When Taylor Roberson, 26, was hospitalized for endometrial surgery three years ago, she was out of work for two weeks. At the time, she was a key-holder at a small boutique, responsible for opening and closing the store. Even though she had long suffered from debilitating period pain and needed this treatment, she felt anxious about the income she lost during her leave — and its impact on her earning potential. “When I was out for two weeks to have surgery, I never got my hours back up to what they had been before,” Roberson tells Refinery29.
Taylor isn't alone. Over half of people who menstruate experience pain or cramping around their period (also called dysmenorrhea). 20% report that their period-related pain is bad enough to interfere with daily activities, while roughly 10% have endometriosis, which can completely incapacitate sufferers. Yet taking time off to manage this pain is often a huge burden to women* — especially hourly workers — as the U.S. doesn’t require employers to provide paid sick leave. According to the U.S. Bureau of Labor Statistics (BLS), only half of employers provide five to nine days of paid sick leave per year. And while schedule flexibility is becoming increasingly common and many professionals now opt to freelance or work from home, for workers who experience period pain on a monthly basis, most workplace policies are woefully inadequate.
Last year, news of an Australian company’s paid period leave policy started a worldwide debate, with opponents arguing that creating exclusive policies instead of more inclusive, flexible ones could hurt women more than help them by perpetuating stereotypes that women are unfit for the workplace. (Meanwhile, Indonesia, Italy, Japan, and South Korea all offer government-mandated period leave.) As it stands, this debate is centered on a two-pronged question: How can we make the workplace more accessible to women and begin to erode existing taboos around menstruation?
“The current system of how we work was built by and for people who don’t get periods, so they never would have considered making accommodations for periods in the workplace or anywhere else,” says Amanda Laird, a registered holistic nutritionist who is the author of Heavy Flow: Breaking the Curse of Menstruation and the host of the Heavy Flow podcast. “This is the same reason why we have soap and toilet paper in public restrooms but not menstrual products.”
Chloe Gilbert*, 29, works at a grocery store and lives with endometriosis. “I’ve had to take days off work due to crippling pain where I am unable to stand or walk. It’s either that or go to work heavily medicated,” Gilbert tells Refinery29, noting that she takes large doses of muscle relaxants in order to curb her pain. “The pills I need to take really make me non-functional. On the first day of my period, things are very foggy and I go in and out of consciousness.”
Despite the severity of Gilbert’s symptoms, she admits she feels guilty taking time off from work. She wishes that period pain was regarded with the same amount of concern as other illnesses. “The entire population can understand ‘cold’ and ‘flu,’ but only half really understands the pain of periods,” says Gilbert. On days when she has been physically unable to work, Gilbert has had to call in sick and doesn’t get paid, as her employer only offers one paid sick day per year.
Laird believes that tiptoeing around health needs in this way is unacceptable, and she worries that our culture currently prizes employees who work all the time without regard for their well-being. “We’re expected to push through, and those that do are often rewarded,” Laird says, echoing ongoing discussions about "presenteeism," or coming in to work while sick or unwell.
Laird would like to see employers strive to offer flexible, paid working arrangements and policies that recognize that employees have different abilities and needs. “In our quest for equality, we have had to deny the fact that our bodies are different, for fear that this would be used against us. But menstruating bodies are different from those that don’t menstruate,” Laird says.
Jaime-Alexis Fowler is the founder and executive director of Empower Work. Her organization provides immediate, confidential support for tough work situations — ranging from disclosing a pregnancy to your boss to navigating health concerns while in a high-pressure job — via text message. Her work is a direct response to problems arising from inadequate workplace policies, and she recognizes that these policies must be expanded to recognize employees’ differing needs.
While Fowler doesn’t think an explicit period-leave policy is the answer, she does argue that flexibility must be at the center of conversations regarding the future of work. Luckily, more than ever, things like remote work, four-day work weeks, and unlimited time off are reshaping antiquated understandings of how the workplace should operate.
“It's important for anyone menstruating to have support for pain, but it's also important to have broad policies that are inclusive, minimize any potential stigma, and make room for a variety of needs,” Fowler tells Refinery29. This not only has economic benefits for hourly workers, it can also be a boost for salaried employees — regardless of gender. “Having to disclose time off for periods, pain, or an appointment with a therapist may have negative unintended consequences. Broadening policies to respect individual discretion may be more supportive.”
Ultimately, conversations around menstrual pain and the workplace are certainly complicated, particularly as women continuously struggle to obtain the same rights — and pay — as men. While some people who deal with menstrual pain still hesitate to ask for accommodations that could make the workplace more accessible, others are adamant that something needs to change.
As for Roberson, she still struggles to find a balance between fulfilling her work-related responsibilities and caring for her body. She is now a salaried employee and has an accommodating supervisor. Even though she no longer has to contend with unpaid time off, she has anxiety around sick days. "I tend to hoard my sick days and end up not using them all, because I'm nervous I'll have a bad flare-up and not have any sick or vacation days left to use," she says.
And though she appreciates that some employers attempt to make the workplace more welcoming to people who menstruate, Roberson acknowledges there’s still a long way to go: “I want to be able to work for a company where I can tell my boss that I’m having a bad pain day and won’t feel like I’m a bad employee because of it,” she says. “I want [employers] to trust that women can get their work done from home and on their own time and still be an invested member of their team.”
*Though we use the word "women" throughout this piece, we acknowledge that these challenges also affect trans and gender nonconforming people who do not identify as female.