Should Paid Period Leave Be a Thing?
This controversial idea could be a game-changer for women with chronic reproductive conditions—but it could also create unexpected problems.by Sarah Ellis Health Writer
On average, a woman spends 3,000 days of her life menstruating. This breaks down to 40 years, once per month, for approximately six days each cycle. That’s a lot of time to be on your period, especially when you’re also contending with a reproductive condition that causes heavy bleeding, like endometriosis or uterine fibroids. If you struggle with painful periods, you’re familiar with the occasional (or frequent) need to take sick leave or WFH when cramps derail your day.
What if your workplace was more straightforward in acknowledging–and accommodating–your monthly flow? Paid menstrual leave is a concept that would allow people who menstruate to take paid time off (usually a certain number of allotted days per month or year) during their period. It’s already being implemented in countries like South Korea, Indonesia, and Zambia. And the concept recently made U.S. headlines, too–The New York Times reported on Aug. 11 that global food-delivery company Zomato has just adopted the policy for employees.
For women with chronic reproductive pain, this probably sounds like a life-changing benefit. Getting employer-sanctioned time to deal with your heavy flow? Yes, please! But to say that paid menstrual leave is controversial would be an understatement.
“If menstrual leave is thoughtfully implemented, it has the potential to improve the health and well-being of menstruators, particularly those with illnesses related to the menstrual cycle,” explains Jessica Barnack-Tavlaris, Ph.D., associate professor of psychology at the College of New Jersey in Ewing, NJ. Barnack-Tavlaris has spent years researching menstruation and health-related stigma.
In a 2019 study in Health Care for Women International, she and her colleagues found that 42% of U.S. adults surveyed said they would support a menstrual leave policy, but half of the overall sample said they felt menstrual leave might have negative societal effects (more on that later).
The idea behind menstrual leave, besides providing a reprieve for women during uncomfortable days of bleeding, is that it could de-stigmatize periods by bringing them into the everyday discourse. “It normalizes something that happens to women every month from age 13 to age 50,” says Eve Feinberg, M.D., medical director at Northwestern Fertility & Reproductive Medicine in Chicago. “That’s the biggest pro; it starts the conversation.”
Not only does a substantial portion of the American workforce have monthly periods, but these women (or trans men or nonbinary individuals) often also live with chronic reproductive conditions that make their periods irregular, heavy, or painful. A global review of menstruation symptoms in BJOG found that 5 to 20% of women report severe dysmenorrhea (menstrual pain) that prevents them from participating in their usual activities. Uterine fibroids affect up to 80% of women by the time they reach age 50.
Endometriosis affects around 11% of women between ages 15 and 44. These conditions have no scientifically identified origin or cure, and researchers estimate that many cases go undiagnosed for years or even decades.
Menstrual leave, ideally, could help to normalize the conversation around periods. “I would like the deconstruction of menstrual stigma to become more mainstream,” Barnack-Tavlaris says. A 2019 survey of U.S. teens, commissioned by period-proof underwear company Thinx and advocacy group PERIOD, found that 64% of those surveyed believe that society teaches people to be ashamed of their periods, and 66% do not want to be at school while menstruating. Paid menstrual leave could be a good reminder for everyone that periods are nothing to hide.
Before you run to your employer suggesting this new benefit option, let’s dive into the conflicting factors at play here. According to Barnack-Tavlaris’ research, many U.S. adults are concerned about the potential for workplace discrimination if period leave is introduced.
Sioban Harlow, Ph.D., is a professor of epidemiology and global public health at the University of Michigan School of Public Health in Ann Arbor who has conducted extensive research on the history of menstruation-related workplace stigma. Harlow explains that widespread period leave could lead to perceptions that women are not as productive at work. “Gender-specific leave for menstruation would reinforce myths about women's incapacity to work, especially in high-demand [and] high-pay jobs,” she says. Harlow notes that if menstrual leave is specifically designated and a woman’s coworkers know she is taking it, she could be subject to discrimination in performance reviews and promotions.
Likewise, if most women at an office start utilizing period leave, that leaves those who don’t menstruate in an uncomfortable position, Dr. Feinberg says. A woman who went through early menopause or a trans woman might be subject to scrutiny or intrusive questions from others at her workplace, forcing her to reveal something about herself she would rather keep private. Another potential downfall of menstrual leave policy, notes Dr. Feinberg, is that it could normalize heavy menstrual bleeding that should really necessitate professional care.
“Periods are a normal, healthy part of being a woman,” she says, but “if someone has such severe periods that they need to take off work, they probably want to seek medical attention.” She defines heavy bleeding as soaking more than one pad per hour or changing a super-plus tampon more frequently than every two hours.
Conditions like uterine fibroids and endometriosis can be treated with medication and/or surgical procedures, depending on the location and severity of symptoms. Dr. Feinberg notes that heavy bleeding can also be a sign of early endometrial cancer. In some cases, medical intervention can be lifesaving. It can also significantly reduce pain and allow you to live normally again.
While period leave may be a great option for some women, there are other ways to help improve quality of life for those with heavy menstrual bleeding. “In the U.S., many workers have no sick leave, so for them additional period leave is a moot point,” Harlow says. “A key policy issue is ensuring that all workers have adequate sick and family leave.” She also hopes to see more access to free menstrual hygiene products in workplaces, schools, and public restrooms, to make sure all women can access what they need. A 2019 study in Obstetrics & Gynecology surveyed low-income women in St. Louis and found that 64% were unable to afford necessary menstrual hygiene supplies.
Dr. Feinberg hopes to see more flexibility with holidays and paid time off in general, which could help not only menstruating workers but families who need time off for a new baby or an unexpected health crisis. Barnack-Tavlaris agrees. “I would like to see the U.S. move toward a healthier balance between work and health in general,” she says.
One more takeaway here: If your period symptoms are preventing you from functioning normally each month, talk to your doctor. This applies whether you work from home, in an office, or not at all. “The message should be that heavy menstrual bleeding is actually not normal, and you should seek medical attention for it,” Dr. Feinberg says. That way, with or without paid period leave, you’ll be able to live in greater comfort.
Lifetime Menstruation Statistics: UNICEF. (2016.) “Menstruation matters… period.” blogs.unicef.org/blog/menstruation-matters-period/
Zomato & Menstrual Leave: The New York Times. (2020.) “Company’s Paid Leave for Periods Takes On a Workplace Taboo.” nytimes.com/2020/08/11/business/india-zomato-period-leave.html
Period Leave Perceptions Study: Health Care for Women International. (2019.) “Taking leave to bleed: Perceptions and attitudes toward menstrual leave policy.” tandfonline.com/doi/abs/10.1080/07399332.2019.1639709
Menstrual Symptoms Review: BJOG. (2004.) “Epidemiology of menstrual disorders in developing countries: a systematic review.” pubmed.ncbi.nlm.nih.gov/14687045/
Uterine Fibroids: U.S. Department of Health and Human Services, Office on Women’s Health. (n.d.) “Uterine fibroids.” womenshealth.gov/a-z-topics/uterine-fibroids
Endometriosis: U.S. Department of Health and Human Services, Office on Women’s Health. (n.d.) “Endometriosis.” womenshealth.gov/a-z-topics/endometriosis
Undiagnosed Fibroids: Journal of Women’s Health. (2018.) “Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women.” liebertpub.com/doi/full/10.1089/jwh.2018.7076
Menstrual Hygiene Needs: Obstetrics & Gynecology. (2019.) “Unmet Menstrual Hygiene Needs Among Low-Income Women.” pubmed.ncbi.nlm.nih.gov/30633137/
Period Stigma Survey: Thinx. (2019.) “State of the Period.” cdn.shopify.com/s/files/1/0795/1599/files/State-of-the-Period-white-paper_Thinx_PERIOD.pdf?455788