Endometriosis support is a missing piece of women's health benefits

Workforce attitudes have progressed around recognizing the unique medical needs of women at work, such as infertility and menopause. Yet there are still many other chronic conditions that have yet to receive the same much-needed attention. 

Endometriosis — a disorder in which tissue similar to the lining of the uterus grows outside the uterus — affects 11% of women, according to the U.S. Department of Health and Human Services. A recent study from the National Library of Medicine found that women lost an average of 10.8 hours per week of work due to endometriosis symptoms, and one in six women with endometriosis will give up work entirely.

"Imagine trying to do your job with horrible cramps that you've tried everything for, from over the counter remedies to other medications, to using a heating pad," says Barb Dehn, vice president of women's health at Peppy, a digital health platform. "And because this is such a deeply personal and private issue, women are not going to be telling their manager why they're less productive." 

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For many women, limited access to female-centric healthcare means they're not even aware they have endometriosis: according to the U.S. Department of Health and Human Services, it currently takes an average of seven to 10 years to diagnose endometriosis, and it has often progressed to where there are new issues and complications.

Untreated, endometriosis can cause significant pain, bloating, excessive menstrual bleeding, and digestive distress. Over time, it could permanently affect a person's fertility or lead to a higher risk of developing ovarian cancer. Endometriosis treatment could also include multiple surgical procedures. Getting a diagnosis, and then the appropriate care and coverage, is crucial. 

"Women are going from provider to provider and are being dismissed — and it's costing them and their companies a lot of money," Dehn says. "The average woman has to see 20 providers before getting an accurate diagnosis, but if we can diagnose endometriosis early and treat it, we can help prevent some of those other costly impacts like infertility treatments. It's not only about treating day-to-day  chronic pain, but also the downstream impact that it has." 

Over the course of the last few years, more and more companies have prioritized the expansion of reproductive healthcare offerings. According to a recent study by the International Foundation of Employee Benefit Plans, 40% of American organizations have expanded their benefits to include fertility benefits in 2023. And while those kinds of policy changes have done a lot to open more pathways to care, workplaces have yet to completely address the taboo surrounding other aspects of women's health outside of family-building. 

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"Whenever we talk about the menstrual cycle there's a lot of people who are very hesitant to talk about it under any circumstances," Dehn says. "It takes a lot to be able to say 'I'm bleeding through my protection' or 'I have to go to the bathroom more often' or 'I don't really want to attend a meeting in person, because I never know how I'm going to feel.' And a big part of it is just cultural and long-standing taboos about women's health issues."

Employers can address endometriosis much in the same way they've addressed other aspects of reproductive health, Dehn says. For example, employees should be given flexibility in their work schedules to accommodate for painful menstruation cycles, in the same way they would for fertility appointments or symptoms. Employers should also continue to ensure that the healthcare offerings within their networks are culturally competent, and be vocal about the resources available. 

"There is so much employers could do to support all of their employees, not just those with chronic pain," Dehn says. "It's important to remember that when employees bring themselves to work, they bring our whole selves to work — including their biology."