What is Endometriosis – and Who is Affected?
Endometriosis is a chronic disease where tissue similar to the lining of the uterus grows outside the womb – for example, on the ovaries, fallopian tubes, or within the abdominal cavity. Affected women often suffer from severe menstrual pain, chronic fatigue, digestive issues, pain during intercourse, and in some cases, infertility. Many also experience irregular cycles, back or leg pain, and persistent discomfort that extends beyond menstruation.
Despite its prevalence, endometriosis is still not recognised for what it is: a widespread disease. According to the World Health Organization, about one in ten women of reproductive age is affected – that’s over two million women in Germany alone. Experts even believe there is a significant number of unreported cases, as many women remain undiagnosed for years. On average, it takes seven to ten years to receive a diagnosis – during which time the quality of life is significantly impaired.
In medical care, there is still a lack of standardised diagnostic pathways, widespread knowledge, and specialised endometriosis centres. Many affected women feel dismissed or are incorrectly diagnosed with psychosomatic conditions.
Unfulfilled Desire for Children, Psychological Strain – and Societal Costs
Endometriosis is one of the most common causes of infertility. Studies suggest it affects up to 50% of women who are unable to conceive. Adhesions, inflammatory processes, or hormonal imbalances can lead to blocked fallopian tubes or reduced egg quality. Reproductive treatments such as inseminations or IVF are often necessary – procedures that are not only physically and emotionally taxing but also costly – partly for the affected individuals and partly for employers in terms of absences and additional benefits.
Psychological impacts are also profound. Living with chronic pain, social withdrawal, unfulfilled desire for children, and a lack of understanding both privately and professionally often lead to exhaustion, anxiety disorders, or depression. Studies show significantly higher rates of psychological comorbidities among women with endometriosis.
Despite these far-reaching health and societal effects, public research into endometriosis remains limited. Research funding for endometriosis falls well below that of other chronic diseases with similar prevalence. There is a lack of systematic awareness, care structures, and political initiatives.
Endometriosis at Work – Invisible but Costly
Many employers underestimate how endometriosis can affect daily work life – and thus their business:
Absenteeism: On days of severe pain, affected women are often unable to work. Some are regularly absent, others try to persevere – risking exhaustion and burnout in the long term.
Presenteeism: Many employees with endometriosis continue working despite their symptoms. The result: reduced concentration, slower work pace, higher error rates – all directly impacting productivity and quality.
Career Restrictions: Affected women often forgo promotions, reduce their working hours, or withdraw entirely – not because they lack motivation, but because support structures are missing.
Reproductive Treatments: Necessary medical treatments for infertility mean further absences, psychological pressure, and often lengthy treatment periods – affecting both teams and the business.
Economic Impact: Studies estimate that endometriosis costs Germany several billion euros every year – mainly through indirect costs such as productivity losses, sick leave, and early retirement.
Most of these effects are not caused by the disease itself but by delayed diagnoses, lack of support, and insufficient knowledge – including within companies.
What Companies Can Do – and Why It’s Worth It
Endometriosis is not just a “private issue”. From an economic perspective too, it makes sense for employers to take the health realities of their employees seriously. Early support helps prevent long-term absences, increases team satisfaction, and strengthens employee loyalty.
Concrete actions companies can take:
Raise Awareness and Educate: Sharing information about women’s health – through internal campaigns, workshops, or platforms like Onuava – helps to identify symptoms early and foster understanding.
Facilitate Access to Diagnosis and Treatment: Corporate health insurance schemes or supplementary health services can help close care gaps.
Offer Flexibility: Remote work, flexible hours, or personalised working models create breathing space when physical symptoms are severe or medical appointments are needed.
Train Leaders: Managers should learn how to deal with invisible illnesses respectfully and openly – not delving into medical details but fostering a culture of inclusion and health.
Establish Active Health Management: Companies that integrate reproductive health into their corporate health programmes position themselves as modern employers and address demographic changes proactively.
Frequently Asked Questions from Employers: What if Employees Have Endometriosis?
Do we need to know or document medical diagnoses as employers?
No. It’s not about medical details – but about fostering a climate of trust and understanding. Simply allowing open conversations about challenges can be a huge relief for affected employees.Is this really relevant – even with a low percentage of female employees?
Yes. Even one affected employee can have a long-term impact on a team or organisation – or may leave if they do not feel seen. Additionally, partners of male employees can be affected, impacting their psychological wellbeing.What will it cost us?
Many measures, such as raising awareness, providing training, or offering flexibility, come at minimal additional cost. On the contrary, they prevent costly long-term absences, strengthen loyalty, and improve the working atmosphere.Where do we start?
Getting started is easy: with an internal awareness campaign, a health webinar, or by partnering with specialised providers like Onuava.
How Onuava Supports Companies and Employees
At Onuava, we help companies integrate reproductive health practically and sustainably into everyday work life. Our platform offers well-founded information, access to medical advice, and individual support – for example, with endometriosis, fertility challenges, or other women’s health issues. Together, we ensure that fewer women fall through the cracks – and that employers no longer look away.
Endometriosis affects millions – including in the workplace. It’s time to break the silence. And it’s in everyone’s best interest to take action.
