Period Pain at Work: What to Say and What to Ask For

TL;DR: You can tell your manager as much or as little as you choose, though pay and adjustments may need some detail. Ask for specific changes, such as a later start, home working or a seat near the toilets, and confirm them in writing. Sick pay rules differ by country. If pain stops your usual day or keeps getting worse, see a doctor, because severe pain can have a treatable cause.

It is 11am in an open-plan office on the Island, or on a ward in Kumasi, or at a till in Peckham. The painkillers have not worked yet, your back aches, and you are wondering how long you can stand up before anyone notices. Many of us were raised to manage this quietly. But you are allowed to ask for what would make the day easier, and you can do it without giving a speech about your womb. This post gives you words to borrow, a list of things to ask for, and a clear line on when the pain needs medical attention.

Why do so many women hide period pain at work?

Mostly because it feels risky or embarrassing to say it out loud, and the numbers reflect that. In a Dutch survey of 32,748 women aged 15 to 45, 13.8% had missed work or school because of their period, and only 20.1% of those who called in sick gave the true reason. Far more, 80.7%, kept going while feeling less productive, and 67.7% wished they had more flexibility in tasks and hours. The women were recruited through social media and reported their own symptoms, so it is not a perfect picture, but it fits what women describe elsewhere. In a small study of 13 women working in Namibia, participants described pain, heavy bleeding, a lack of emergency products and unsupportive bosses, and asked for the option to work from home or take leave on their worst days.

Do you have to tell your manager it is your period?

Often you can keep it general, such as "a health issue", at least at first. The catch is that sick pay rules or a formal adjustment may need more detail.

In the UK, Acas says employees can self-certify for 7 calendar days without medical evidence, and a fit note is only needed from the 7th day. In Kenya, the Employment Act says that to get full sick pay you must tell your employer about your absence and the reasons for it, and produce a certificate from a medical practitioner, so "unwell" may not be enough there. Your contract or staff handbook may add its own rules, so read those first. Beyond what pay or an adjustment requires, what you share is your decision.

What to say to your manager

Keep it short, say what you need, and say what will happen to the work. Change these to fit your voice.

When you need the day off and want to stay general: "I am unwell today and will not be able to work. I expect to be back on Wednesday. Ada has the notes for the client call."

When it happens every month and you want a plan, without naming periods: "I have a health issue that flares up for a day or two most months. I would like to agree how we handle those days so the team is not caught out. Could we talk for 15 minutes this week?"

When you are ready to name it: "I get very painful periods. On the worst day or two, I struggle to sit through long meetings or stand for a full shift. I am seeing a doctor about it. In the meantime, could I work from home on those days and move my calls to the afternoon?"

When you are on shifts or on your feet: "On my heaviest days I need to get to the toilet more often than the break schedule allows. Can we agree a way for me to step away for a few minutes without waiting for cover?"

When you do not want to discuss it with your line manager: "This is a women's health matter and I would be more comfortable talking to someone in HR, or another manager. Who is the right person?"

When someone pushes for details you do not want to give: "I would rather keep the details private. What I need is the change we discussed, and I am happy to get a doctor's note if the policy calls for one."

The follow-up, in writing: "Thanks for speaking with me today. To confirm, we agreed that I can start at 11 on up to two days a month when I am unwell, and I will message you by 8am. Please tell me if I have misunderstood anything."

That last one matters. A short message gives you a record if your manager moves on or the arrangement is forgotten.

What adjustments can you ask for?

Ask for the smallest change that would make the biggest difference, and offer to try it for three months. Acas lists changed hours or breaks, flexible or home working, paid time off for medical appointments and a phased return among the adjustments employers can make for disabled staff, and they are useful starting points for anyone. Tick the ones that would help you:

That final point is worth raising. Acas warns that absence review points can disadvantage disabled employees who need regular time off, and says employers can choose not to count disability-related absence. If you lead a team, our guide to women's health at work sets out what a fair policy looks like.

What the law says where you work

Rules differ widely, and of the five countries below, only Zambia gives a specific right to time off linked to periods. This is general information, not legal advice, and laws change, so check the current position or ask a union, HR or an employment lawyer.

• Nigeria: the Labour Act entitles a worker to wages for up to 12 working days a year of absence for temporary illness certified by a registered medical practitioner. The Act's definition of "worker" leaves out people in administrative, executive, technical or professional roles, so your contract may be what counts.
• Kenya: after two consecutive months of service, the Employment Act gives at least seven days of sick leave on full pay and then seven on half pay in each 12 months, with a medical certificate.
• South Africa: the Basic Conditions of Employment Act gives paid sick leave equal to the days you normally work in six weeks, across a 36-month cycle. Your employer can ask for a medical certificate if you are off for more than two days in a row, or on more than two occasions in eight weeks.
• Zambia: the Employment Code Act gives female employees one day's absence each month without a medical certificate or giving a reason, known as Mother's day.
• UK: you have the right to request flexible working from your first day. If a condition has a substantial negative effect on normal daily activities for 12 months or more, it may count as a disability, and your employer would then have to consider reasonable adjustments. Severe period pain from a long-term condition such as endometriosis may meet that test, depending on how it affects you.

When does period pain need a doctor?

See a doctor if the pain stops your normal day, gets worse over time, or comes with other symptoms. Pain that makes you miss work is a reason to book an appointment, not something to keep managing alone.

For everyday cramps, the NHS suggests paracetamol or ibuprofen, a heat pad or hot water bottle wrapped in a tea towel, a warm bath, gentle exercise and massaging your tummy and back. It says period pain usually starts around the beginning of your period and lasts up to 3 days. Book an appointment if:

• your periods become more painful, heavier or irregular
• the pain stops you doing your usual daily activities
• you have pain during sex, or when peeing or pooing
• you bleed between periods
• you have a swollen tummy, lose your appetite or lose weight without trying

The NHS says to ask for an urgent appointment or get help if the pain is severe or worse than usual and painkillers have not helped.

Pain like this can have a cause that can be treated, including endometriosis, fibroids, adenomyosis and pelvic inflammatory disease. The WHO estimates that endometriosis affects about 10% of women of reproductive age, with an average of 4 to 12 years before diagnosis. Read endometriosis explained and the signs that it is more than a bad period.

If bleeding is the bigger problem, the NHS signs of heavy periods include changing your pad or tampon every 1 to 2 hours, bleeding for more than 7 days, or periods that make you miss work. Our post on heavy periods covers tests and treatment, and our periods guide has the whole picture.

Keep a simple record

A few months of notes make both conversations easier, the one with your doctor and the one with your manager. Write down the first day of each period, how bad the pain is from 0 to 10, and the days it affected work. You can do this in a notebook or in Asele, which offers cycle tracking and symptom logging, and the Health Brief can turn it into a short summary for your appointment.

This post is education, not medical advice, and the employment information is general, not legal advice. If something about your pain worries you, speak to a doctor, nurse or pharmacist who can examine you.

References

1. 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
2. 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
3. Acas. Sick leave. acas.org.uk
4. Acas. Fit notes and proof of sickness. acas.org.uk
5. Republic of Kenya. Employment Act, 2007. Kenya Law. kenyalaw.org
6. Acas. Reasonable adjustments at work. acas.org.uk
7. Acas. Absence review points. acas.org.uk
8. Federal Republic of Nigeria. Labour Act, Cap L1, Laws of the Federation of Nigeria. placng.org
9. Republic of South Africa. Basic Conditions of Employment Act 75 of 1997. gov.za
10. Republic of Zambia. Employment Code Act No. 3 of 2019. parliament.gov.zm
11. GOV.UK. Flexible working. gov.uk
12. GOV.UK. Definition of disability under the Equality Act 2010. gov.uk
13. NHS. Period pain. nhs.uk
14. World Health Organization. Endometriosis fact sheet. who.int
15. NHS. Heavy periods. nhs.uk