Menstrual Leave: What the Evidence Says for Employers

TL;DR: Zambia, Japan, South Korea, Indonesia and Spain all have menstrual leave or a related right in law, but they work very differently. Reported use is often low, and stigma and strict rules are the most common explanations. There is little evidence either way on what it does to women's careers. If the law does not require it, the evidence does not point to one right answer, so ask your staff, and look at flexibility and fair absence rules whatever you decide.

If you run HR in Lusaka, Lagos, Nairobi or London, someone has probably asked you about menstrual leave by now. It tends to arrive with strong feelings attached: some colleagues see it as overdue, others worry it will make women look less committed. Both reactions deserve an answer, and the research can only partly give one. This post sets out what the laws say, what is known about who uses the leave, where the risks are and what else you could do. For the wider picture, see our guide to women's health at work.

Which countries have menstrual leave in law?

Several countries in Africa, Asia and Europe do, and no two laws work the same way. Some give a set number of days, while Japan's sets no number and Spain's treats it as a form of medical leave.

Summarised from the sources below. This is general information, not legal advice. Laws and how they are applied change, so check the current law where you operate.

The sources for each row are Zambia's Employment Code Act, Japan's Labor Standards Act and AFP's reporting on pay there, the Korea Herald on South Korea, AFP and the Jakarta Post on Indonesia, and Spain's Organic Law 1/2023 with Personnel Today on how it is paid.

The differences matter. Zambia and South Korea ask for no proof. Spain's law only covers pain caused by a condition that has already been diagnosed, with endometriosis and fibroids among the examples its preamble gives. If you employ people across borders, one policy will not fit every country without local checks.

Do women take menstrual leave when it is offered?

Reported use is often low, though the figures are hard to compare because each country counts differently.

• Japan: a labour ministry survey of about 6,000 companies found just 0.9% of eligible workers had taken it.
• South Korea: a 2018 survey found 64.4% of 604 companies with at least 100 staff offered the leave, and 19.7% of 2,347 women at assistant manager level or above had taken it.
• Spain: the leave was used 1,559 times in the first 11 months, with an average length of about three days. A later account reported 2,668 women using it between June 2023 and February 2025, against a ministry estimate that about 60,000 workers might need it.
• Indonesia: AFP reported that many employers allow one day a month or none, and the Jakarta Post found few women knew about the rule.
• Zambia: AFP reported that not all employers comply, though unions are encouraging women to use the right. We could not find reliable national figures for how often it is taken.

Low use does not show that women do not need it. In a Dutch survey of 32,748 women, 13.8% had missed work or school during their period and 80.7% kept going while feeling less productive, losing a mean of 8.9 days a year to reduced productivity. Those women were recruited online and reported their own symptoms, but the pattern is clear: most of the cost happens at a desk, where leave policy does not reach.

Does menstrual leave increase stigma or hurt women's careers?

We do not know yet. Women report fearing judgement, and critics have warned about hiring, but we found no strong study measuring what happens to pay, promotion or hiring after a law or policy is introduced.

What the research does show is that attitudes are mixed. In a study asking 600 members of the US public about a possible policy, the themes included support for women, "what do men get?", concern about workplace effects, "just deal with it", and a worry that the policy would make women look bad. In a survey of 923 Australian women, 85% were somewhat to definitely in favour of paid leave, though many were recruited through social media, including groups for conditions such as endometriosis, so they are not a cross-section of workers. In focus groups with 21 working women in Japan, participants described formal support, including menstrual leave, as often impractical because of stigma, hierarchy and concerns about fairness and workload. In Namibia, 13 women interviewed about periods at work asked for the option of home working or leave on bad days.

News reports add colour to this. In South Korea, women fear being judged or seen as less committed. In Indonesia, some women told the Jakarta Post they avoid the leave so they will not look as if they are making excuses.

On hiring, the concern is old but untested. AFP reported that a 2003 International Labour Organization report warned that Indonesia's leave was a significant cost that led some employers to discriminate against women when hiring. In Spain, an academic writing in 2026 noted that there was still no evidence on whether the leave had harmed women's employment, and said it remained unclear whether it improves wellbeing. A warning is not a finding, and an absence of evidence is not proof of safety, so treat both sides with care.

What are the main risks for an employer?

These are the issues to plan for if you introduce it voluntarily.

Disclosure. Any process that needs a reason tells someone about an employee's health. In the UK, the Information Commissioner's Office treats workers' health information as special category data and says that as far as possible you should leave detailed medical information to medical professionals. Nigeria's Data Protection Act lists health status as sensitive personal data. Zambia's no-reason model avoids much of this, while Spain's doctor's note adds a step.

Unused policy. A leave that nobody feels safe taking looks good on paper and changes little. Japan's figure is the clearest warning. If managers roll their eyes, use will be low however generous the policy is.

Fairness and cover. The "what do men get?" reaction and worries about workload both appear in the studies above. Decide in advance who covers the work so that colleagues do not carry it.

Who it leaves out. A doctor's note or a diagnosis shuts out women who cannot get one. With endometriosis taking an average of 4 to 12 years to diagnose, that matters.

What are the alternatives to menstrual leave?

You can combine these with a leave policy or use them instead of one. We did not find a trial comparing them with menstrual leave, so this is reasoned guidance.

• Flexibility on bad days. In the Dutch survey, 67.7% of women wanted more flexibility in tasks and hours during their periods. Later starts, home working and task swaps need no diagnosis and no announcement. One researcher has argued for "menstrual flexibility" as a broader umbrella that could make these policies work as equity tools.
• Fair absence rules. Acas says absence review points can disadvantage disabled employees, and that employers can choose not to count disability-related absence. Applying the same thinking to recurring period-related sickness avoids penalising a monthly pattern.
• Better basics. The WHO says people who menstruate need products, water, sanitation and disposal facilities, and care when they need it, and that they should be able to fully participate in work. The women in Namibia named a lack of emergency products as a practical problem.
• Manager training. A manager who responds well may do more than a policy document. Our post for employees on what to say about period pain at work shows the conversations your managers can expect.
• Health days open to all staff. This responds to the fairness concern because nobody has to say why they are off, but we found no evaluation of it.

How to decide

Start with what the law requires where you operate. If it is silent, run a short anonymous survey and ask what would help most. If you choose leave, keep the reason private, make it easy to use, have senior staff speak about it openly, and review use and survey results in aggregate after a year. Severe period pain can also point to a condition that needs treatment, such as endometriosis or heavy menstrual bleeding, so make sure any policy encourages people to see a doctor. On the podcast, we also talk about women's health at work.

If you want to offer private health support alongside your policy, Asele for Business gives employees their own cycle and symptom tracking, and employers only ever see anonymised, aggregate usage.

This post is education, not medical or legal advice. Employment and data protection laws change, so check the current law where you operate or speak to an employment lawyer before you finalise a policy.

References

1. Republic of Zambia. Employment Code Act No. 3 of 2019. parliament.gov.zm
2. Japan. Labor Standards Act, Article 68. Japanese Law Translation. japaneselawtranslation.go.jp
3. AFP via Medical Xpress. The global push for paid menstrual leave, February 2023. medicalxpress.com
4. Korea Herald. Menstrual leave in South Korea. koreaherald.com
5. The Jakarta Post. Go with the flow: Indonesian women divided over menstrual leave, 2021. thejakartapost.com
6. Spain. Ley Orgánica 1/2023, de 28 de febrero. Boletín Oficial del Estado. boe.es
7. Personnel Today. Take-up slow for Europe's only state menstrual paid leave policy. personneltoday.com
8. de la Iglesia Aza L. Menstrual leave: stigma and uncertainty mean these progressive measures are being underused around the world. The Conversation via Yahoo News, 2026. yahoo.com
9. Schoep ME, et al. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open, 2019. pubmed.ncbi.nlm.nih.gov
10. Barnack-Tavlaris JL, et al. Taking leave to bleed: perceptions and attitudes toward menstrual leave policy. Health Care Women Int, 2019. pubmed.ncbi.nlm.nih.gov
11. Wong A, et al. Exploring Australian women's attitudes towards paid menstrual leave: a mixed-methods study. Aust N Z J Obstet Gynaecol, 2025. pubmed.ncbi.nlm.nih.gov
12. Sasayama K, et al. Cyclical women's health needs at work: focus groups in Japan. Women Health, 2026. pubmed.ncbi.nlm.nih.gov
13. Mbongo EN, et al. A narrative inquiry into women's experiences of menstruation at the workplace in Namibia. J Public Health Afr, 2023. pubmed.ncbi.nlm.nih.gov
14. Furlano M. Disrupting menstrual stigma at work? A thematic analysis of menstrual leave policy announcements across five countries. Cult Health Sex, 2025. pubmed.ncbi.nlm.nih.gov
15. Information Commissioner's Office. Data protection and workers' health information. ico.org.uk
16. Federal Republic of Nigeria. Nigeria Data Protection Act, 2023. Nigeria Data Protection Commission. ndpc.gov.ng
17. World Health Organization. Endometriosis fact sheet. who.int
18. Acas. Absence review points. acas.org.uk
19. World Health Organization. WHO statement on menstrual health and rights, June 2022. who.int
20. AFP via Medical Xpress. From Japan to Zambia: the push for paid menstrual leave, May 2022. medicalxpress.com