Sanju Pal built a successful career in management consulting, winning major awards and working at a senior level. Then her health changed.
Author
- Aishwarya Viswamitra
PhD Researcher, School of Applied Social Sciences, De Montfort University
After being diagnosed with severe endometriosis and undergoing surgery, she returned to work but struggled with pain and fatigue. Months later, she was dismissed for not meeting performance targets. What followed was years of legal action, culminating in a January 2026 ruling that she had experienced discrimination arising from disability under the Equality Act 2010 .
Her case may set an important precedent. It also highlights a wider issue: how many others are navigating chronic illness at work without recognition, flexibility or legal support?
Endometriosis is a long-term condition in which tissue similar to the lining of the womb grows elsewhere in the body. It can cause severe pelvic pain, fatigue, heavy bleeding and other debilitating symptoms. For many, the impact on daily life, including work, is significant .
Despite this, diagnosis is often slow . Endometriosis affects 1.5 million women in the UK (one in every ten) , and yet the average diagnostic delay is around eight years . During that time, people may continue working while managing escalating symptoms without formal recognition or support.
Pain may be dismissed as normal. Fatigue may be hidden. Without a diagnosis, adjustments at work are difficult to request and even harder to secure.
Work and endometriosis - the research
Evidence consistently shows that endometriosis can shape working lives in significant ways. Some studies suggest that around 38% of people with the condition worry about losing their job because of it. Others report that roughly 35% experience reduced income linked to symptoms. Many describe working through severe pain to avoid triggering absence procedures or being seen as unreliable.
Research highlights a culture of presenteeism and overcompensation. Employees push themselves to meet productivity targets, conceal symptoms and avoid disclosure. Annual leave is often used to manage flare-ups. Some reduce hours, shift into part-time roles or move into self-employment seeking flexibility, sometimes at the cost of career progression and financial security.
Disclosure itself can feel risky . Endometriosis remains poorly understood and is often invisible . Symptoms such as pelvic pain or heavy bleeding can be difficult to discuss in professional settings. Some fear being seen as less capable or less committed.
Workplaces, meanwhile, are often structured around uninterrupted availability and consistent productivity . Performance models that rely on fixed timelines and metrics may struggle to accommodate fluctuating conditions. When absence policies, promotion criteria and workloads remain rigid, employees can be penalised for symptoms beyond their control.
Sanju Pal's experience of being assessed against standard progression targets during illness reflects patterns described in this research.
Recognition and its limits
Endometriosis has gained increasing political and public attention in the UK over the past decade. Parliamentary debates , inquiries and awareness campaigns have highlighted the challenges around diagnosis, workplace support and education.
Yet recognition at policy level does not always translate into everyday practice. Under the Equality Act 2010, a formal diagnosis is not required for someone to be considered disabled. What matters is whether an impairment has a substantial and long-term impact on normal daily activities. In some cases, endometriosis may meet this threshold.
In reality, recognition often comes only after lengthy disputes. Tribunals can be stressful, time-consuming and emotionally draining. Not everyone has the resources or stamina to pursue one.
Work is more than income. It shapes identity, confidence and social connection. Research on chronic illness and employment shows that supportive environments can make a meaningful difference. Flexible schedules, understanding managers and open communication can help people stay in roles they value. Rigid systems, by contrast, can intensify stress and push people out of the workforce.
Where workplaces go from here
Endometriosis UK's Employer Friendly Employer scheme works with organisations to improve awareness and workplace practice. Initiatives like this aim to close the gap between policy and experience.
At the same time, significant questions remain. We know a growing amount about how endometriosis affects employees. We know far less about how employers understand the condition, how they interpret their legal responsibilities and what prevents adjustments from being made.
Cases like Sanju Pal's should not be seen as isolated disputes. They reveal structural tensions between chronic illness and contemporary work culture, where productivity is often measured through consistency and visibility rather than wellbeing and sustainability.
If workplace equality is to improve, two things are needed. Employers must design systems that anticipate fluctuating health and build flexibility into everyday practice. Researchers must continue producing evidence that highlights the realities of living and working with endometriosis.
The question is no longer whether the condition affects working lives. It is whether workplaces are prepared to adapt before the next employee has to fight a legal battle to be recognised.
Aishwarya Viswamitra receives funding from the Economic and Social Research Council (ESRC).
