Earlier this month, the BBC reported that Spain intended to introduce legislation to give women suffering from severe period pain, three days' medical leave each month, paid for by the government. This could be extended to five days in appropriate cases.
In response, a number of UK charities with an interest in this issue called on the government to introduce similar legislation. Although the government is planning to develop a Women’s Health Strategy for England (it recently launched a survey which is looking at menstrual health alongside other female health issues), it's unlikely to impose legal rules on employers in the near future.
However, there are good reasons for businesses to provide better support for women now.
What causes period pain?
Most women experience some form of pain in the run up to, and during their period. In many cases, this can be alleviated by taking over the counter pain killers. But, women who have medical conditions such as adenomyosis, endometriosis, fibroids, and pelvic inflammatory disease can suffer from excruciating pain and heavy periods.
Why is it a workplace issue?
According to the most recent data, 72.2% of women aged 16 to 64 are in work - that's around 15.5 million women (for men it's 78.8%). Many businesses are waking up to the fact that women need particular support during the peri-menopause and menopause but haven't really considered whether they need to implement similar policies to support those women who suffer from debilitating periods.
Anecdotal evidence suggests that many women have traditionally pushed on through the pain even though it impacts their ability to focus and work productively. Some are too embarrassed to mention it to their line managers, others don't want to be seen as "weak" or in some way inferior to men and there's also the issue of phoning in sick every month (and triggering absence reviews and warnings).
But things are starting to change. The younger generation are much less embarrassed by people knowing they are having a period than my generation (for context, I'm in my 50s). I remember scuttling to the loo with a tampon concealed up my sleeve (and still do so - old habits and all that). My daughters and their friends have far fewer inhibitions and are up front about when they are having a period if it comes up in conversation or they need to ask for a sanitary towel etc.
There are also signs of wider societal change. Manufacturers advertising sanitary products are less squeamish than they used to be (although blood is still blue)! Earlier this year, the government published the results of its Women’s Health – Let’s talk about it survey which examined women's experiences of dealing with five key health issues, one of which was menstrual health. It found that around 1 in 3 respondents said women feel comfortable talking about health issues in their workplace (35%), and 1 in 2 said their current or previous workplace had been supportive with regards to health issues (53%). They called on the government and employers to:
'create new policies to better support women in work, such as paid leave and counselling for miscarriage and baby loss, and reasonable adjustments for women who are going through the menopause, or living with painful gynaecological conditions.'
Is menstrual pain a disability?
I'm not aware of any decided cases on this, but it could be - particularly if the root cause is due to one of the underlying medical conditions mentioned above. The legal test is whether an individual has a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. If they can clear this hurdle, their employer is under a duty to make reasonable adjustments. This might include adjusting triggers in their absence management policies.
We are seeing an increasing number of women with severe menopausal symptoms bringing claims under the disability framework in the Equality Act - reflecting the increase in awareness of this issue. It's possible that we'll see similar challenges around debilitating period pain and associated symptoms as women become more comfortable discussing these.
But, even if menstrual symptoms aren't serious enough to amount to a disability, they may still impact on staff performance.
What can employers do?
Start to break down the existing prejudices. Periods and the associated pain are not a taboo topic and should be talked about in the same way that people discuss other health problems.
1. Be reasonable
Women suffering extreme symptoms may phone in sick during their periods. They may complain of stomach ache or other general symptoms rather than expressly referring to menstrual problems. Therefore, before triggering your formal absence management policy, have a sensitive conversation to find out if there is an underlying reason for their regular absence (or even irregular absence as not all women have periods on a fixed cycle or experience the same levels of pain each month). If it is related to their periods, consider making some adjustments to the trigger points in the policy and/or allowing women to work more flexibly during this time (if that's possible).
2. Be flexible
Periods affect women in different ways and to different degrees. Some women may need immediate access to a toilet because of a heavy flow, to a hot water bottle or over the counter medication to sooth cramps.
Are there any changes you can make to support staff to continue to work rather than phone in sick? Can they work at home, or make up their hours at some other time? This won't be possible for all jobs but it might be worth thinking ahead about how you might be able to accommodate flexible working for a few days each month.
3. ... and be supportive…
Try and be supportive, rather than judgemental. Don't bring your own experience into the discussion (or that of your friends, wife or girlfriend). Find out what you can do to help.
Do you need a policy?
It might be helpful to develop a policy so that your female staff understand what support is available to them and who to approach for help. This should help to create a positive and more productive working environment and encourage women to speak more openly about “that time of the month”.
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