Menstrual leave debate: What studies say about women’s work productivity, and the way forward

Link between paid menstrual leave, health and stigma

Some studies suggest complex perceptions on the question of menstrual leave. A recent observational study from South India, “Mindsets and Menses: Decoding young women’s attitudes towards menstrual leave”, published in the British Medical Journal (BMJ), found that young women generally supported menstrual leave policies, particularly for hygiene and pain management. It covered 955 students above the age of 18 and enrolled in educational institutions in a rural district of Tamil Nadu.

According to the study authors, these views were accompanied by significant concerns about workplace stigmatisation and gender stereotyping. Almost all respondents said they had experienced dysmenorrhea (painful menstruation). While 65.5% had never taken leave during their periods, 54.6% said they would prefer menstrual leave policies over well-being rooms.

The same study suggested that 48% women worried it might medicalise menstruation as debilitating, and 43.4% thought it might reinforce notions of female fragility. Another 43.1% feared it could portray women as less suitable for prominent positions.

Prof Bhaswati Mookerjea, Chairperson of the Department of Astronomy and Astrophysics, Tata Institute of Fundamental Research (TIFR) and also the chair of the TIFR’s internal committee on gender harmony, cautioned against simply instituting leaves. Without sensitising society and gauging the response to such policies, women’s professional growth and employability could be easily impacted, she said.

“The child care leave, while it has helped many women to balance their work-family responsibilities, has also reinforced the fact that it is primarily the mother’s responsibility to take care of the children, since even a willing caregiving father is not entitled to the leave.” She added that such leaves can affect work and may not be viewed favourably by employers and colleagues.

Productivity studies imply loss of around 9 days annually

Another study in the BMJ, “Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women,” said that menstruation-related symptoms cause significant loss of productivity for women. “There is an urgent need for more focus on the impact of these symptoms especially in women aged under 21 years for discussions of treatment options with women of all ages and ideally more flexibility for women who work or go to school,” it said.

In another study published in the Journal of the Egyptian Public Health Association, titled “Dysmenorrhea among working women and its effect on their work productivity and activity impairment,” the authors detailed the productivity of dysmenorrheic working women. They reported higher rates of absenteeism (absence from work) and presenteeism (productivity loss despite being present at work).

“While productivity studies from across the world imply a loss of roughly nine days a year due to menstruation, this is highly variable depending on the nature of the work and also the individual,” Dr Rajeev Jayadevan, convenor of the research cell of the Indian Medical Association, Kerala, said.

He added, “The relationship between menstruation and work is complex because it does not affect all women in the same manner. Some are fortunate to have no physical symptoms at all that affect their work, while others suffer from severe dysmenorrhea and heavy bleeding, which compels them to take medical leave.”

Dr Jayadevan also observed that experienced doctors might be able to diagnose and treat underlying conditions such as endometriosis or fibroids, significantly improving their quality of life and ability to work.

Deprioritising a ‘one size fits all’ strategy

Numerous studies have called for more research on supporting women affected by menstruation-related symptoms and improving their productivity.

According to Prof Mookerjea, the issue is further complicated by workplace/industry-specific conditions and depends somewhat on the job description. “Clearly, a college professor has a very different job requirement compared to a bank employee or a person in the service industry. So, instead of a blanket “one size fits all” leave, organisations should be asked to come up with the best possible solutions which allow women to remain professionally equally productive as their male counterparts,” she said.

Flexible work-from-home policies could be one solution if the work profile allows for them. Setting up hygienic restroom facilities will also be helpful. “Since for some women the menstrual periods are regularly accompanied by almost debilitating discomfort due to pre-existing conditions, introducing provisions for additional medical leave on this ground with medical certification will be a step forward,” Prof Mookerjea said.