Menstrual leave, which allows workers to take time off due to their periods, is not a particularly new concept. Russia had a history of offering it in the 1920s, while Japan introduced it into labor law in 1947. Other Asian countries, like South Korea and Indonesia, also enacted similar policies of period leave in the 1950s. More recently, Spain enacted menstrual leave in 2023, and other countries are in the process of adopting a national policy.

The U.S. on the other hand, has no formal period leave, and very few U.S. companies have enacted it. Two exceptions are FreeFrom, a grassroots company that helps domestic survivors build financial security, and Chani, an astrology company and app. (Both share a CEO, Sonya Passi.) So why aren’t more U.S. companies offering this benefit? And for those that do—or are considering such an option—what does the policy look like in practice?

“We are all taught to normalize, disassociate from, and push through pain,” says Passi. “By calling out menstrual leave, we’re saying to our employees that we recognize this pain and don’t expect you to work through it.” Passi implemented the practice at FreeForm (and later at Chani) in 2020, after a new employee told her about the concept as it related to her work in South Korea. “When she explained it to me, it made all the sense in the world and I asked for her help creating the policy. We implemented it a week later,” says Passi.

While menstrual leave is seen as both a practical, supportive offering for workers who experience period pain and a way for companies to signal their values, there is also the criticism that by offering this type of leave, companies are saying that workers who get periods—predominantly women—have diminished returns during their cycle. And that’s an image that can possibly have harmful effects. 

“Menstrual leave is a total double-edged sword,” says Nadya Okamoto, cofounder of August, a period care brand and author of Period Power: A Manifesto for the Menstrual Movement. “It allows people to take the time off that they need—especially if they have period pain, endometriosis, uterine fibroids. It’s needed, but on the other side, when you have blanket period leave, in addition to patriarchal stigma that thinks of periods as a weakness, the cons are that women are less likely to get promoted. There’s an assumption that they’re actually only working 75% of the month because they have this automatic period leave. And we’ve seen time and time again that it actually really stunts the accelerated success of women in the workplace.” 

Okamoto’s company has seven employees and doesn’t offer menstrual leave, but does allow for unlimited paid time off. Employees let each other know via Slack or email if they need to lie down for a bit or take the day, though Okamoto notes that obviously any leave—whether period leave or PTO—gets much more complex when you’re on a team of hundreds or thousands of people. 

Also, working for a period care company generally means you (and your employer) are okay with talking about periods. And on a small team, there’s a level of trust with time off that big, corporate giants may not have, since your impact is very visible. “I think it really comes down to how we value work and how we value women, which is a bigger issue,” says Okamoto.

Other menstrual companies, like Cora, also offer unlimited vacation and remote work, instead of menstrual leave. “Our fully remote setup provides even more flexibility, allowing employees to manage their period symptoms comfortably from home,” says Dana Cohen, chief marketing officer of Cora. “We strive to normalize conversations about periods. We want employees to feel as comfortable as possible to share ‘I’m having terrible cramps today.’ Additionally, we provide free Cora products to our employees each month to ensure they have access to quality period care.”

But what about at other companies, especially those not centered around periods? Many are still figuring out the possibility of menstrual leave in the workplace. Tori Dunlap of HerFirst100K, a financial and career platform, offers unlimited PTO to employees, but is looking into naming and giving menstrual or period leave, as a way to encourage the team to take off when they need for their period pains. “People don’t need a permission slip to take off work, but I think unfortunately in America, sometimes people need the permission slip to take off work,” says Dunlap. There is, for instance, data that suggests employees at companies that offer unlimited PTO take fewer days off than those at companies with set PTO policies.

“[Employees with menstrual leave can say] ‘oh, okay, I’m good. It’s okay, I can take rest,’” says Dunlap, who is currently planning to roll out this provision, but is still finalizing the details with HR. “Again, unlimited PTO can carry a lot of stuff within it, but you’re signifying there’s a reason that it’s menstrual leave and that it’s separate from something like unlimited PTO.” 

“Having a uterus, and dealing with the cyclical pain associated with having a uterus, is not sickness and should not deplete your sick days,” says Passi. For Passi, whose companies offer both unlimited vacation and unlimited menstrual leave, staffers can take the time they need to deal with their health—and disclose as much or as little as they want. “Making it unlimited takes away any administrative burden on the employee or their supervisor to track this time,” says Passi. She notes that in practice, “folks end up taking no more than one half or one full day a month, emphasizing that this applies to those who call it out. The important part is that it does not apply to your sick days, she says. 

Using sick days and the idea of making it okay to take off during your period brings up another related issue: A lot of menstrual leave is based around pain, and those pains can often be attributed to health problems that have often been historically overlooked, underdiagnosed, and downplayed, such as PCOS (polycystic ovary syndrome) and endometriosis. 

Tory Eisenlohr-Moul, PhD, is an associate professor at the University of Illinois Chicago and an academic clinical scientist studying premenstrual disorders and reproductive mental health. She directs an NIH-funded clinical trials lab, where she works with menstruators to understand menstruation and body-mind connection, and is also a licensed clinical psychologist with a focus on premenstrual disorders. While she says the majority of women don’t experience severe symptoms related to their menstrual cycle, for the subset that do, it can be really debilitating.

“I think of [period leave] more as something that could be important for someone who has either really severe physical or emotional symptoms,” Dr. Eisenlohr-Moul says, noting that she’d be interested to see if it could be used as a disability accommodation overall. (She and Okamoto note that PCOS and PMDD, or premenstrual dysphoric disorder, are covered by the American for Disabilities Act.) Dr. Eisenlohr-Moul also notes that most emotional and psychiatric disorders associated with one’s cycle, like PMDD, actually tend to get better during one’s period, and it’s the time leading up to it that has more severe symptoms. 

Another issue that menstrual leave brings up in practice is that, according to most state labor laws, employers are not allowed to inquire about the use of sick days. That means you can just say you’re sick and don’t have to provide a detailed medical explanation. With menstrual leave, having to disclose that you are on your period could get complicated—particularly for those with menstrual-related disabilities or for those who are transgender. That being said, most experts agree that you’d just have to cite menstrual leave, not provide a full-blown breakdown of what’s going on, or why you need to use it. 

As both Dr. Eisenlohr-Moul and Okamato note, one benefit of menstrual leave is the educational component of what it means to deal with a uterus and period pain—and that’s where the framing of leave comes into play. As Dr. Eisenlohr-Moul says, it can be positive for a company to explicitly acknowledge that it cares about workers’ physical and mental health, and recognize that there can be pain, or changes in function, for some during one’s menstrual cycle. The other framing of “we know you have changes in your ability during this time,” would—and should—raise red flags, she says. (To that point, Dr. Eisenlohr-Moul suggests calling it “cycle leave” or some other iteration. Okamato prefers “period leave.”) 

Okamato agrees with Dr. Eisenlohr-Moul on not framing leave as something abilities-based, and instead focusing on educating all employees. “We are literally coming off of centuries of conditioning to think that a cramp is just a cramp. Most people don’t even know what endometriosis is, or uterine fibroids, or anything like that,” says Okamato. She notes that period leave can be seen as a form of education—the same sort of education that an employee might get from a company’s DEI efforts or mental health policies. “There could be an element of educating on your bodily health, and how do you develop a sense of ‘where is my level of pain and at what point can I take time off?’” 

We’re far from seeing this regularly included in company benefits, but with more nations adopting the practice, and more people understanding what period leave is and how it works, we could see more companies adopt policies. “What I find really exciting about menstrual leave and the conversation around it is that it’s also a gateway conversation,” says Okamato. “It’s so directly linked to so many other conversations around reproductive health in the workplace, which is also very much a hot-button subject. Whether it be maternity leave, family planning, abortion, supporting people in reproductive health, it’s not just period leave.” 

Fast Company

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