Guest blog by Rachel Sherratt, Engineering Trainer, NTS (DRS)

Rachel Sherratt shares her personal experience of living and working with Endometriosis in the railway, reflecting on what she went through and what she learned along the way.

Endometriosis affects an estimated one in ten women, yet it remains widely misunderstood and often misdiagnosed. Many people are initially told they have anxiety, IBS or stress‑related conditions. While anxiety can sit alongside Endometriosis (and symptoms can influence one another) this can delay people getting the right investigations and support.

For those working in the railway, that period of uncertainty before diagnosis can be particularly difficult to navigate.

My experience of diagnosis

I was diagnosed with Endometriosis at the age of 30, following surgery in March 2023. My symptoms began when I was 16.

For more than a decade, I experienced persistent pelvic pain, bowel urgency, nausea, fatigue and increasing food intolerances. I saw multiple GPs and specialists and was repeatedly told that my tests were normal. Over time, I was diagnosed with anxiety and IBS, and at one point I was even misdiagnosed with an eating disorder.

It was only when I returned to my GP with detailed symptom records and professional support that I was referred again and eventually diagnosed.

By that point, Endometriosis had already had a significant impact on my life and my career.

Working on the railway while undiagnosed

At the time I was seeking a diagnosis, I was working as a train conductor, a role I genuinely loved. Becoming a train driver had been a childhood ambition, and working onboard felt like a step towards that goal.

However, the physical demands of the role, the impact of shift work, and unreliable access to toilet facilities became increasingly difficult to manage alongside my symptoms. I often worked services where toilets were unavailable or unusable, while also feeling under pressure not to delay trains or disrupt passengers.

Physically and mentally, it became unsustainable. I made the decision to change direction within the railway, not because I lacked capability or commitment, but because my health was incompatible with the inflexibility of the role while I remained undiagnosed.

I later moved into an office based role at NTS (DRS) and was diagnosed around six months after joining. With supportive management and flexibility, I have since moved roles again and now work in a position that plays to my strengths, and one that I enjoy.

Why reasonable adjustments matter, especially before diagnosis

In my experience, the period before diagnosis is often when support is needed most.

Rigid sickness policies, inflexible rostering and a lack of alternative duties can unintentionally make it harder for people with fluctuating health conditions to remain in frontline roles.

Reasonable adjustments do not mean lowering standards or compromising safety. They mean recognising that chronic conditions can vary day to day, and that people may need flexibility at certain times.

Examples that can make a difference include:

For traincrew and on‑the‑ground staff

• Temporary alternative or light duties during symptom flares
• Access to toilet facilities where possible
• Regular breaks
• Flexibility around diagrams and links
• Seating or anti‑fatigue mats for staff on their feet for long periods

For office‑based staff

• Flexible start and finish times
• Ability to work from home during severe symptoms
• Understanding around short‑notice changes or cancellations
• Equipment that supports comfort, such as chairs or heat support

For all staff

• Recognition that chronic illness does not follow predictable patterns
• Flexibility around medical appointments
• Open conversations without assumptions

Why this matters

Many people leave frontline roles not because they are incapable, but because their health needs cannot be accommodated at that time.

From my own experience, awareness, flexibility and supportive management can make a real difference. During one of the hardest periods of my life, work — and the support of my manager, was one of the few constants that helped me cope.

No one should feel they have to choose between their health and their career.

Support and resources

For anyone seeking further information, Endometriosis UK provides evidence‑based resources, including:

• A symptoms checker and GP letter
• First‑consultation questionnaires
• Pain and symptom diaries

Being informed and believed can make a difference.