Sanju Pal's story is not hers alone. There are countless women who suffer from endometriosis and the discrimination that comes with it. Pal was diagnosed with the condition in 2018 and it soon progressed to stage 3. The doctors said removal of cysts needed immediate attention and an operation was needed.
She took a month off from work, and upon returning, she was told that she missed her performance target in 2019. Pal said, "I wasn't a high performer anymore, because I had a disability."
Despite a stellar 10-year work experience, Pal was terminated from her job and told to leave the building. The impact of the whole experience on Pal's psyche was too much. She felt deep shame. "I was so sad and shocked and anxious. I didn't feel like I could tell anyone. I literally became a shell of myself," she shared with BBC.
Eventually, Pal decided to go to an employment tribunal. Last month only, she won a significant employment appeal tribunal and her case can pave the way on how employers treat women suffering from endometriosis at workplace.
Moneycontrol team spoke to Dr Hrishikesh Pai, consultant gynaecologist and IVF specialist, Lilavati Hospital, Mumbai, and Fortis Hospitals Delhi & Chandigarh, to understand more about endometriosis, how it impacts daily life and more.
Dr Pai shared that endometriosis is a prolonged illness where tissue that resembles the lining of the uterus grows outside the uterus, usually in the ovaries, fallopian tubes, or inside the pelvis. "This tissue reacts to hormones and can cause inflammation, severe pain, and in some cases, infertility," he added.
A lot of women continue to suffer from endometriosis without really realising that something is amiss. On this, Dr Pai said, "In cases of mild endometriosis, where there is no collection of blood in the ovaries, it is very difficult to diagnose endometriosis unless you do a laparoscopy. However, in many cases of endometriosis, there is collection of blood in the ovaries, called endometriomas. This can be easily diagnosed by doing a pelvic ultrasound or MRI. Nowadays, advanced 3D ultrasound is available for a more accurate diagnosis."
Dr Pai opined that in view of Sanju Pal's case, one thing was clear and that was a major gap in knowledge surrounding endometriosis. "What one needs to understand is how this condition can significantly alter the daily life of women suffering from it. Workplaces should try to offer a fair, equitable support and dignity to women going through such a challenging process, both mentally and physically. I hail the decision of the tribunal and I hope this will help make workplaces more conducive for women suffering from endometeriosis," he explained.
Dr Pai told Moneycontrol that medication can be of two types. A: To control the pain B: To suppress the disease. "A decade back, patients used to be managed by hormonal medication such as oral contraceptive pills or progesterone pills. However, nowadays, oral medicines such as Dienogest or the newer oral GNRH antagonist tablets called Elagolix are available," he shared.
In some patients, collection of blood becomes very large and also, endometriosis causes inflammation which results in sticking of the bowel to each other. It can sometimes involve the bladder as well as the ureter, he cautioned. "To deal with a severe stage like this, laparoscopic surgery is done to remove the disease. At a more serious stage, where there is a lot of penetration of endometriosis into the tissues, which is called DIE Deep Infiltrating Endometriosis, robotic surgery is very effective in tackling the disease," Dr Pal explained.
Prior to laparoscopic or robotic surgery, it is important to preserve fertility in the form of egg freezing, as surgery can damage their ovaries and ovarian reserve, he pointed out.
Namita Sharma (name changed), 42, who works as a IT professional, shared her story with endometriosis. "In my 20s, I would always experience painful periods, fatigue and many other health issues that went undiagnosed for a long time. Back in the day the awareness was less, and which is why I was never able to understand what was happening with me," she shared with Moneycontrol.
Workplaces are unforgiving. It doesn't matter what crisis one is going through, what organisations are concerned with are results. On days when she would suffer frome excruciating pain, she would work additional hours just to complete her daily tasks. "It was not only exhausting, but also mentally challenging for me," she said.
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"There were many occasions when I forced myself to work, because I did not want my pain to affect my professional growth. Many women with endometriosis worry about having job security; or losing the opportunity for career advancement if they take time off to recover from illness. In addition, it became an emotional struggle to try to balance both health and career. Eventually, I learned that taking care of yourself comes first over anything else in long-term," Sharma added.
Shivangi Kapoor (name changed), 36, shared how she came close to tears when she came to know about Sanju Pal's case. "I too suffered from endometriosis at some point in my life. I would dread having periods, as it would just render me incapable of meeting workplace deadlines. Plus, I didn't know what to tell my manager about my situation. I wondered if my seniors would even understand what I went through. I remember being too hard on myself and dragging myself to work. On some days, my manager let me work from home. However, on other days, I would cry out of bed and go to work," she narrated.
Kapoor said a lot of women continue to suffer. "At workplaces, the realisation must dawn that some women have difficult periods. Accomodating them is the need of the hour, or else, many would eventually feel forced to leave the workforce. It's a lose-lose situation," she concluded.
Q. What is endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, commonly affecting the ovaries, fallopian tubes and pelvic lining.
Q. What are the common symptoms of endometriosis?
Symptoms may include severe menstrual cramps, chronic pelvic pain, pain during intercourse, heavy periods, fatigue, bloating and, in some cases, infertility.
Q. What causes endometriosis?
The exact cause is unknown. Possible factors include retrograde menstruation (when menstrual blood flows backward into the pelvic cavity), hormonal imbalances, immune system issues and genetic predisposition.
Q. Who is at risk of developing endometriosis?
Women in their reproductive years are most commonly affected. A family history of endometriosis may increase the risk.
Q. Can endometriosis affect fertility? Yes. Endometriosis can interfere with the function of the ovaries, fallopian tubes and uterus, making it harder for some women to conceive.
Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.
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