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The controversy behind paid menstrual leave, explained

“Really for all of modern working life, menstruation has been dismissed.”
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Story at a glance


  • For some people who menstruate, periods can be extremely debilitating. 

  • A handful of companies in the United States offer paid menstrual leave or menstruation accommodation for workers.

  • But a lack of research on these policies and limited understanding of their implementation has prompted concern.

Periods can be debilitating, especially for people who menstruate and have certain conditions like endometriosis or polycystic ovary syndrome (PCOS). 

This past spring, Spain introduced legislation that would permit workers with severe pain to take menstrual leave for up to three days each month. 

Although this practice is already commonplace in Japan, South Korea and Zambia, if adopted, the country will be the first in Europe and the West to implement such a measure. 

Spain’s actions brought renewed attention to the concept of period leave for U.S. workers at the time, but as of September 2022, only a handful of companies in America currently offer the benefit. 

These include Diva International Inc, makers of the Divacup; Chani, a queer and feminist-led tech and media company; and Nuvento, a global software company with locations in Kansas and New Jersey.

Proponents of the measure argue it allows people who menstruate to take optional time off from work without fear of repercussion to deal with what can be excruciating pain, fatigue and other menstrual symptoms. 

But others claim it could lead to increased workplace stigma and may reinforce stereotypes that women or people with uteri are physically inferior to men. It may also perpetuate myths that women are less effective in their jobs while menstruating.

A lack of information on how companies implement the policies, how many people who menstruate take advantage of the benefit and response to the policies overall hinder a broad understanding of paid menstrual leave in the United States. 

What does the data say? 

An online survey conducted by ResumeBuilder in May 2022 found that among 1,250 U.S. participants, 78 percent support paid menstrual leave and nearly identical proportions of men and women backed the proposal.

Nearly 80 percent of women under 45 surveyed said they would likely use the policy if it existed, while younger workers were more likely to be in favor of paid menstrual leave compared with older workers. Older workers may feel that because they had to struggle with menstruation throughout their career, others should, too. 

Menstruation in and of itself is not a disorder, but symptoms of menstruation along with disorders relating to it like premenstrual dysphoric disorder (PMDD) can significantly affect on everyday life.

Recent research published in Archives of Women’s Mental Health concludes the frequency of premenstrual anxiety and mood swings constitutes a public health issue.

The study, which reflected data from more than 140 countries, revealed “a majority of women reported that their premenstrual symptoms interfered with their everyday life at least some of the time,” said senior author Jennifer L. Payne of the University of Virginia School of Medicine in a statement

Previous studies have also documented the economic and physical tolls both premenstrual symptoms and menstrual symptoms take.

One paper published in 2003 found women with premenstrual syndrome reported lower work productivity and a greater number of workdays missed for health reasons.

More recent research from 2019 showed that among a sample of 32,748 women aged 15 to 45 years, menstruation-related symptoms resulted in significantly more productivity loss while at work or school (presenteeism) compared with absenteeism, supporting the economic case for paid menstrual leave. 

“There is an urgent need for more focus on the impact of these symptoms, especially in women aged under 21 years, for discussions of treatment options with women of all ages and, ideally, more flexibility for women who work or go to school,” authors wrote at the time.

How companies can respond

Because young workers are more inclined to seek employment at a company that reflects their values, paid menstrual leave could help attract and retain talent

Receiving paid time off for menstruation and recognizing it as a barrier to effective work without having to lump in symptoms with regular sick time could also empower women to feel more visible in the workplace, advocates say. 

Furthermore, for those with debilitating menstrual symptoms, the policies could be considered validating and prompt these individuals to seek medical help. 

“Not everyone who menstruates is going to request an accommodation,” said Ameer Abdul, National Campaign Manager of Period, in an interview with Changing America. The nonprofit organization works to eradicate period poverty around the world and end period stigma. 


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“But people with heavy menstrual bleeding, people with discomforts, like PCOS, like endometriosis, like fibroids, we want to make sure that they feel that they are in safe environments and that they are safe at work and getting the accommodations that are necessary.” 

Period also designates certain companies as “Workplace Champions” if they meet eligibility requirements, including recognizing menstrual pain as an eligible reason for sick time and promoting menstrual equity in the workplace through educational materials, research and learning opportunities.

Both Pfizer and Myovant Sciences are listed as current Champions.

“Really for all of modern working life, menstruation has been dismissed,” Abdul said. “Period is in support of recognizing menstrual leave as a reasonable accommodation, especially for people who experience heavy menstrual bleeding or any type of menstrual disorders.” 

Accommodations can take many forms, he added, including paid menstrual leave, a flexible work schedule or additional reasonable accommodations for an individual’s needs. “So, whatever really works for that employer.”

What are some drawbacks to paid menstrual leave?

Despite the practice’s goal of eradicating stigma around menstruation, whether the policy is introduced with sufficient education in the workplace, and any intentions underlying the policy, could determine how it is received. 

As the policies apply only to people who menstruate, unlike sick leave policies, people who don’t menstruate could argue they are discriminatory. But if employers do implement the policy, they can also introduce an accompanying menstruation anti-discrimination policy.

“What’s important is that we don’t get caught up in some outrageous pushback and the sexism that may be coming from pushing for the rights of folks,” Abdul said. “We don’t pay attention to any of the sexism that we feel might come from doing the right thing.” 

Although some liken paid menstrual leave to maternity leave, as it’s more accommodating to females’ biological demands and could be seen as a step toward workplace equity, others worry paid menstrual leave leads to privacy concerns. 

These include whether people who menstruate would need to show proof they were on their period to take the time off. For transgender individuals, taking the time could mean outing themselves to colleagues. 

Individuals with uteri may also be hesitant to take paid menstrual leave for fear their non-menstruating co-workers — or those who don’t use the policy — will appear more capable at the job. On the flip side, morale may drop among workers not offered extra time off. 

“It’s key to understand that policies need to be passed to be inclusive of all folks who menstruate. That is what this is about,” Abdul said. 

“Turning it into anything else other than that, I think is sidetracking what the point is here, and the matter of fact is, folks who menstruate, folks with menstrual disorders are not being given the rights that they deserve, including the need for menstruation to be considered for reasonable accommodation.” 

Another concern with implementing paid menstrual leave is the paucity of research on policies’ effects on people who menstruate and menstrual stigma, as well as on the places of employment that are offering them, wrote Rachel B. Levitt and Jessica L. Barnack-Tavlaris in “Addressing Menstruation in the Workplace: The Menstrual Leave Debate,” published in 2020.

The researchers note a lack of studies on how menstrual leave could negatively affect menstruators’ welfare though discrimination in hiring practices, salaries or wages and promotions. 

Information as to whether leave will be offered to those who don’t identify as women is scarce.

“Fair policies must be inclusive and provide options for confidential disclosure,” Levitt and Barnack-Tavlaris added. 

Should companies opt to implement these policies, the language should foster normalization and open discussion of menstruation, as opposed to perpetuating objectification, sexism and patriarchal misconceptions about menstruation, authors wrote. 

More flexible working conditions, similar to those mentioned by Abdul, could serve as an alternative to paid menstrual leave. 

But overall, “menstrual leave policies will only advance gender equality if they are adopted in spaces committed to challenging menstrual stigma and dismantling gender-based oppression,” Levitt and Barnack-Tavlaris concluded.