Why menstrual leave is not the solution.

Last Friday, menstrual leave was back in news headlines again, after a BBC-commissioned YouGov survey found that ‘most women workers have experienced period pain that affects their ability to work’.

UPDATE: After a formal complaint to the BBC, the misleading content in the original article (linked to above) was changed. The headline now states ‘Period pain affects ‘about half’ of women workers’…  


However, this type of gender-specific employment policy, is likely to result in negative consequences, and in fact, obscure the real problem: A lack of clinical, and public, understanding of menstrual cycle-related health issues and their effective treatment.

Whilst it is always great to have more people speaking out about the menstruation taboo, and the impact that the menstrual cycle can have on health and wellbeing, here are a few reasons why menstrual leave is not a viable solution…


1. The survey result is misleading– The 52% figure stated by the YouGov survey is highly likely to be the result of poor survey design e.g. asking if individuals ‘had ever’ taken time off work due to period pain, rather than doing so on a regular basis.

Clinical research has fairly consistently shown that, although up to 90% experience period pain, less than 5% of menstruating people have severe enough symptoms to prevent work on a regular basis. This makes an ‘all-women’ and ‘every month’ employment policy seem like overkill. [Also, not all women menstruate, and not all menstruating people identify as ‘women’]


2. Sick leave already covers this problem. Most people in secure employment are already able to take paid leave if they are too ill to work. This includes period pain, and other menstrual cycle-related health issues.

However, in some sectors, days taken as sick leave can count against an individual in terms of career progression or pay-scale etc. So, since menstrual cycle-related health issues are highly likely to frequently recur, it could mean that some individuals are forced to work despite illness, or risk a negative work record. Special provision for chronic health issues, such as menstrual cycle-related symptoms, should therefore be taken into account in these situations, to avoid any discriminatory practice.

The rise of insecure employment in the UK also means that increasing numbers of employees may not have access to sick leave and so be forced to work despite illness, or take time off at their own expense. However, this is a wider employment policy issue, and not resolved by the introduction of menstrual leave.


3. Gender-specific employment policies can actually lead to further discrimination against those they seek to protect. For example, maternity leave (as opposed to parental leave): Women of reproductive age (regardless of their reproductive plans or status) continue to be unfairly denied interviews, jobs, or promotions, simply because employers resent, or wish to avoid, paying for maternity leave. Workers cannot afford to face yet another gender-specific employment policy backlash, and this is precisely what menstrual leave threatens to create.


4. Severe period pain requires professional attention. Most period pain is caused by powerful contractions of the uterine wall (similar to those experienced during childbirth), lasting up to an hour, and thought to help remove the uterine lining during menstruation. But, in severe cases, abdominal pain might be due to endometriosis (a condition where other parts of the body also shed tissue each month, leading to internal bleeding), or fibroids (non-cancerous tumours).

People are already reluctant to seek medical advice for menstrual cycle-related problems because the subject is taboo. Some fear that their doctor will dismiss the issue, or be unable to offer any effective treatment, and so prefer to ‘cope’ with their symptoms, alone. For example, the average length of time from symptom onset to a diagnosis of endometriosis, is around 7 years. By allowing employees to stay at home to manage their pain and other symptoms, menstrual leave could encourage women to further delay visiting their doctor.


5. Period pain is just the tip of the iceberg. Premenstrual Syndrome (PMS), has over thirty commonly experienced symptoms that if severe, could result in the need for time off work. These symptoms include nausea, vomiting, fainting, upset stomach, headache, migraine, fatigue, low mood, and anxiety.

Similarly, people with female reproductive systems are between 2 to 3 times more likely to suffer from a range of chronic health conditions that share many of the same symptoms of ’PMS’, and are affected by the menstrual cycle (e.g. anxiety, depression, irritable bowel syndrome, chronic fatigue syndrome, and migraine).

– Although only a small percentage of people experience these problems severely enough to limit their ability to work, menstrual leave might encourage more to ‘cope’ with undiagnosed symptoms of such chronic health issues, rather than seeking professional help.

dietary_medication6. Health solutions are out there, even if they are not always well-known- NICE (National Institute for Health and Care Excellence) treatment guidelines are available for severe period pain, heavy menstrual bleeding, cyclical breast pain, menstrual migraine, and PMS. However, they do not enable GPs to differentiate between menstrual cycle-related symptoms and various chronic health issues, or include dietary advice that might be worth trying before turning to medication.

By tracking symptoms over three menstrual cycles, a patient can help their GP diagnose any potential hormonal factors in their ill health. Note: Symptoms may occur around ovulation, as well as ‘pre-menstrually’.

Alternative treatment options then become available e.g. a hormone balancing diet, certain nutritional supplements, or hormonal therapy (such as contraceptive medication). These approaches can be more effective, and less likely to result in unwanted side effects, than symptom-specific medication.

In conclusion, our goal ought to be to help the 5% of people regularly missing work due to menstrual cycle-related health issues, not a policy that implies that ‘all women’ are the same, or that encourages individuals to suffer in silence at home (risking resentment from fellow colleagues), when professional help is available.

Categories: Menstrual Leave, No shame, Underlying conditions and What's normal?.