What happens at work when inflexible frameworks meet fluctuating conditions?
In a recent landmark legal case, we learned that employers don’t always win - even when they set the parameters for performance.
This was Pal v Accenture, a tribunal appeal case that put the spotlight on organisations still struggling to grasp the reality of menstrual health at work, particularly chronic conditions like endometriosis.
The case
Sanju Pal was an Accenture employee of 10 years when she was diagnosed with endometriosis in 2018 - a condition with no cure, and treatment often limited to pain relief. After surgery to remove cysts from her left ovary, and during a phased return to work, Sanju was assessed as “underperforming” and dismissed within a few months.
Despite a strong track record at work.
Despite a diagnosis.
And despite following internal processes.
For Sanju, this marked the start of a 6.5-year legal battle, concluding in January 2026 when she won her Employment Appeal Tribunal against Accenture on all grounds, represented by Barrister Elaine Banton.
The key issue
Sanju’s condition had not been adequately accounted for in how her performance was assessed.
But this isn’t just about one employer. It exposes a wider problem in how workplaces deal with - or fail to deal with - menstrual health.
These systems and structures are so often built around fixed frameworks. Employees with fluctuating conditions like endometriosis, PMDD, adenomyosis or fibroids often privately manage symptoms behind the scenes, without flexibility or clarity around what support they can ask for.
A major blind spot
Pal v Accenture may be a moment for menstrual health at work, but it also exposes a much bigger issue: the UK has broader blind spots when it comes to how we view women’s health.
Under the Equality Act 2010, conditions can qualify as disabilities if they have a substantial and long-term impact on day-to-day life. Conditions like epilepsy, rheumatoid arthritis, depression and chronic fatigue syndrome are specifically referenced in guidance around disability.
No menstrual or gynaecological conditions are specifically listed in guidance.
That gap matters.
It leaves people unsure of their rights and having to argue for recognition for their chronic, fluctuating and genuinely debilitating conditions.
Case by case.
Manager by manager.
Tribunal by tribunal.
And when diagnosis itself can take close to a decade, the reality is many employees spend years trying to navigate work without support.
The takeaway for employees
A fixed workplace framework does not override your right to reasonable adjustments when you are unwell. And yes - that can include menstrual health.
If symptoms are having a substantial and long-term impact on your ability to function day to day, you should not assume you simply have to “push through”.
Understanding your rights matters.
Documenting symptoms matters.
And advocating for yourself matters too.
And for employers?
The organisations getting this right are not necessarily introducing endless policies or making huge changes. In many cases, they are simply becoming more realistic about how health shows up at work, and proactively supporting their teams.
That means:
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Taking symptoms seriously before crisis point.
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Not waiting years for formal diagnosis before offering support.
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Training managers to handle conversations confidently.
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Understanding that chronic menstrual conditions are not minor inconveniences - they can be debilitating.
Employees are becoming more informed. Legal scrutiny is increasing. Conversations around women’s health at work are becoming far more mainstream.
Pal v Accenture will not be the last case of its kind.
More organisations are now being forced to examine whether their systems genuinely reflect the reality of long-term and fluctuating health conditions at work.
We spoke to Elaine Banton, the barrister behind the Pal v Accenture appeal, to unpack what this case really means inside workplaces: where employers are getting it wrong and what the law expects when performance is affected by long-term conditions.
As Elaine Banton puts it:
“The bigger issue is failing to support people who genuinely need it.”
Read the full interview here.
Blog disclaimer
Our blog is intended to share information and ideas around periods, health, and sustainability. While we do our best to keep content accurate and up to date, things can change over time. The information here is not intended as medical advice — for any health-related concerns, please consult a qualified healthcare professional. For more information on our claims, please see our Claims Page, and for the most up-to-date product information, please visit our Product Pages.
