The Spanish Government has recently adopted a new Bill to allow leave to staff suffering with menstrual problems. In this briefing, Amy White considers whether the UK could introduce something similar in the future and the issues that need to be considered.

On 10 January 2023 I was asked if I would participate in an interview with ITV concerning Spain’s decision to introduce menstrual leave for workers who experience painful periods. I agreed and then spent some time considering the Spanish proposal and what a similar initiative might look like here in the UK. What I found was that, while, on the face of it, offering paid leave to support those experiencing a recurring health complaint might appear to be a positive step in the direction of greater workplace inclusivity, a little more thought might actually be needed.

The Spanish proposal
In December 2022, Spanish lawmakers adopted a new bill proposing the introduction of menstrual leave for those who experience painful periods. The bill was adopted by deputies in the lower house of the Spanish parliament on its first reading (190 in favour, 154 against and five abstentions). It will now go to the Senate and, if changed, will return to the lower house for another vote before becoming law.

While the finer details have yet to be confirmed, it’s understood the leave would need to be certified by a doctor, but that employees would then be entitled to three days’ paid leave per month (or five in the case of incapacitating pain), subject to such certification. What we do know with certainty is that the Spanish state will pick up the bill, rather than employers having to cover the additional cost.

When the bill is adopted, Spain will become the first country in Europe to offer this type of leave. While there are other countries around the world who offer it in some form (for example, Japan, Indonesia and Zambia), they’re few and far between. The introduction of menstrual leave by an administration within Europe will therefore undoubtedly spark debate amongst other European legislatures, so it’s worth considering now the impact it might have were it to be introduced here.

The health perspective
According to the Spanish Gynaecology and Obstetrics Society, one third of people who menstruate experience severe pain. Pain isn’t the only difficulty those who menstruate experience. Other common symptoms include nausea, vomiting, migraines and diarrhoea, as well as tiredness, lack of concentration and physical fatigue. It’s a significant list of symptoms which can have a profound effect on those who menstruate and that’s without considering those who suffer with endometriosis or premenstrual dysphoric disorder.

Despite this, 60% of those who menstruate would feel uncomfortable discussing the topic of menstruation with a colleague or their manager (DPG) and half of those suffering with severe pain won’t disclose this to anyone (Spanish Gynaecology and Obstetrics Society). It’s therefore clear that there’s a mismatch between the significance of the issue, from a health and wellbeing perspective, and how comfortable those who menstruate feel about discussing it.

The potential benefits
You’ll probably agree that menstruation is little spoken about in most workplaces. Many employers, and even menstruating employees themselves, believe it’s an inappropriate topic of discussion at work. In a recent study by HR Zone, a third of men surveyed said they believed it was unprofessional to talk about periods at work. Similar research conducted by DPG found that 74% of people who menstruate feel it’s necessary to hide sanitary products at work. But given that menstrual health is a fundamental aspect of wellbeing for those who menstruate and in light of the significant symptoms people can experience while menstruating, it must be time for a change?

Spain’s introduction of menstrual leave will ensure the conversation gets under way. It will put menstruation on the boardroom table and, in turn, remove some of the mystery and taboo associated with it. This is to be celebrated as it will not only encourage those experiencing difficulties with their monthly cycle to be open about the same with their employers, it will also contribute to the ongoing push to make workplaces more inclusive and equitable for everyone.

Brighton and Hove is known for its social inclusivity and many of the employers based in the city and its surrounding areas seek to reflect this in their workplace practices. By way of example, the city boasts a highly successful living wage campaign, with approximately 900 businesses signed up at last count. Those behind the campaign have found that staff morale improves across the board when an employer is seen to be doing the right thing by its people, so introducing a policy that contributes to the creation of inclusive and compassionate workplace cultures may well have broader benefits for staff morale.

In addition, a business that is seen to be supportive of its staff will likely see improvements from a reputational perspective which can, in turn, contribute to talent attraction (and, assuming the support is genuine, retention). At a time of cross-industry talent shortages, few employers can afford to ignore the extent to which their employee value proposition contributes to the success of their recruitment strategies, so considering the introduction of a benefit for those who experience menstrual difficulties could be worth some serious thought.

At present, in England and Wales, if your monthly period causes you such severe pain that you can’t work, you can take sick leave. Given the first three days of sick leave are unpaid under the Statutory Sick Pay regime, those who menstruate could find themselves incurring one or more days of unpaid sick leave each month. A paid leave initiative like Spain’s would therefore have a positive impact on the pockets of those who are incapacitated by their monthly cycle. Alternatively, an employee who finds themselves in this position and who has 26 weeks’ continuous employment with their employer could submit a flexible working request to vary their working arrangements. They could, for example, request permission to work from home for a specified number of days each month or the ability to flex their specific working hours, subject to hitting an overall weekly or monthly number of hours. This would ensure those who encounter issues with period pains can continue working, albeit with adjustments, and are not financially penalised as a result of their monthly cycle. That said, an employer can fairly easily reject a flexible working request by relying on one or more of eight statutory grounds, so it’s not a surefire way to achieve what you’re looking for.

There may well also be financial benefits for employers. While the cost of absenteeism is fairly easy to understand, we often pay less attention to the cost of presenteeism (employees turning up to work when they’re not actually well enough to be there). Unwell staff are unproductive, which can slow down projects and day-to-day business, as well as opening the door to errors and mistakes that can carry a high price-tag. All too often those experiencing severe period pains will ‘soldier on’ at work, in the mistaken belief period pains don’t warrant time off. And while there’s a nobility in that, there could also be a financial benefit to having them stay at home rather than, at best, working at a reduced level of ability or, at worst, making a significant error.

The queries and concerns
Menstrual leave is intended to support gender equality. There are, however, those who question whether it might actually damage it, including the Deputy Secretary of one of Spain’s largest trade unions, who reminds us we “have to be careful with this type of decision”. The concern is that a policy so closely focused on the female body risks perpetuating gender stereotypes (i.e. women are unreliable or incapable while menstruating) and potentially giving employers another reason not to hire or promote women. And this is a legitimate concern. We know, for example, that the uptake of menstrual leave in Japan is low because, in part, of a fear that utilising it would damage career progression.

The fact the Spanish leave is to be funded by the state will make a significant difference and hopefully dissuade some employers from making discriminatory hiring choices. That said, simply removing the financial issue won’t be enough to stop all employers making questionable hiring choices – the leave could potentially see an employee off for five days each month or so, which could have an impact on consistency and productivity and be enough to encourage an employer to hire someone they believe doesn’t menstruate, over someone they believe does.

In addition, there are health-related issues to consider. For example, might normalising period pain actually deter those experiencing unusually painful periods from getting the same checked by a doctor? In addition, the Spanish proposal provides leave only if the individual in question is experiencing physical symptoms. This excludes those who experience psychological symptoms, including premenstrual dysphoric disorder which can be debilitating for sufferers.

On the practical side, were we in the UK to adopt a similar form of leave here and require employees to get a doctor’s note each time they need to take leave, we might find staff coming up against not inconsiderable barriers. It’s fairly well established that women are more likely to have their pain dismissed by medical professionals than men (see the 2001 study ‘The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain’ authored by researchers at Maryland University), which could result in certificates not being issued when requested. Simply getting an appointment with a GP, whether face-to-face or virtual, could also be too high a hurdle for many to overcome.

The available options
It’s likely we will, at some future stage, receive guidance from the government as regards its position on menstruation leave. Until then, there’s nothing to stop employers introducing support to those who menstruate on an individual basis.

If you want to think about doing that, why don’t you consult your staff to find out exactly what they think would be beneficial? While leave might work for some, it won’t be what everyone wants. Imagine you’re working on a big project but experiencing severe period pains – do you want to have to take a full day’s leave to get the extra rest you need or would you rather be granted flexibility to take extended rest breaks during the working day as suits you and your state of health? Consulting with staff before you introduce any new initiative is always a good idea. It ensures the initiative actually addresses a real employee need and results in greater buy-in and uptake after the roll-out, as staff feel a sense of ownership and empowerment over it.

Thereafter, you can prepare your policy. Be mindful of the need to be inclusive. It’s not just women who menstruate. So too do trans people and non-binary people who retain their ovaries and do not alter their hormone profile. Think about the language you use and how you can ensure the policy and what it offers is inclusive. As to what the policy offers, as above, it doesn’t need to focus on time off. Flexibility might be of more use (working from home, late start/early finish/extended rest breaks, etc). So too might staff-wide training or the provision of free sanitary products in workplace bathrooms.

Be careful not to rely simply on encouraging staff to come to you and openly chat about their periods. While you might hope you’re creating an open, inclusive culture, such an approach doesn’t account for certain privacy issues. For example, will a trans male employee who is not yet out want to speak to their manager about their menstrual health?

Once you’ve drawn up your policy, you need to bring it to life. Start by training your managers – it’s no good having a policy if managers don’t show, through their words and actions, that it reflects reality. Managers need to understand menstruation, the possible symptoms and their potential severity. They need to have clarity as to the support available within their organisation if someone is experiencing difficulties. And they need to feel comfortable having conversations with staff about menstruation without feeling embarrassed, nervous or fearful. Once your managers are trained, you could consider rolling out the policy alongside an awareness campaign, whether focused on menstruation or wellbeing more broadly. Host lunchtime talks supported by relevant guest speakers, use your intranet to provide guidance and stick up posters around the workplace.

The key is to remember that we’re all different, so adopting a one-size-fits-all approach won’t necessarily result in a wholly positive reaction. Instead, providing your managers with the training and, in turn, the confidence to handle situations as they arise on a case-by-case basis will likely prove more beneficial, both for individual employees and the organisation at large.

Summary
While any workplace initiative that forces employers to think about the wellbeing of their staff and encourages managers to adopt a ‘whole person’ approach to managing their teams, is to be celebrated, it’s never as simple as that where people management is concerned. There are practical, social and personal issues at play that need to be thought through in detail, to ensure that the end result (whether government-backed or rolled out by individual organisations) has the desired effect and genuinely supports staff wellbeing.

Amy White is Head of Training and Wellbeing at Loch Associates.