Menstrual Leave, or policies that allow anyone with a period to take time off of work due to symptoms associated with menstruation, has been a hot topic for debate of late. It touches on issues of women’s health, gender equity, and workplace culture.

Menstrual leave policies date back to the 1920s in Communist Russia. The earliest mandates addressed concerns about fertility as women were called upon to work during wartime. Modern focus has shifted to productivity and workplace wellness, but there is much debate about whether menstrual leave actually serves or targets those for whom it is meant to be a benefit.

Spain has quickly become one of the most progressive countries in Europe, with big wins regarding abortion and transgender rights. They’ve also approved menstrual leave, which will allow three days of paid time off every cycle for those experiencing debilitating symptoms from periods.

While Spanish society, and its new law, are not necessarily comparable to Japan, the menstrual leave policy in that Asian country, which has been in effect since the late 1940s, is rarely invoked.  Only about 10% of people have used it, and not regularly.

While there is not a lot of data available regarding menstrual pain, 10% is roughly the percentage of people, research shows, whose lives are disrupted by extreme pain and heavy bleeding, among other severe period symptoms. Perhaps the low usage rate of menstrual leave in Japan reflects those who really need the law. But some theorize that menstrual leave is not invoked often in Japan because of fear of retaliation by anyone who might use it. According to a survey done in Japan in 2022, women with male superiors are reluctant to take menstrual leave or don’t because so few other women use the benefit.

In most modern societies, such as in the United States, there is still widespread shame and stigma associated with menstruation that is cultivated through culture and lack of reproductive education, among other factors.

Menstrual symptoms have long been taboo in the workplace, but in the last few years, advocacy efforts have put periods and period pain in headlines worldwide. Anyone with a period can tell you about the challenges in their life trying to balance education or work and menstruation (and menopause) symptoms. But the research regarding the effect on the workplace and productivity is scarce.

One of the studies referenced most widely is a 2019 survey done in the Netherlands of more than 32-thousand women. It showed that menstrual symptoms account for nine days of lost productivity per person yearly  due to “presenteeism.” In other words, employees come to work but cannot work effectively or at full capacity because of pain, heavy bleeding, or other symptoms they endure rather than taking days off.

Sally King, who writes the blog “Menstrual Matters,” makes the case that gender-based policies are not beneficial for women, and menstrual leave specifically, among other reasons, is actually bad for women’s health because it leaves workers with the idea that just staying home when their period symptoms are debilitating is a good idea. She writes, “If your menstrual symptoms are severe enough that you regularly find yourself unable to work, this is NOT normal. It is probably an underlying health issue, such as anxiety or depression, PMDD, Heavy Menstrual Bleeding (HMB), iron-deficiency anemia, fibroids, or endometriosis, and you should seek medical assistance.”

Menstrual leave in the United States has become just one more matter for human resources teams to figure out, particularly since attracting and keeping high-performing employees has been challenging since the Covid-19 pandemic. Employers have had a tricky time figuring out the right balance of in-person versus remote work, and making the workplace more accepting is something many workers are demanding.

McKinsey & Co. report three out of four employees report that having control over when they work was a key factor impacting their decision to take their position. Policies that allow all employees, regardless of whether or not they get periods, the most flexibility will help those who do menstruate manage whatever level of symptoms they have.

More companies in the United States will likely grapple with and settle on some sort of menstrual leave. But there are many ways workplaces can and must become more accepting of those who get periods, including supplying free menstrual products in all bathrooms and providing menstruation/menopause education (through facilitated discussions, for example) for all employees.