“Out of Sight, out of Mind?” Menstrual Leave vs. Workplace Supports for Employees with Endometriosis

Danielle Howe, Michelle O’Shea, Sarah Duffy, Mike Armour
In: Women's Reproductive Health · 2025 · vol. 13(2) , pp. 385–395 · doi:10.1080/23293691.2025.2556173 · W4414598945
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This paper examines the effectiveness of menstrual leave policies and workplace support strategies in addressing the needs of employees with endometriosis.

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Abstract As women’s workforce participation nears parity in many countries, there is growing recognition of the need for workplace policies that support reproductive and gynecological-related health. Endometriosis, a chronic inflammatory illness that begins in the uterus and can spread throughout the body, causes debilitating symptoms such as pelvic pain and fatigue that negatively impact people’s work, education, and well-being. Despite affecting ∼5–14% of women and those presumed female at birth, endometriosis is poorly understood, stigmatized, and insufficiently supported in most workplaces. As a result, many employees rely on sick leave and unpaid leave to manage their condition and often avoid disclosing their diagnosis due to fears of stigma and discrimination. This commentary draws from global literature on workplace policies related to menstruation, menopause, and endometriosis, applying Bacchi’s “What’s the Problem Represented to be?” framework to critically examine two policy responses—additional leave and flexible work—and explore their potential for supporting employees with endometriosis. While additional (menstrual) leave entitlements may offer financial security during symptom flares, they risk reinforcing stigma by framing endometriosis as an individual health issue and removing endometriosis-affected employees from workplaces rather than addressing organizational and cultural shortcomings. Conversely, flexible working arrangements, when codesigned and combined with education and training, show greater potential to accommodate diverse needs, reduce stigma, and foster inclusive workplaces for employees with endometriosis. We recommend that researchers, policymakers, unions, and workplaces codesign, implement, and evaluate policies that support people with endometriosis at work in ways that are inclusive, evidence-informed, and fit-for-purpose. Disclosure Statement No potential conflict of interest was reported by the authors. Data Availability Statement Data sharing is not applicable to this article, as no new data were created or analyzed in this study. Notes 1 This article sometimes uses the term “women” in recognition of the specific workplace experiences and challenges faced by cisgender women, particularly those related to menstruation, menopause, and chronic conditions such as endometriosis and chronic pelvic pain. This terminology also reflects the fact that most existing research in this field has focused on cisgender women in workplace contexts. However, the authors acknowledge that trans men, intersex, nonbinary, and gender-diverse people may also experience menstruation, menopause, and chronic illnesses, including endometriosis and chronic pelvic pain. The use of the term “women” in this article serves to both accurately represent the populations studied in prior research and highlight gaps in our knowledge regarding the unique experiences, challenges, and support needs of gender-diverse communities at work. Where possible, this article adopts the term “women and those presumed female at birth (PFAB)” in alignment with research on inclusive language and accurate reporting (Adler et al. Citation2024).

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endometriosis

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License: CC0 · commercial use OK