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Endometriosis-sufferer wins landmark tribunal case on workplace discrimination

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A former Accenture employee has won an appeal tribunal ruling after a judge said her endometriosis may amount to a disability under the Equality Act 2010.

A senior employment law judge last month quashed a 2022 tribunal decision that rejected claims brought by Sanju Pal, 43, against the consulting firm.

The judge found the original ruling did not properly consider whether Pal’s endometriosis, a condition where tissue similar to the womb lining grows elsewhere and can cause chronic pain, amounted to a disability under the Equality Act 2010.

The decision also said the ruling mischaracterised her reasons for dismissal and lacked evidence for some claims.

Pal has previously described how Accenture terminated her contract in 2019 despite her having a “cyst the size of a Coke can” on one of her ovaries, in what was a severe and chronic case of the condition.

For Pal, however, the fight is not over. The judgement ordered a fresh employment tribunal to reconsider her claims, and Accenture reserves the right to appeal.

The case has drawn attention since the appeal decision, with Pal appearing on BBC News and Radio as well as ITV News.

Pal said: “Whilst my faith was shaken after the initial employment tribunal, this judgement has restored it somewhat.

“Luckily, I got an appeals judge who finally heard me.

“A line one of my close friends said was ‘the system failed Pal’. Oh my God, just to hear and see that.”

She added: “I’m not surprised my case is making waves in the media, as there is no other case in the UK that has gone to this level of court, for a respondent that refused to concede.

“Of course it’s going to gain traction now, and I think women are absolutely outraged that this could be possible.”

Emma Cox, head of Endometriosis UK, suggested on BBC Radio 5 Live that Pal’s case will make a “real difference”.

She said: “It yet again highlights that endometriosis and its impact are not properly understood in the workplace, and the appeal ruling makes it quite clear that those living with endometriosis may be protected, and it should be considered.

“I also hope it gives a push to our campaigns, one of the things we are pushing for is to have menstrual health included in the employment’s rights act.”

Pal, who also referenced a government petition to introduce menstrual leave for those with endometriosis and adenomyosis, a related condition where tissue grows into the muscular wall of the womb, due to be debated in parliament, said far more needs to be done to acknowledge the reality of workplace discrimination.

She commented: “Those with endometriosis are hearing from their employer: ‘What do you mean you can’t come into work? What do you mean you can’t do this shift’? Or ‘what do you mean that you need to take time off for X, Y and Z?’

“It’s happening every day across this country to millions of women, and that’s just endometriosis before you start talking about other conditions.”

Hormonal health

Non-hormonal menopause pill approved for NHS use

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A new daily menopause pill approved for NHS use could bring relief to women with debilitating hot flushes and night sweats.

Around 500,000 women are expected to be eligible for the treatment, which experts say could help those unable to take hormone replacement therapy, or HRT.

The drug, fezolinetant, also known as Veoza, is a daily non-hormonal tablet designed to target the brain signals that trigger some of the most disruptive menopause symptoms.

In final draft guidance published today, the National Institute for Health and Care Excellence recommended the 45mg tablet for women experiencing moderate to severe hot flushes and night sweats.

More than two million women in the UK are thought to suffer these symptoms during menopause, often beginning during the earlier stage known as perimenopause.

For many, the effects are severe, disrupting sleep, affecting concentration and straining relationships. In some cases women are even forced to cut back on work.

An estimated 60,000 women in the UK are currently out of work or on long-term sick leave due to severe menopause symptoms, costing the economy roughly £1.5bn a year.

Research also suggests one in 10 women has left the workforce entirely because of a lack of support.

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Insight

Women’s health leaders warn of censorship

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More than 600 women’s health leaders warn social media censorship is restricting medically accurate, life-saving women’s health information.

In an open letter, as reported in the Independent, they said essential health advice was being restricted as posts about menstruation, fertility, menopause, postpartum recovery and sexual wellbeing were being systematically censored.

The posts are frequently misclassified as “adult content” and removed or restricted by automated moderation systems, even though they are educational or medically accurate.

Dr Aziza Sesay, medical doctor and broadcaster, said: “Online censorship perpetuates the narrative that women’s and gynaecological health is inappropriate and should remain taboo.

“This amplifies the embarrassment that already surrounds these topics.

“I often say that women are dying of embarrassment because they’re not coming forward about their problems due to shame, and when they present late, outcomes are poorer.

“Shame and stigma are costing lives.”

A survey by CensHERship, a campaign to tackle the social media censorship of women’s health and sexual wellbeing content, found 95 per cent of women’s health creators experienced censorship in the past year.

Respondents cited rejected advertising campaigns, removal of educational posts, reduced reach on social platforms and a lack of transparent appeals processes.

More than half said they now self-censor their language to avoid being taken down from social media platforms.

The warning comes as leading brands including Essity, Clue, Hertility, Daye and Mooncup join a newly formed coalition, the Women’s Health Visibility Alliance (WHVA), created to challenge what campaigners say is systemic bias in how digital platforms moderate women’s health content.

Clio Wood, co-founder of CensHERship, said: “Women’s and reproductive health content is not a threat to anyone’s safety.

“This is about accurate, life-saving health information being treated as obscene, and about women-led innovation being blocked at scale.

“Our members are tired of self-censoring, of replacing ‘vagina’ with euphemisms, of seeing menopause and fertility treated as taboo.

“Visibility is not a ‘nice to have’. It is fundamental to public health, innovation and gender equity.”

The open letter also called for policymakers to “help bring platforms to the table”, by ensuring “digital regulation addresses gender bias and recognises the public health and economic cost of this issue”.

Deirdre O’Neill, chief commercial and legal officer at Hertility, said: “Hertility has carried out more than 29 research trials and operates within some of the strictest regulatory frameworks in healthcare.

“If a company like Hertility, built on peer-reviewed science and clinical evidence, can be censored while misinformation spreads freely, then the system designed to protect people is clearly failing them.”

Rhiannon White, chief executive of Clue, a period tracking app, said: “Women are the world’s largest health and wellness consumers, controlling the majority of household spending in every market, yet they remain strikingly underserved relative to their economic power.

“This gap creates three systemic pain points: a profound lack of accessible female health knowledge that forces women to self-diagnose, a confusing marketplace filled with unproven products and little evidence-based guidance, and persistent barriers to accessing care.

“Yet when companies such as ourselves and the other members of the Women’s Health Visibility Alliance seek to address these pain points, providing health information that prioritises evidence-based guidance rooted in real science, we are consistently blocked for an array of baffling, unclear and frankly biased reasons.”

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Features

Study reveals how oestrogen protects women from high blood pressure

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Oestrogen helps protect premenopausal women from hypertension by relaxing and widening blood vessels, according to new research examining why women develop high blood pressure less often before menopause.

High blood pressure, also known as hypertension, affects more than a billion people worldwide and is a leading cause of heart disease and stroke.

Premenopausal women are less likely to develop the condition than men or postmenopausal women, but the biological reason has been unclear.

Researchers used a mathematical model of the cardiovascular and kidney systems to analyse how oestrogen influences blood pressure.

The analysis found that oestrogen’s strongest protective effect comes from vasodilation, the process by which blood vessels relax and widen, helping blood flow more easily and lowering pressure in the arteries.

Anita Layton, Canada 150 Research Chair Laureate in Mathematical Biology and Medicine and professor of applied mathematics, said: “Oestrogen is often thought of only in terms of reproductive health, but it plays a much broader role in how the body functions.

“It affects how blood vessels respond, how the kidneys regulate fluids and how different systems communicate with one another.

“What we found is that its impact on blood vessels is especially important for regulating blood pressure.”

The findings may also have implications for treating women after menopause, when oestrogen levels naturally decline.

The model predicted that angiotensin receptor blockers, a common class of blood pressure drugs, could be more effective than another widely used treatment group known as angiotensin converting enzyme inhibitors in treating women with hypertension, even after oestrogen levels decline after menopause.

Layton said her team has spent years developing a mathematical model of women’s kidneys and the cardiovascular system, designed to explore how different biological mechanisms affect blood pressure.

The model allows researchers to test individual effects separately and examine how each influences the body.

“We can turn on one effect, then another, and see exactly how each one affects the body,” Layton said.

She added: “For too long, women’s health, especially older women’s health, has been overlooked by medicine.

“Understanding how age and sex affect the body and, therefore, treatment, is an equity issue.”

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