Menstrual leave is about protecting pay, not asking for perks

It’s about recognising the very ordinary reality that millions in the UK live with chronic pelvic pain from periods (dysmenorrhoea) and conditions like endometriosis and adenomyosis.

Recent ONS analysis shows women in England with endometriosis experience a statistically significant drop in monthly earnings one to five years after diagnosis, compared with their pay two years before they were diagnosed. The ONS points to reduced hours and shifts into lower-paid roles as likely drivers behind these figures. That’s not a 'productivity myth' - it’s a measurable penalty for having a gynaecological disease.

Right now, the UK tells women to fold these flare-ups into ordinary sick leave. In practice, that means self-certifying short absences, then chasing a GP note after seven days to keep pay flowing in a system designed for linear illnesses, not cyclical pain. Many simply soldier on, hide symptoms, or downgrade jobs to cope. We shouldn’t have to choose between being believed and being paid.

Spain and Portugal offer a blueprint. Since 2023 (Spain) and 2025 (Portugal), workers with incapacitating menstruation can get state-funded paid leave from day one, typically three days, and extendable to five with a doctor’s note. Pay is covered by social security at 75% of earnings up to a cap. Early uptake has been modest, as stigma and awareness are holding it back, but the principle is clear: the need to protect income during medically certified episodes of pelvic pain.

What would a UK version look like? It should be kept simple and targeted. There should be day-one protection for medically certified pelvic-pain episodes linked to diagnosed conditions (e.g., endometriosis, adenomyosis). The pay replacement should be state funded, mirroring maternity-style funding rather than pushing costs onto small employers. To maintain patients’ privacy and dignity, there needs to be straightforward certification pathways and clear guidance to reduce stigma and HR guesswork. Data and evaluation is critical, and it should involve publishing anonymised uptake and outcomes annually, so policy aligns with the evidence.

This isn’t a culture war. It’s a labour-market fix. When one in 10 women are affected by endometriosis, the cost of doing nothing is visible in the ONS pay data and invisible in the careers that never get started, the hours shaved off and the promotions missed.

I run a femtech company that quantifies menstrual flow so patients can walk into a clinic with data, not just doubt. Technology helps, but it can’t replace policy. Statutory menstrual leave for pelvic pain would tell every employer, and every woman, that flare-ups are not a moral failing or an HR inconvenience. They are health events and your payslip shouldn’t punish you for them.

____________________

Justyna Strzeszynska is founder and CEO of Joii, an AI-powered platform advancing menstrual care.

LBC Opinion provides a platform for diverse opinions on current affairs and matters of public interest.

The views expressed are those of the authors and do not necessarily reflect the official LBC position.

To contact us email opinion@lbc.co.uk