Could menstrual leave reinforce inequalities at work?

Menstrual leave is often framed as a progressive response to a workplace built around bodies that do not menstruate. But without tackling the stigma around periods and women’s health, such policies could end up reinforcing the inequalities they were meant to address.

In April, the UK government announced that it had no plans to introduce statutory menstrual leave for those diagnosed with endometriosis and adenomyosis. Rejecting the model introduced in Portugal last year, the UK will apparently focus on improving gender-neutral employment health rights.

For campaigners, menstrual leave signals progress. Period pain, long dismissed as something to simply endure, is finally being recognised as a legitimate workplace issue.

Yet, real world use of Portugal’s policy is low – and similar blueprints used in countries like Spain, Japan, Taiwan and South Korea tell the same tale. Something about menstrual leave doesn’t appear to be working for the women it seeks to support. 

The cultural context 

The right to time off when menstrual symptoms become debilitating isn’t really the point of debate. The question is whether these policies can work without reinforcing the cultural assumptions that have historically shaped attitudes towards women at work.

Dr Robert Thompson, a physician specialising in women’s health, acknowledges the gap between a well-intentioned policy and its implementation.

“Menstrual leave is more about identifying associated medical conditions,” he says. “There are serious health issues, such as endometriosis, adenomyosis, or large fibroids, which could dramatically affect a patient's capacity to perform at work. However, implementing policies for menstrual leave only presents real-world problems.”

One concern is that menstrual leave could reinforce outdated stereotypes about women’s bodies and their perceived roles at work. Women have historically been characterised as more fragile, emotionally driven or less reliable because of their reproductive biology, assumptions that have been used to justify excluding them from certain roles and questioning their professional capability.

A separate category of leave specifically for menstruation could unintentionally give those stereotypes new currency, particularly if employers begin to associate women who menstruate with greater absenteeism, reduced availability or lower productivity. The low uptake of menstrual leave in Spain and Portugal suggests that workplace culture and gender stereotyping remain significant barriers. When job security is already fragile, employees may understandably avoid using a policy if they fear being seen as less reliable, less employable or less promotable.

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A question of design

One of the biggest flaws in menstrual leave is the name itself. ‘Menstrual leave’ suggests that menstruation is the problem, when the issue is often the debilitating symptoms caused by underlying conditions such as endometriosis, adenomyosis and fibroids. By grouping these experiences under one label, the policy risks conflating a normal biological process with a serious reproductive health condition. And, in doing so, framing menstruation itself as a form of illness.

“Statutory menstrual leave, however well-intentioned, is the wrong shape for the problem,” says Kim Croasdale, an expert in gender pay gaps and employment rights.

More fundamentally, Croasdale argues, menstrual leave can exclude the very people it is intended to help. The name suggests a right available to anyone who menstruates, but in practice, eligibility may depend on experiencing severe symptoms linked to an underlying condition.

Spain’s requirement for proof of pain illustrates the problem. “It excludes anyone undiagnosed,” says Croasdale, “but many people managing endometriosis don’t menstruate at all.”

Thompson points to another gap. “Because hormonal therapy often allows individuals to completely stop menstruating, it is possible for someone to be experiencing very little menstrual-related discomfort, but still have symptoms related to their condition,” she says. “For example, some have chronic pelvic pain throughout the entire month and not just during menstruation.”

This creates a fundamental mismatch between the condition and the policy designed to support it. Someone can have a serious reproductive health condition without experiencing menstrual pain, while someone experiencing painful periods may have no underlying condition at all. A policy built around menstruation risks treating these very different experiences as one and the same.

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The privacy issue

In the UK, standard sick leave offers relative medical confidentiality. You can take seven days leave without a note from your doctor. So far, countries that have created a separate category for menstruation ask women to provide proof to their employer.

Lisa Volkers, co-founder of confidential cycle tracking app PERIOD, says such policies are intrusive. “Menstrual data is some of the most sensitive data there is, and it should never sit with an employer,” she says. “A US jury recently found Meta liable for harvesting period tracker data from Flo, which shows how badly this can go.

“The better path is flexible, private support that never forces disclosure, rather than a leave form that puts a woman's body on file.”

Is the answer better sick leave?

Menstrual leave has helped bring period health and reproductive conditions into the workplace conversation. But there is a question about what happens next. Does creating a separate category help dismantle stigma, or does it reinforce the idea that menstruation is a ‘women’s problem’ — something separate, additional and other in the eyes of employers?

A women-only category, however well-intentioned, may be flawed by design. A more effective approach could be gender-neutral, flexible and based on symptoms rather than diagnosis or menstruation itself. Crucially, it should also protect employees’ privacy.

For Croasdale, the UK’s existing sickness-absence system is the right framework. The focus, she argues, should be on making it work properly, rather than creating “a bespoke, women-only category with support contingent on a diagnosis or a disclosure most employees shouldn’t have to make.”

“Self-certification already solves the intrusive-proof problem,” she adds, “since no diagnosis or disclosure is required for the first 7 days.”

Thompson agrees that a policy centred specifically on menstruation could “ultimately reinforce negative stereotypes regarding women and their abilities as workers.” Instead, she advocates for greater flexibility within sick-leave frameworks, reasonable adjustments for documented disabilities, remote working where possible, and timely access to quality healthcare.

The point is not that debilitating menstrual symptoms should be ignored. It’s that they should be treated as a health issue, rather than an inevitable part of being a woman.

Persistent or debilitating menstrual pain should not be something women are simply expected to endure. As Thompson puts it: “Instead of promoting acceptance, we should shift the focus, and encourage those who currently need days off to seek medical help.”