Menstrual leave: stigma and uncertainty mean these progressive measures are being underused around the world

Menstrual symptoms can severely affect a person’s working life. To combat this, the idea of menstrual leave has emerged. This legal measure allows workers to take time off when their period symptoms are too difficult to manage at work. It falls under the umbrella of menstrual health, a relatively new and broad concept that looks at menstruation not just as a biological process, but also as an issue that affects people’s daily lives, wellbeing, and fundamental rights. Several countries have menstrual leave policies, but they approach it in different ways. In the European Union, most countries have done very little in this regard – as of 2026, Spain is the only EU Member State with a specific regulation on menstrual leave, which was introduced in 2023. Japan was the first country to introduce menstrual leave, in 1947. After World War II many women faced harsh working conditions. Inadequate toilets and a lack of sanitary products made it impossible to work during menstruation, and the solution was the right to seirikyuuka or “physiological leave”, which recognises menstruation as a natural condition that employers must consider. However, Japan’s legislation, like its more modern counterparts, is flawed. It does not specify how many days can be taken, pay is not guaranteed, and employers decide whether leave counts as paid or unpaid – as of 2020, only about 30% of companies offered full or partial salary. In practice, fewer than 1% of women use it, and those who do often face discrimination or harassment. These difficulties are a recurring theme in implementing similar policies around the world. Read more: Menstrual health literacy is alarmingly low – what you don’t know can harm you Menstrual leave around the world More recently, several other countries and regions have introduced menstrual leave policies: Indonesia, South Korea, Zambia, Mexico, Taiwan, three Chinese provinces (Hubei, Shanxi, and Ningxia), one Argentinian province (Federación) and two Indian provinces (Karnataka and Bihar) . Taiwan’s 2002 Gender Equity at Work Act established one day off per month for women, but only up to a maximum of three days per year. These days are not deducted from sick leave, but only if they remain within that limit. Women receive only 50% of their wage during menstrual leave, mirroring the rules for sick leave. Indonesia introduced menstrual leave in 2003, allowing up to two days of paid rest each month. The law requires employees to notify their employer in advance, and the specific arrangements (part time leave, consecutive or discontinuous days) are left to be discussed between the parties involved. South Korea followed with its own regulation in 2007, granting women one day of unpaid leave per month. Employers are legally obligated to respect this right, failure to do so can result in high fines. Both Taiwan and South Korea face similar challenges, as many employers fail to implement the regulations properly, refusing to provide the promised leave or demanding intrusive proof from employees, undermining their dignity in the process. Read more: Period pain and heavy bleeding cost the Australian economy billions every year in lost productivity: study In 2014, the municipality of Federación, in Argentina, introduced a policy granting its female public employees one paid day off each month if they were unable to work due to their period. Locally, this initiative became known as the “día femenino”, or “feminine day”. In Zambia, menstrual leave was established in 2015, and women are entitled to one day off per month, without needing to provide a medical certificate or even prior notice to their employer. This policy is known as “Mother’s Day”, which reflects a cultural emphasis on women’s perceived role in society. In the State of Mexico, public employees have been granted leave for dysmenorrhea (period pain) as a policy framed as upholding labour rights. Interestingly, Mexico’s policy is not limited to menstruation alone. It identifies three main groups of beneficiaries: women experiencing severe dysmenorrhea, women in mid-adulthood dealing with symptoms of menopause or the climacteric phase, and men in mid-adulthood facing discomfort linked to andropause. Mexico’s regulation is better described as physiological leave rather than strictly menstrual leave, as it extends support to workers across different stages of life that have health implications. Menstrual leave in Spain Spain’s menstrual leave regulation came into force on June 1, 2023, following a bill introduced by the coalition government of the Socialist Party and Podemos, its left wing partner. The measure was far from unanimously accepted: it passed with 185 votes in favour, 154 against, and 3 abstentions. From the outset, the proposal sparked heated debate. Its innovative and ambitious nature drew strong criticism from several political parties, particularly the conservative People’s Party (PP), who warned that the law could lead to marginalisation, stigmatisation, and even negative consequences in the labour market for women. However, the law’s approval was hailed by feminist groups and labour rights organisations as a historic milestone. For them, menstrual leave represents a long-awaited recognition of women’s needs and a step toward greater equality in employment. The law introduces new rights for women within Spain’s Social Security framework, reflecting what some scholars have described as the “right to work without pain”. It creates a new situation of temporary incapacity linked to disabling menstrual conditions. This includes secondary dysmenorrhea and related conditions such as endometriosis, fibroids, pelvic inflammatory disease, adenomyosis, endometrial polyps, polycystic ovary syndrome, or any difficulty in menstrual blood flow. In these cases, Social Security covers the subsidy from the very first day of leave. This is different to general sick leave, where payments begin only on the fourth day. Additionally, women don’t need to have made previous payments into the Social Security system to access this protection. Read more: Traumatic experiences and genetics may increase endometriosis risk, a new study finds An underused system The Spanish Ministry of Equality’s original draft bill estimated that around 1% of the six million women aged 16–50 in Spain, roughly 60,000 workers, might suffer from incapacitating menstrual symptoms. According to the Ministry’s own figures, between June 1 2023 and February 3 2025 only 2,668 women made use of the allowance, with each leave lasting an average of three days. This number is much lower than the original estimate, meaning it is not being used as much as it should be. Given its recent introduction and the small number of beneficiaries, there is still no evidence as to whether menstrual leave has had any negative impact on women’s employment in Spain. The problem with menstrual leave Menstruation is often treated as something shameful or inconvenient. Period stigma makes it hard for women to express their needs at work, which means managing menstruation becomes a private struggle, unrecognised in the workplace. Menstrual leave is just one possible solution to this problem. Other policies – flexible working hours, well-equipped rest areas, and so on – could also be extremely beneficial. The key question is whether menstrual leave truly improves the wellbeing of those who need it, or whether it unintentionally reinforces discrimination, negative stereotypes and resentment toward employees who make use of it. The debate remains open, and it underscores the importance of designing labour laws that acknowledge workers’ biological circumstances. But one thing is clear: addressing menstrual health at work is vitally important. The starting point is to recognise that every month, around 2 billion people worldwide experience menstruation. They need fair and supportive workplace practices. 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