Urbanbased alchemy blog
Endometriosis at Work: How to Get Through Flare Days
It's 10am. You've got a presentation at 11, a heat pad hidden under your desk, and a pain in your pelvis that's making it hard to string a sentence together. You've already taken painkillers. You're counting the minutes.
If that sounds familiar, you're not alone, and you're not being dramatic.
So how do you get through a working day with endometriosis? The short answer: you plan for flares before they happen, you know your rights, and you support your body across the whole cycle rather than just firefighting on the worst days. Here's how that looks in real life.
Why endo flares don't respect your diary
Endometriosis affects around 1 in 10 women and people with periods in the UK, and it's not "just a bad period." Tissue similar to the womb lining grows outside the womb, where it can trigger inflammation, pain and fatigue.
Clinically, what I see time and again is that flares aren't random. For most of the women I work with, they cluster around:
The 2–3 days before a bleed and the first 1–2 days of it — the classic peak
Ovulation (around day 12–16) — a sharp, one-sided pain many women never connect to their cycle
High-stress weeks — deadlines, poor sleep and skipped meals seem to turn the volume up
Bowel and bladder flares — bloating ("endo belly"), pain on opening your bowels, or needing the loo constantly
Once you can see your pattern, work stops feeling like an ambush.
Step one: map your flares before you plan your month
You can't plan around something you can't predict. For two to three cycles, note:
Cycle day
Pain level (0–10) and where it sits
Energy, bloating and bowel changes
What was happening at work that day
Most women are surprised by how predictable their "random" bad days turn out to be.
Takeaway: your cycle calendar is as important as your work calendar. Put them side by side.
The flare-day toolkit to keep at your desk
The women I see in clinic who cope best at work are the ones who stopped relying on willpower and started relying on preparation. A simple desk kit might include:
A stick-on heat patch (discreet under clothes, great for meetings)
A spare pair of loose trousers or a dress with no waistband for endo belly days
Period products for heavier-than-expected bleeding
Water bottle and a warm drink option — ginger tea is a favourite
Snacks with protein, so you're not running on biscuits and adrenaline
Any medication you've been prescribed, so you're not caught short
The honest conversation with your manager
This is the bit most women put off. It's also the bit that changes things most.
In the UK, endometriosis may be treated as a disability under the Equality Act 2010 if it has a substantial, long-term effect on your day-to-day life. That can mean your employer has a duty to consider reasonable adjustments, such as:
Working from home on predictable flare days
Flexible start times
Moving big meetings or deadlines away from your worst cycle days where possible
A desk near the toilets
Breaks to rest, use a heat pad or move around
You don't need to share every detail. Something like: "I have endometriosis. Most months there are 2–3 days where the pain is significant. Here's what helps me keep working well on those days." Short, factual, solution-focused.
If you're unsure where you stand, ACAS and Endometriosis UK both have practical guidance for employees.
Beyond firefighting: supporting your body across the whole cycle
Here's where I'd gently challenge the usual approach. If all your energy goes into surviving the worst three days, the other 25 days are left untouched — and that's often where the groundwork happens.
As a registered medical herbalist, I look at the whole picture, not just the pain. In clinic, the areas I tend to focus on with endometriosis include:
Inflammation — research suggests inflammatory pathways play a key role in endo pain
Oestrogen clearance — how well your liver and gut process and clear hormones
Nervous system load — because chronic pain and a stressful job feed each other
Gut health — given how many women with endo also experience bloating and IBS-type symptoms
Herbs traditionally used by herbalists for pelvic and uterine cramping include cramp bark and ginger, and there's some research suggesting ginger may support period pain. But herbal medicine works best when it's prescribed for your pattern, not picked off a shelf. Herbs can interact with medications, including hormonal treatments, so always speak to a qualified practitioner first.
Western herbal medicine doesn't mask a symptom — it supports the pathway behind it.
When to push for more help
Please don't accept "it's just period pain" if work is becoming impossible. Speak to your GP (and push for a referral if needed) if you notice:
Pain that stops you working, even with painkillers
Pain during or after sex
Pain on opening your bowels or passing urine, especially around your period
Very heavy bleeding or bleeding between periods
Difficulty getting pregnant
The average wait for an endometriosis diagnosis in the UK is still around eight years. Keeping a symptom record gives you the evidence to be taken seriously sooner.
Endometriosis at work: your questions answered
Do I have to tell my employer I have endometriosis? No, you're not legally required to. But sharing even a little can open the door to reasonable adjustments and make sick days easier to explain.
Can I be disciplined for endometriosis-related sick days? If your endometriosis meets the definition of a disability under the Equality Act, your employer should consider this when managing absence. ACAS is a good first port of call if you're worried.
Why is my endo worse when work is stressful? Clinically, I see this pattern constantly. Stress affects sleep, digestion, inflammation and how sensitive your nervous system is to pain — so a heavy work week can make a flare feel much louder.
Can herbal medicine help with endometriosis pain? Herbal medicine may support inflammation, hormone clearance and nervous system resilience alongside your medical care. It's not a cure, and it should be prescribed by a qualified herbalist who knows your medication history.
Is it normal to be exhausted with endometriosis, even outside my period? Fatigue is one of the most common things women with endo tell me about, and it's often overlooked. It's worth tracking and raising with your GP and practitioner.
Start with your flare pattern
If you're ready to stop being ambushed by your cycle at work, start with my free Endo Flare Map — a simple worksheet to help you spot when your flares cluster and what seems to set them off.
Want a personalised plan and bespoke herbal medicine? Book a Priority Session — 90 minutes with me, a written two-week plan, and herbs made up for your pattern.
This article is for educational purposes only and isn't a substitute for medical advice. Always speak to your GP about new or worsening symptoms, and consult a qualified practitioner before taking herbal medicine, especially if you're on medication or hormonal treatment.
