Bringing period policy up to date

07 November 2018

Working women are expected to cope unsupported with period problems. Journalist Juliette Astrup looks at ending the stigma of periods at work and asks if taking time off could be the answer.

Period Policy

While the woman cycling in white shorts on the tampon advert might have us believe otherwise, periods bring unwelcome symptoms for many women. Painful cramps, heavy bleeding or low mood can all interfere with normal daily activities, including work.

A survey carried out by Public Health England (PHE) found that menstrual issues were reported by half of women in all age groups and three-quarters of women in the 16- to 24-year-old age group (PHE, 2018).

The telling survey appeared in What do women say?, a report exploring a series of reproductive health issues. This hidden burden was particularly evident in the workplace: focus groups taking part in the study revealed that reproductive symptoms often affect women’s ability to carry out their duties, yet many conceal their symptoms from work colleagues.

‘I never did say to work that I was off because of period pain,’ said one interviewee. ‘I would have to invent reasons month after month, and soldier on and dose myself up and try and get through the days the best you could – then collapse when you go home.’


A sense of shame

While reproductive health issues and concerns change throughout a woman’s life, the feelings of stigmatisation and embarrassment are widespread, with less than half of women seeking help for their symptoms, regardless of severity (PHE, 2018).

What do women say? is one of a suite of recent PHE publications that seek to clearly define reproductive health as a more comprehensive public health issue. They will form the basis of a cross-governmental five-year action plan with the aim of making a significant difference to how women experience and manage their reproductive health throughout their lives.

One of the points it clearly highlights is ‘the need for a more open and supportive approach in the workplace and in the health system’, says Dr Sue Mann, public health consultant in reproductive health at PHE.

She adds: ‘We encourage women to seek support from their workplace, and for workplace management to be aware of how reproductive health symptoms can affect women’s daily life.’

But is encouraging women to seek support enough?


A backward step?

In Australia, the Victorian Women’s Trust has called for employers to follow its 18-month-old policy and offer paid days off for period pain to employees. This campaign, too, has renewed debate around the concept of menstrual leave.

Menstrual leave is not a new concept. Women in Japan, South Korea and Indonesia already have legal provisions that allow them to request days off work. In 2013, the idea was proposed in Russia, but not enacted, and last year the Italian parliament discussed making it mandatory for companies to offer three days of paid leave each month to female employees who experience painful periods.

It is an idea that has been fiercely criticised, with some regarding it as a backward step for feminism, one that links menstruation with illness and weakness, inviting discrimination and making it harder for women to progress (Cohen, 2014; Ostler, 2014).

There are also the practical concerns. How would it work in women-dominated workforces? Or in healthcare settings where it could exacerbate problems among the ill or vulnerable?

Consultant in infertility and gynaecology Dr Gedis Grudzinskas, who has been a vocal proponent of workplaces accommodating what he calls the ‘turbulence’ of a woman’s menstrual cycle, wants to see menstrual policies in place more widely – including in healthcare settings.

‘I think we should try harder,’ he says. ‘It’s up to the business or corporation to factor that level of human resource into their business plan.

‘Employers should be sufficiently flexible to permit that person to leave the workplace and go and do whatever works for them to make them feel better.

‘If their employer is sensible – and by that I mean accommodating, reasonable, sensitive, supportive – then they will make up that time, not because they have to, but because they want to. There’s an accountability and responsibility that the woman takes for her actions.’

The practice is already in place in a few organisations in the UK, but not enough, Dr Grudzinskas says: ‘Women shouldn’t feel there is something extraordinary going on. To me it’s common sense.’

He adds: ‘I don’t think a change in the law will do it – there is a great potential for that being misunderstood. It will take education in the home and at school – demystifying menstruation and making people feel more comfortable. We shouldn’t sneer at it, and we shouldn’t be ashamed or embarrassed.’

'A menstrual policy is one aspect of creating a culture where periods are more openly discussed and accepted’

Flexible model

While there is nothing in UK law to compel them, some companies have taken the issue on. In 2016, Bex Baxter, who was then people development manager and director at Bristol-based social enterprise Coexist, implemented a menstrual policy for her team of 31, of whom 24 were women.

The need to act struck her when she came across a staff member ‘doubled over in pain and white as a sheet’ with period pains, but who had insisted on struggling on with her work. The introduction of the policy resulted in widespread media coverage.

‘There was a backlash – mainly from women – who felt it deemed them weak and not able to handle their periods, when they had fought so hard for equality,’ explains Bex. But their approach at Coexist addressed that ‘understandable fear’, she believes.

‘We developed a flexible model that allowed women to take time back and put it back in. We asked women who opted in to take responsibility by tracking their cycle and learning about it.’

Bex believes the policy has empowered the women at Coexist: ‘They all have their cycles up on the wall in the department, and when they have check-in meetings they will talk about where they are in their cycle – it has been totally normalised.’

The flexitime offer, which is also open to women who don’t suffer debilitating symptoms, is key to distinguishing menstruation from illness, says Bex, and because all hours are ‘paid back’ it dissolves any stigma associated with taking time out during periods.

‘It’s not about giving women special treatment. Flexitime gives women dignity, and allows them to look after themselves in the way they need.

‘The result is that women feel empowered, not embarrassed and shamed. Women feel really nourished, more productive, and have a greater sense of responsibility to their organisation because they feel cared for.

‘There are huge fears about people abusing a policy like this – but at Coexist no one has abused anything. There is a trust element. People feel respected and in fact they give more.’

‘Management should be aware of how reproductive health symptoms can affect women’s daily life’

Tackling the taboo

Another pioneer is the Women’s Environmental Network (WEN). Co-director Kate Metcalf says a menstrual policy has been in place there for more than a decade.

Written into the contract of employment is a statement: ‘WEN recognises that some women need to take sick leave at certain times during their menstrual cycle, and in such cases the employee is entitled to take up to one day per month absent without loss of earnings.’

She says the option is rarely taken up, noting that only one of 10 full-time colleagues has needed to use it.

‘I see that it might be difficult in some workplaces, but you need to look at it like a maternity policy – you wouldn’t say you’re not going to have a maternity policy in place,’ she says.

‘You already have women calling in sick during their period and having to make up another excuse – it would be much healthier to have it out in the open.’

She admits that ‘there is a real danger of it being used against women’ in a world where ‘the male biological experience is the norm, and women can only have equality if they deny their biology’.

But she adds: ‘We need to have a much more open conversation, and introducing a menstrual policy is one aspect of creating a culture where periods are more openly discussed and accepted.’

While blanket menstrual leave for all women could be seen as heavy-handed, and some might still balk at the more nuanced menstrual policies being enacted by some companies, few could argue against addressing the stigma and taboo around menstruation.

It is a monthly reality for the vast majority of working women, and takes a tangible toll on many of them – so, menstrual leave or not, perhaps it is time for employers, including those in the NHS, to recognise the challenges and take action.

Suffering in silence



Cohen C. (2014) What working women don't want: menstrual leave. Period. See: telegraph.co.uk/women/womens-life/11273189/Working-women-dont-want-menstrual-leave.-Period..html (accessed 4 October 2018).

Latthe P, Champaneria R, Khan K. (2012) Dysmenorrhea. American Family Physician 85(4): 386-7.

Ostler C (2014). An idea so damaging to women, only a man could have dreamt it up: Catherine Ostler says top doctor's advice on 'menstrual leave' couldn't be more wrong. Mail Online. See: dailymail.co.uk/femail/article-2869182/An-idea-damaging-women-man-dreamt-male-professor-says-three-days-work-time-month.html (accessed 4 October 2018).

Public Health England. (2018) What do women say? Reproductive health is a public health issue. See: assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/731891/What_do_women_say_reproductive_health_is_a_public_health_issue.pdf (accessed 4 October 2018).

Raapkin AJ, Lewis EI. (2013) Treatment of premenstrual dysphoric disorder. Women’s Health 9(6): 537-56.

Subscription Content

Click To Return To Homepage

Only current Unite/CPHVA members or Community Practitioner subscribers can access the Community Practitioner journals archive. Please provide your name and membership/subscriber number below to verify access:

Membership number

If you are not already a member of CPHVA and wish to join please click here to JOIN TODAY

Membership of Unite gives you:

  • legal and industrial support on all workplace issues 
  • professional guidance on clinical and professional issues 
  • online information, training and support 
  • advice and support for all health professionals and health support workers
  • access to our membership communities 
  • CPHVA contribution rate is the Unite contribution rate plus £1.25 per month 

Join here https://www.unitetheunion.org/join-unite/

If you are not a member of Unite/CPHVA but would like to purchase an annual print or digital access subscription, please click here