Adenomyosis Awareness Month | The Lesser-Known "Sister" of Endometriosis Employers Need to Understand

Following Endometriosis Awareness Month in March, April marks Adenomyosis Awareness Month — a condition often referred to as the lesser-known “sister” of Endometriosis.

Awareness doesn’t stop in March, and April gives us a chance to keep the conversation going.

Despite affecting many women, Adenomyosis is still not widely recognised. According to Endometriosis UK, around 77% of people have never even heard of it.

Research also suggests that people with Adenomyosis are over three times more likely to also have Endometriosis, with around 80% of patients living with both conditions simultaneously.

I was diagnosed with Adenomyosis in October 2024, alongside a likely long history of Endometriosis, and one thing that’s become really clear to me is just how difficult these conditions can be to navigate while working.

While they’re closely linked, they affect the body in different ways.

With Endometriosis, tissue similar to the uterine lining grows outside the uterus — often on the ovaries, fallopian tubes, bowel, and other areas. In some cases, it’s even been found on the lungs and kidneys.

With Adenomyosis, that same type of tissue grows within the muscular wall of the uterus itself. Instead of being shed normally during a period, it bleeds into the muscle, causing inflammation, enlargement of the uterus, and often significant pain.

A simple way to think about it is this: Endometriosis moves outside the uterus — Adenomyosis grows from within.

Symptoms can include:

• Chronic pain

• Heavy bleeding

• Fatigue and brain fog

• Pelvic pressure

• Digestive issues and bloating

• Fertility difficulties for some

• Flare-ups that can be hard to predict

For many people, these symptoms don’t stay contained to their cycle — they can spill into everyday life, including work.

Understanding Adenomyosis Severity

Adenomyosis is usually described in stages, depending on how deeply the tissue has infiltrated the uterine muscle.

Stage 1 – Mild

The tissue has just started to enter the muscle. Symptoms may be very mild, or not noticeable at all.

Stage 2 – Moderate

The tissue goes a bit deeper. This is often when symptoms like heavier periods, increased pain, and bloating start to become more noticeable.

Stage 3 – Severe

At this stage, symptoms can start to feel much more disruptive — with ongoing pelvic pain, fatigue, and heavier bleeding becoming harder to manage day to day.

Stage 4 – Advanced

The uterus can become enlarged or “bulky”, and symptoms are often severe enough to significantly affect daily life and wellbeing.

Symptoms go beyond period pain

A common misconception is that Adenomyosis only affects periods — but it can impact much more than that.

Physical pressure

As the uterus enlarges, it can press on surrounding organs like the bowel and rectum. This can lead to bloating, constipation, digestive discomfort, and a general feeling of pelvic pressure.

Hormonal influences

Adenomyosis is influenced by hormonal changes, especially Oestrogen. These fluctuations can increase Prostaglandins, which may contribute to inflammation, bowel changes, and worsening symptoms.

Inflammation

Ongoing inflammation in the pelvic area can irritate surrounding tissue and affect nerve signalling, which can lead to persistent pain, fatigue, and discomfort even outside of menstruation.

Psychological and emotional impact

Alongside the physical symptoms, there’s often a significant emotional toll. Living with chronic pain, unpredictable flare-ups, and ongoing fatigue can contribute to anxiety, low mood, frustration, and a feeling of losing control over your own body.

For many people, there’s also the emotional weight of trying to “carry on as normal” at work and in daily life while managing something that isn’t always visible or understood by others.

The invisible reality

One of the hardest parts of living with a condition like Adenomyosis is that it’s invisible.

On the outside, someone may look completely fine — while privately dealing with pain, exhaustion, medical appointments, or simply trying to get through the day.

In workplaces where awareness is limited, that can feel isolating.

Many people don’t disclose what they’re dealing with at all, often because they worry about being judged, misunderstood, seen as less capable, or, just simply embarrassed.

I’ve experienced first-hand how challenging it can be to balance work and health while still trying to show up professionally and keep going. Conversations around women’s health in the workplace still don’t always feel easy — and that often leaves people managing things in silence.

Why employers should care

Women’s health is often treated as a personal issue, but in reality, it has a very real impact on work.

When support isn’t there, it can lead to:

• More absence

• Presenteeism (being at work but not well enough to function properly)

• Burnout

• Lower engagement

• People eventually leaving their roles altogether

It’s also worth noting that chronic gynaecological conditions like Adenomyosis and Endometriosis may be considered a disability under the Equality Act 2010 where they have a substantial and long-term impact on daily life.

What good support actually looks like

Support doesn’t have to be complicated. In most cases, it comes down to a few key things:

✔️ Awareness and understanding

✔️ Managers who feel confident having open conversations

✔️ Flexibility (where possible)

✔️ Clear wellbeing and reasonable adjustment processes

✔️ A culture where people feel safe being honest about their health

With traction gaining around these conditions, we’ve definitely seen progress in conversations around women’s health — but there’s still a long way to go.

Adenomyosis and Endometriosis affect thousands of people in the workplace, many of whom are quietly managing significant symptoms while still trying to do their jobs.

When employers take the time to understand this and build supportive environments, the impact goes far beyond attendance or productivity — it improves trust, retention, and overall wellbeing.

I recently shared a wider blog on Women’s Health at Work: Why Employers Need to Pay Attention, where I explore workplace support, legal context, and practical steps employers can take. Even small changes can make a real difference.

Need support?

If you’re looking for help reviewing workplace adjustments, guidance around chronic health conditions, or support with absence management, HDHR can help you — supporting your people while protecting your business.

Get in touch today