In this article, I use the terms ‘women’, ‘people who menstruate’ and ‘people with menstrual cycles’ interchangeably. I recognise that not all women menstruate and not all people who menstruate identify as women.
Menstrual health is a fundamental aspect of women’s daily wellbeing and is essential for full participation in social life. The largest menstrual study to date, conducted in 2021 by Radboud University Medical Centre in the Netherlands, surveyed 42,000 women and found that one in three experience such intense pain during menstruation they are unable to carry out daily tasks. Despite the seriousness of these symptoms, the study revealed that half of those suffering did not disclose them to anyone. The survey highlights the difficulties many women face once a month, but also shows that the people around them lack the information and tools to support them and take their health concerns seriously.
The lack of education about menstrual health affects working environments too. Most workplaces lack safe spaces and a supportive culture to openly discuss menstrual health and the issues that may come with it. For these reasons, working while experiencing painful periods is just the norm in most jobs, a reality that makes it difficult – if not impossible – to advocate for policies that would accommodate such needs.
When it comes to securing equality in the workplace, women have always faced hurdles – be it bias when it comes to promotions, the challenge of securing flexibility to juggle both professional and personal responsibilities, or the prevailing worry that taking maternity leave or seeking reduced hours might signal a preference for family life over professional success.
Some areas are seeing progress, but others are still being woefully overlooked. Menstrual health is one such aspect of women’s daily life that has, for far too long, been considered a taboo topic – both in and outside of the workplace. At least until now…
While other countries have discussed the possibility of making paid menstrual leave a legally enshrined right, Spain is the first European country to put a formal proposal forward. The bill, yet to be debated in parliament, sets out that women and people who menstruate should be granted up to three days of sick leave per month for painful periods, which can be extended to five for those experiencing incapacitating pain. If approved, the provision will come into force by 2023.
Such a visible acknowledgement of menstrual health is long overdue, and making professional settings a comfortable place for women and people who menstruate is a vital step towards gender equity in the workplace. At the same time, securing menstrual leave as a standalone policy might do more harm than good for women and people with cycles if some concerns are left unattended. But why?
It may normalise period pain
Experiencing some cramps and discomfort is a normal part of menstruation, but severe menstrual pain should always be investigated and brought up to medical professionals. While allowing regular time off for those experiencing pain is indeed a step forward, it may end up normalising extreme pain and discourage people from finding the root causes behind it.
It fails to consider other debilitating symptoms
People with menstrual cycles experience more than just physical symptoms each month. The leave in its current form does not apply to those experiencing (severe) psychological symptoms, such as people suffering from pre-menstrual dysphoric disorder, a condition that affects mental health throughout the cycle. Furthermore, the current draft bill specifies that those seeking leave must present a note from their doctor to confirm their painful periods. Unfortunately, menstrual-related concerns are often brushed aside or minimised by GPs, making such doctors’ notes a high threshold to accessing menstrual leave.
It risks increasing sex-based discrimination
While strides are being made in favour of securing equal opportunities in the workplace, women are still, routinely and unfairly, overlooked for promotions and other opportunities to advance their careers purely based on gender. Existing sex-specific measures such as maternity leave, while vital for society, already risk impacting women’s employability and future career progress. It is therefore not unfair to assume that the current Spanish proposition might give employers another reason not to hire those who make use of the policy or to offer them more responsibility.
Other discriminatory risks may arise around employees’ right to privacy. There may be instances where employees do not wish to disclose details of their menstrual health to their employer; for example, for fear of being perceived differently. There are various reasons that such a topic could cause distress, with infertility, gender dysphoria and medical trauma being at the top of the list.
So should Spain rescind its offer if there is so little to be gained? Well, perhaps not. The draft bill, in its current form, has already been an effective means in sparking debate about the introduction of wider menstrual support in professional settings across Europe. It could pave the way to other similar schemes being introduced elsewhere. Such strides should not be discouraged.
Instead, more careful consideration should be paid to what is being offered, to better address the potential pitfalls. Before bringing the Spanish bill into law, the following steps might be worth lawmakers’ attention:
Wider menstrual health education: At the root of the silence around menstruation and its dismissal in policies and workplaces, is lack of education about menstrual – and more widely reproductive – health. Therefore, before such bills are introduced, medical professionals must receive better training about hormones and menstrual cycles and the related complaints they may cause, so that they’re in a better position to hear and support those who come to them for help.
Managers too must be brought up to speed, not only about employees’ rights in such instances but also in what their response should be, what treatments might be available and how they might best adapt working arrangements to support their staff.
Introduce greater flexibility: Employers must be ready to provide flexibility without bias or penalty. We have learned, during years of global lockdowns, that remote working is effective in some sectors. While we should not eschew the office entirely, allowances should be made not only for where employees work but also when. However, since not everyone has an option to work remotely, employees should be able to access adequate spaces to take a break and rest in the physical work location(s).
Funding menstrual research: Instead of merely making allowances for those in need, greater attention and investments should go towards the pursuit of medical research about debilitating menstrual symptoms and their treatment. Making such treatments available could ultimately decrease anxiety around skipping work, improve employee satisfaction and most importantly improve the quality of life of those who suffer from menstrual pain.
Policies such as this can only go so far in creating real change. At its core, a culture shift must happen. We cannot merely wait for policies to be put in place: each person, whether menstruating or not, has a role to play to contribute to menstrual equity. We must cultivate a culture of compassion – at work and beyond – that does not glamourise overworking and burning out. We must rethink rigid structures in the workplace for everyone, not only women and people with cycles, because, ultimately, an inclusive workplace is one that values employees' physical and psychological wellbeing.
Maria Carmen Punzi is a menstrual health researcher, activist and PhD student in menstrual health and social enterprises at Rotterdam School of Management, Erasmus University