Pain should not be a career risk: the workplace reality of endometriosis

Endometriosis affects one in seven Australian women, yet its impact on careers, leadership and frontline work is rarely discussed.

Janine Yeates, GM Brand and Marketing at Care & Co Group, reflects on living with endometriosis and the workplace realities many women quietly navigate.

The recent Four Corners investigation into gynaecologist Simon Gordon has unsettled many women across Australia.

The allegations are serious. Patients have claimed unnecessary surgeries and long-term harm. Dr Gordon has disputed aspects of the reporting. Regulatory and legal processes will determine what follows.

But for women living with endometriosis, the reaction is not just about one doctor. It is about trust.

Dr Gordon’s name will be familiar to many women with endometriosis in Australia. In online forums and support groups, he has often been described as a leading excision surgeon. Excision surgery, which removes endometriosis lesions at the root rather than burning the surface, is widely regarded as best practice when performed appropriately within a multidisciplinary model of care.

When you have lived with chronic pelvic pain for years, those names start to carry enormous weight. They become more than reputations. They become hope.

The investigation has also prompted broader concern about how women with chronic pelvic pain are treated within the health system.

Independent Member for Kooyong Dr Monique Ryan said the allegations raise serious questions about oversight.

“The revelations about an Epworth Hospital surgeon’s alleged malpractice aired in ABC’s Four Corners episode against many women with chronic pelvic pain, over a long period of time, suggest a catastrophic failure of our health system,” she said.

“Patients place their trust in our health professionals. They deserve best practice care and effective, conscientious oversight by hospitals, colleges and the healthcare regulator, AHPRA.”

Endometriosis specialists say the investigation also highlights the importance of careful, evidence-based treatment.

Professor Jason Abbott, Interim Director of the Ainsworth Endometriosis Research Institute at UNSW, says surgery must be approached cautiously.

“The story highlighted in Four Corners is deeply distressing. Every woman deserves care that is evidence-based, transparent and centred on her long-term wellbeing,” he said.

“Repeated endometriosis surgery when there is no reasonable symptomatic relief the first time is making things worse, not better.”

The desperation behind the decision

Endometriosis affects an estimated one in seven Australian women by the age of 44. Yet diagnosis still takes, on average, six to seven years.

That is years of being told painful periods are normal. Years of escalating pain relief. Years of planning your life around your cycle.

When a specialist finally says, “I know what this is and I can treat it,” you want to believe them. Pain changes your risk calculation.

You are not chasing surgery. You are chasing your life back.

My own turning point

I have lived with painful periods since my teenage years. After the birth of my daughter in my late twenties, the pain became significantly worse.

While living in the UK, I was eventually diagnosed with endometriosis after scans revealed a large ovarian growth. The diagnosis was confronting. Alongside the reality of a chronic disease came conversations about fertility and the likelihood that having another child would require IVF.

I underwent surgery soon after.

Following a second surgery some years later, just before beginning IVF treatment, I unexpectedly became pregnant. That pregnancy ended in miscarriage. It was another reminder that endometriosis does not only affect pain. It reaches into fertility, family planning and emotional wellbeing.

I have since had three surgeries. One in the UK and two in Australia.

Sharing this experience is not about sympathy. I consider myself fortunate in many ways. I have a career I care deeply about, a beautiful teenage daughter, a supportive husband and a strong family around me.

But endometriosis is part of my reality. And it is the reality for millions of working women.

When pain collides with careers

The lead-up to my third surgery happened during COVID. At that time, I was in a client-facing, highly visible leadership role.

Every two weeks, I was dealing with acute pain, often severe enough to leave me curled up and unable to function. The fatigue that followed could last days. Standard pain relief rarely worked. I found myself in emergency departments more than once simply trying to get the pain under control.

What unsettled me most was not just the physical pain. It was the professional anxiety that came with it.

Leadership roles often come with an unspoken expectation of constant availability and stamina. When you are dealing with a chronic illness, that expectation can feel quietly threatening.

I worried about letting my team down. About disappointing stakeholders. About appearing unreliable.

Chronic pain also takes a toll on mental well-being. The uncertainty alone can be exhausting. When you cannot predict when the next episode will hit, it becomes difficult to plan, to focus and sometimes even to trust your own capacity.

The reason I remained in that role was not resilience alone. It was flexibility and trust.

Working from home during COVID allowed me to manage my energy more carefully. I could start later on difficult days. I could step away between meetings.

Most importantly, I had a manager who believed in me and never equated illness with a lack of commitment.

In truth, I have been fortunate to have thoughtful leaders and supportive teams at different points throughout my career. Without that kind of understanding, continuing in demanding roles during some of the hardest periods would have been far more difficult.

The reality for frontline workers

But flexibility is not available to everyone.

In sectors such as aged care, healthcare and retail, large numbers of women work in frontline roles that require them to be physically present. They are on their feet for long shifts, lifting, moving and caring for others.

Taking time off for severe pelvic pain is rarely simple. Too often, the response is dismissive.

“What is she taking time off for? Period pain?”

For women living with endometriosis, the pain can be debilitating. It can involve vomiting, fainting, severe fatigue and inflammation that makes standing or walking extremely difficult.

The physical pain is only part of the burden. The mental strain of repeatedly having to justify that pain, worrying about how colleagues perceive you or fearing you will be seen as unreliable can quietly erode confidence over time.

What this means for aged care leadership

Aged care and retirement living are sectors with predominantly female workforces. Many clinical leaders, facility managers and executive teams are women.

Endometriosis is already present within those leadership pipelines.

Research shows the condition significantly affects workforce participation, with high levels of absenteeism and even greater levels of presenteeism. The broader economic cost in Australia is estimated to approach $10 billion each year when healthcare expenditure and lost productivity are combined.

For sectors already grappling with workforce shortages and leadership succession, this should not be considered a niche issue.

If we want to retain experienced female leaders in aged care, we cannot treat chronic gynaecological conditions as private inconveniences.

They are workforce realities.

Beyond the operating theatre

The Four Corners investigation has raised serious questions about surgical oversight, consent and governance.

Healthcare systems must continue strengthening multidisciplinary care that includes pain specialists, pelvic physiotherapy, psychological support and clear, evidence-based surgical criteria.

Employers have a role as well.

Flexible work arrangements, compassionate management and psychologically safe workplaces are not soft policies. For some women, they are the difference between remaining in leadership and stepping away from it entirely.

Endometriosis is largely invisible in the workplace. It rarely appears in board papers or performance reviews, yet its impact can quietly shape career trajectories and leadership diversity.

Pain should never determine who progresses, who steps back or who leaves the workforce altogether. It should not be a career risk.

Support and resources

For anyone living with endometriosis or seeking evidence-based information and support, the following organisations provide reputable guidance and referral pathways:

• Endometriosis Australia – education, advocacy and support resources: https://endometriosisaustralia.org
• Jean Hailes for Women’s Health – clinical information and women’s health resources: https://www.jeanhailes.org.au
• Royal Australian and New Zealand College of Obstetricians and Gynaecologists – clinical guidelines and patient information: https://ranzcog.edu.au