Endometriosis Unable To Work and Fibroids: What to Know

September 13, 2025

Endometriosis Unable To Work and Fibroids: What to Know

For many people, endometriosis and uterine fibroids are more than gynecologic diagnoses—they are daily realities that affect pain levels, bleeding, energy, mood, and the ability to do a job safely and consistently. If you’re navigating flare-ups, heavy bleeding, fatigue, and missed work, you are not alone. This guide brings together reliable medical information and practical steps, including treatment options and workplace rights, to help you advocate for your health and your career.

How Endometriosis and Fibroids Affect Work

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, often causing inflammation, pelvic pain, painful periods, pain with bowel movements or urination, and sometimes infertility. The National Institutes of Health estimates it affects about 1 in 10 people of reproductive age. Uterine fibroids are noncancerous growths in the uterus; most people will develop them by age 50, and they are especially common and often more symptomatic among Black women. Fibroids frequently cause heavy menstrual bleeding, pelvic pressure, pain, urinary frequency, and anemia.

At work, these symptoms can translate to absenteeism (missed days) and presenteeism (working while unwell). Heavy bleeding can require frequent bathroom breaks and planning, pain can limit lifting or prolonged sitting/standing, and anemia can cause dizziness, headaches, and difficulty concentrating. When symptoms are uncontrolled or severe, continuing to work without support may be unsafe or unrealistic.

When Symptoms Make Work Unsustainable

Consider talking with your clinician promptly if you experience:

Bleeding that soaks through a pad or tampon every hour for several hours, large clots, or signs of anemia (lightheadedness, shortness of breath, palpitations). The CDC describes these as signs of heavy menstrual bleeding that warrant care.
Pain that is not controlled with over-the-counter medications, or pain that disrupts sleep or daily activities.
New or worsening symptoms like fever with pelvic pain, severe abdominal pain, or fainting.

Document how symptoms affect your job (tasks you cannot complete, near-misses or safety risks, time away from work). This record helps guide treatment and supports requests for accommodations or medical leave.

Treatment Options That May Improve Work Function

Treatment should be individualized and based on your goals (pain relief, bleeding control, fertility plans), medical history, and response to prior therapies. Shared decision-making with a gynecologist is key. Authoritative overviews are available from the NIH and the American College of Obstetricians and Gynecologists (ACOG).

Medical therapies

NSAIDs (e.g., ibuprofen, naproxen) can reduce pain and menstrual bleeding for some people.
Hormonal contraception (combined pills, patch, ring) and progestin-only methods (pill, injection, implant, levonorgestrel IUD) often reduce endometriosis-related pain and fibroid-related bleeding.
Tranexamic acid is a non-hormonal option for heavy menstrual bleeding taken only during menses; see FDA information for safety considerations.
GnRH analogs/antagonists: Leuprolide (an agonist) and newer oral antagonists can suppress hormones to reduce pain and bleeding. The FDA has approved elagolix (Orilissa) for moderate-to-severe endometriosis pain and relugolix-estradiol-norethindrone (Myfembree) for heavy menstrual bleeding due to fibroids and for endometriosis pain. Because these medications can affect bone density and have other risks, they are typically time-limited and may be paired with “add-back” therapy.

Procedural and surgical options

Laparoscopic excision or ablation can diagnose and treat endometriosis lesions and endometriomas, potentially improving pain and function.
For fibroids, options include uterine artery embolization, myomectomy (fibroid removal with uterine preservation), MRI-guided focused ultrasound (in select candidates), and hysterectomy (definitive surgery).

Ask how each option might change your day-to-day symptoms, expected recovery time, and impact on work. ACOG’s patient resources detail benefits, risks, and recovery timelines.

Workplace Rights and Paths to Support

Reasonable accommodations (ADA)

Under the Americans with Disabilities Act (ADA), if symptoms substantially limit major life activities, you may be entitled to reasonable accommodations (for employers with 15+ employees). Examples include:

Flexible scheduling or remote work during flares
Additional or flexible restroom breaks
Access to a private space for heat therapy or rest
Temporary reassignment of heavy lifting or prolonged standing tasks
Ergonomic seating and the ability to alternate sitting/standing

Employers and employees engage in an “interactive process” to find effective accommodations that do not pose undue hardship.

Medical leave (FMLA)

The Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid, job-protected leave per year for a serious health condition if you and your employer are eligible. Leave can often be taken intermittently for flares, procedures, or appointments when certified by a healthcare provider.

Disability benefits

Short-term disability: Many employers or states offer benefits that replace a portion of income during temporarily disabling periods (e.g., post-operative recovery).
Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI): The Social Security Administration considers whether your documented symptoms and limitations prevent “substantial gainful activity” for at least 12 months. Strong medical evidence and functional documentation are essential.

Because benefits and eligibility vary, consider speaking with HR, reviewing official program requirements, or consulting a qualified benefits counselor. Keep copies of medical records and treatment summaries.

How to Document Your Case

Keep a symptom and work-impact journal: dates, pain scores, bleeding volume (number of pads/tampons, clots), missed time, tasks affected, and medication use.
Compile objective findings: imaging reports (ultrasound, MRI) for fibroids; operative reports and pathology for endometriosis.
Request clear clinical notes from your specialist that describe functional limitations (e.g., limits on lifting, standing, or concentration due to pain/anemia).
Track responses to treatments and side effects.

Day-to-Day Strategies That Help at Work

Plan high-focus tasks for times of day you typically feel better; schedule breaks during predictable pain peaks.
Keep a “flare kit” at work: heat wraps, pain relievers as advised by your clinician, extra pads/tampons, spare clothing, water, and iron-rich snacks if you have anemia.
Use ergonomics: a supportive chair, footrest, or sit-stand desk to reduce pelvic pressure.
Hydrate and consider iron evaluation if you have heavy bleeding; follow your clinician’s guidance on iron supplementation.
Communicate early with your supervisor or HR about accommodations; provide medical documentation when requested.

When to Seek Urgent Care

Seek prompt medical care for heavy bleeding soaking through protection hourly for more than 2 hours, severe or worsening pain, fever, fainting, chest pain, or shortness of breath. These can signal complications such as significant anemia or infection.

The Bottom Line

If endometriosis or fibroids make you unable to work—or work safely—there are evidence-based treatments and legal protections that can help. Partner with a gynecologist, document your functional limits, and use accommodations and leave options when needed. With the right plan, many people regain control of symptoms and their work life.

Sources and Trusted References

NIH/NICHD: Endometriosis overview – https://www.nichd.nih.gov/health/topics/endometri/conditioninfo
NIH/NICHD: Uterine fibroids overview – https://www.nichd.nih.gov/health/topics/uterine/conditioninfo
ACOG Patient FAQs: Endometriosis – https://www.acog.org/womens-health/faqs/endometriosis
ACOG Patient FAQs: Uterine Fibroids – https://www.acog.org/womens-health/faqs/uterine-fibroids
FDA: Elagolix (Orilissa) for endometriosis pain – https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-moderate-severe-pain-associated-endometriosis
FDA: Myfembree for heavy menstrual bleeding due to fibroids – https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-myfembree-bleeding-uterine-fibroids
FDA: Myfembree for endometriosis pain – https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-myfembree-manage-moderate-severe-pain-associated-endometriosis
FDA: Tranexamic acid (Lysteda) information – https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/tranexamic-acid-lysteda-information
EEOC Guidance on reasonable accommodations (ADA) – https://www.eeoc.gov/laws/guidance/enforcement-guidance-reasonable-accommodation-and-undue-hardship-under-ada
U.S. Department of Labor: FMLA – https://www.dol.gov/agencies/whd/fmla
Social Security Administration: Disability benefits overview – https://www.ssa.gov/benefits/disability/qualify.html
CDC: Heavy menstrual bleeding – https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html

Note: This article is for general information and does not replace personalized medical or legal advice. Consult your healthcare clinician and, for workplace or benefits questions, your HR department or a qualified professional.