FMLA for Endometriosis and Fibroids: What to Know

Endometriosis and uterine fibroids are common gynecologic conditions that can seriously affect daily life—causing pain, heavy bleeding, fatigue, anemia, and the need for procedures or surgery. If your symptoms or treatment make it hard to work, the federal Family and Medical Leave Act (FMLA) may help protect your job while you take time off to manage your health. Below is a practical, evidence-informed guide to how FMLA applies to endometriosis and fibroids, how to request leave, and what to expect.

Are Endometriosis and Fibroids Covered by FMLA?

Yes. FMLA provides up to 12 workweeks of unpaid, job-protected leave in a 12-month period for a “serious health condition,” which includes chronic conditions that require periodic treatment, cause episodic incapacity, or involve continuing treatment by a healthcare provider. Endometriosis and symptomatic fibroids often meet this definition when they lead to ongoing treatment, significant pain, heavy bleeding, anemia, or surgery.

• Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus, often causing pain and fertility issues. It can require medications, injections, or surgery. See the National Institutes of Health overview: NIH/NICHD on Endometriosis.
• Uterine fibroids: Noncancerous growths of the uterus that can cause heavy menstrual bleeding, pelvic pressure, pain, and anemia. Treatment ranges from medications to procedures like myomectomy or uterine artery embolization. Learn more at NIH/NICHD on Uterine Fibroids.

Importantly, FMLA covers leave for flare-ups, medical appointments, and recovery from procedures when medically necessary.

FMLA Basics: Eligibility and Protections

According to the U.S. Department of Labor (DOL), you are generally eligible for FMLA if:

• You’ve worked for your employer for at least 12 months (not necessarily consecutive);
• You’ve worked at least 1,250 hours in the 12 months before your leave; and
• Your employer has at least 50 employees within a 75-mile radius.

Key protections include:

• Up to 12 workweeks of unpaid leave in a 12-month period for your own serious health condition.
• Continuation of group health insurance on the same terms as if you were working.
• Job restoration to the same or an equivalent position when you return.
• No retaliation for requesting or using FMLA. See DOL’s FMLA Fact Sheet: DOL FMLA Resources and Fact Sheet #28.

Intermittent Leave for Flares and Appointments

Many people with endometriosis or fibroids need intermittent leave rather than a single continuous block of time. Intermittent leave lets you take FMLA in separate blocks (hours, days, or weeks) for episodic symptoms or scheduled treatments, such as:

• Severe pain days, heavy bleeding episodes, or migraines associated with cycles;
• Medical visits, imaging, iron infusions for anemia, or physical therapy;
• Post-procedure recovery (e.g., laparoscopy for endometriosis, myomectomy, uterine artery embolization, hysterectomy).

When intermittent leave is medically necessary, employers must allow it. You should try to schedule planned treatments to minimize workplace disruption when possible. In some cases, your employer may temporarily transfer you to a role better suited for intermittent leave without loss of pay/benefits. See the DOL regulations at 29 CFR Part 825.

How to Request FMLA for Endometriosis or Fibroids

1. Give notice. If your leave is foreseeable (for example, scheduled surgery), give 30 days’ notice. If not, notify your employer as soon as practicable. You don’t have to share your diagnosis with your manager—just enough information to indicate a potential FMLA-qualifying reason.
2. Complete medical certification. Your employer can require a healthcare provider to certify the need for leave. DOL’s standard form for your own serious health condition is WH-380-E. You typically have 15 calendar days to return this form. The certification may describe frequency and duration of flare-ups or appointments. Employers generally cannot demand your diagnosis itself, only enough detail to determine eligibility.
3. Await designation. The employer must notify you in writing whether the leave is designated as FMLA. Keep copies of all communications.
4. Recertification. Employers may request recertification in certain circumstances (often no more than every six months, or sooner if your pattern of leave changes). See DOL FMLA FAQs.

Pay, Benefits, and Job Protection

• Unpaid leave: FMLA itself is unpaid, but employers may require—or you may choose—to use accrued paid time off during FMLA. Some states offer paid medical or family leave benefits.
• Health insurance: Your group health coverage continues under the same terms while on FMLA. You must continue your portion of premiums.
• Job restoration: You must be restored to the same or an equivalent job at the end of FMLA. There are limited exceptions (e.g., certain highly compensated “key” employees).
• No retaliation: It’s unlawful for employers to interfere with, restrain, or deny FMLA rights or to retaliate because you exercised them.

How FMLA Interacts with the ADA and State Laws

FMLA is about leave. The Americans with Disabilities Act (ADA) covers reasonable accommodations if your condition substantially limits one or more major life activities. Many people with severe endometriosis or fibroids meet this threshold, especially when pain, bleeding, or anemia limit walking, standing, concentrating, or working.

Common accommodations (separate from or in addition to FMLA) include:

• Flexible scheduling or remote work during symptom days;
• More frequent restroom breaks or access to supplies;
• Temporary reduced lifting, standing, or travel;
• Modified duties during recovery.

Your state may also provide paid medical leave, pregnancy-related accommodations, or stronger leave protections. Check your state labor department and your employer’s policies.

Planning Around Procedures and Recovery

Recovery times vary by person and procedure. Always follow your surgeon’s guidance. Typical ranges noted by clinical sources:

• Diagnostic/therapeutic laparoscopy for endometriosis: Often 1–2 weeks for light work, longer for full duties.
• Myomectomy: Minimally invasive approaches may need 2–4 weeks; open abdominal procedures can require 4–6+ weeks.
• Uterine artery embolization: About 1–2 weeks for many patients.
• Hysterectomy: Varies by approach; abdominal often 6–8 weeks, minimally invasive typically shorter.

Your certification can cover anticipated recovery time and follow-up visits, and intermittent leave can apply to ongoing symptoms after surgery.

Practical Tips to Strengthen Your Request

• Track your symptoms. Keep a brief diary of pain days, bleeding volume, and how symptoms affect work. This helps your provider complete the certification accurately.
• Be specific with your clinician. Ask your provider to outline likely frequency/duration of flare-ups, expected appointment schedules, and functional limits (e.g., can’t stand for more than X minutes during flares).
• Coordinate with HR. Use the employer’s preferred process and submit forms on time. Ask whether paid time off must be used concurrently with FMLA.
• Plan for coverage. If foreseeable, work with your team to hand off tasks and document responsibilities.
• Know your rights. If your FMLA is denied or you face retaliation, consult your HR department, your state labor agency, or the DOL Wage and Hour Division.

Trusted Resources

• U.S. Department of Labor FMLA: Overview, Fact Sheets, FAQs, and Forms
• FMLA Regulations (29 CFR Part 825): eCFR
• NIH on Endometriosis: NICHD
• NIH on Uterine Fibroids: NICHD
• Office on Women’s Health (HHS): Endometriosis and Fibroids

This article is for educational purposes and is not a substitute for personal medical or legal advice. For guidance about your specific situation, consult your healthcare provider, HR, or an employment attorney.