confidence
• frequent urinary tract infection
• incontinence
• palpitations
• aching limbs or stiffness
• dry skin
• osteoporosis can occur in the longer term.

Potential impact on work

All of these conditions can take years to be correctly diagnosed after symptoms start. Unfortunately, this means that some people may be suffering without adequate treatments, which can adversely affect their performance at work. However, once they receive appropriate treatment, many will be able to manage their conditions well.

The impact on work will vary depending on the severity of symptoms and the work people do. Some common issues include:

• Time off work when symptoms are severe, clinical investigations and treatments, which may include surgery.
• The need to be able to have immediate and frequent access to toilet facilities.
• The emotional impact of these conditions, especially if fertility problems are identified.
• Embarrassment and fear of having to discuss these very personal issues with managers.

Legal duties

The Equality Act 2010

In the UK, employers have duties to:

• prevent discrimination, and
• provide reasonable adjustments

for their disabled employees. This means that it is unlawful for employers to treat applicants, job candidates and employees unfavourably because of their disability.

The Equality Act also requires employers to make ‘reasonable adjustments’ for their disabled employees.

Who is disabled?

It may not seem, at first glance, that someone experiencing these conditions is covered by legal definitions of disability. However, many people with these conditions will be covered by the UK’s Equality Act 2010, and therefore they will be entitled to adjustments and legal protection under it.

This is complicated by the fact that many people experiencing these conditions may not consider themselves disabled. For example, many people don’t consider the menopause to be a disability, and therefore may not ask for adjustments at work while they are menopausal. Employers must be proactive in offering employees support and adjustments to employees who appear to need them.

Proactive duty to make adjustments

The employer’s duty to make reasonable adjustments is a proactive one. This means that the duty applies if you could reasonably know that the person is disabled – the person does not have to tell you, or even be aware themselves that they have a disability.

Therefore, make sure that managers are trained to recognise the signs that a person may need adjustments. Our resource, ‘Having sensitive conversations’ provides advice on spotting the signs that someone might need workplace adjustments.

Suggested adjustments

The adjustments suggested below may be applicable to other gynaecological conditions.

• Easy access to toilet facilities. Some people during their period will have to change their protection every 20-30 minutes in some cases to prevent the embarrassment of ‘flooding’.
• Toilet breaks should be taken as required and not monitored. Comments about the frequency of toilet breaks should not be a performance management conversation.
• The menopause can cause clothing to be uncomfortable, too hot and irritating to dry skin. If a uniform is required for work, it may be necessary to get a different fit or use another material.
• Temperature control can be challenging for people with gynaecological conditions, especially if they are going through the menopause. They may benefit from a desk fan or be able to open a window throughout the year. If that is not possible, then short breaks to cool down may be a good substitute.
• Concentration and memory problems may be reduced with tools used by those with a neuro-minority label, such as ADHD. These may include working in shorter bursts, using reminder apps, different formats for learning, memory aids such as flow charts, and personalised to-do lists and planners. Our Neurodiversity Toolkit has more information – refer to our resource ‘Adjustments – Organisation, planning and time management’.
• Flexibility for working hours and locations can be beneficial in enabling a person to continue working during a flare-up of their condition. For example, a person with heavy periods may struggle with the commute but can work from home rather than take a day off during their period. It can also help manage pain and other symptoms.
• Sometimes a person may need to take time off work due to the severity of their symptoms or treatments associated with them and related conditions. For example, there may be times when a person requires surgery, and a graded return to work and duties can be helpful in these situations.
• Gynaecological problems can be very emotional for some people, especially if it affects there fertility or their image of themselves as an individual. Therefore, CBT and antidepressants may be required, and flexibility to enable these treatment sessions is beneficial.
• It is best practice to have policies and procedures that distinguish between sickness absence taken for a reason relating to a disability and general sickness absence. Disabled employees must not be treated less favourably than their colleagues for a reason relating to their disability.

Further information

For more information on suggested adjustments, specific barriers for gynaecological health and information about the law, please see our other resources in the Knowledge Hub.

For more detailed information and advice about a specific situation, contact the Advice Service: Tel:+44-20-7403-3020 |Textphone: +44-20-7403-0040

Email: advice@businessdisabilityforum.org.uk

NHS

The NHS has pages with dedicated medical advice about gynaecological conditions. Their pages include advice about:

• Polycystic ovarian syndrome
• Menopause
• Endometriosis

Endometriosis UK

75 Gloucester Place, London, W1U 8JP

Helpline: 0808 808 2227

www.endometriosis-uk.org/contact-us