Although it is generally understood that women* can experience symptoms related to their menstruation, little attention has been paid to the way menstruation-related symptoms (MRSs) affect women in the workplace. With women accounting for roughly half of the labour-force in Europe, this topic deserves more recognition. The ongoing silence around it has led the discussion about menstruation to be tabooed. This is worrisome because the period stigma is not only problematic for menstruating employees but also for employers and society as a whole.
Menstruation and work
While some women are lucky enough to experience little or no symptoms related to their period, many suffer from physical and/or emotional symptoms in the luteal phase of their cycle or during menstruation. Common MRSs include menstrual symptoms such as abdominal cramps as well as premenstrual symptoms such as anxiety. The latter are classified as premenstrual syndrome (PMS) or, when more severe, premenstrual dysphoric disorder (PMDD). It is estimated that 50% of women in their reproductive age are affected from pain during their menstruation while 20-40% show premenstrual symptoms. Their severity varies considerably among women, as does the extent to which they affect women's quality of life. Despite the high prevalence of these symptoms among women in the workforce, discussing menstruation is still a taboo at most workplaces. This is problematic for women whose MRSs interfere with their professional lives.
As a result of feeling uncomfortable discussing their symptoms, many women feel the need to come to work even when they are not able to work productively. Instead, women pretend that they are feeling fine while underplaying their symptoms, which depletes their resources even more and makes them more susceptible to MRSs. Other women stay at home altogether, calling in sick. Both phenomena result in stress and unnecessary productivity losses. Formally, the reduced productivity of ill employees attending work is defined as presenteeism and the lost productivity due to being absent from work as absenteeism. In fact, researchers identify these two behaviours as the main drivers of overall productivity loss at the workplace.
A Dutch study from 2019, which is the largest cohort study to date analysing how MRSs affect productivity, finds that MRSs account for 22% of absent days of employed women. The same study also finds that a staggering 80% of women who called in sick due to experiencing MRSs did not state menstruation as the reason of absence. Most merely mentioned the symptom (46%) whereas others did not state any reason at all (28%). A small proportion even reported a made-up reason (6%). This finding clearly demonstrates that many women feel uncomfortable talking about MRSs or fear that those will not be considered legitimate reasons to stay at home.
Another striking finding of this study is that productivity losses due to presenteeism are seven times higher than the productivity losses due to absenteeism. This implies that the biggest part of the total productivity loss derives from women coming to work when feeling unwell rather than from staying at home.
Often, women try to make up for their lost productivity by engaging in overcompensating behaviour once their symptoms recede, which causes stress and affects their work-life balance.
A longitudinal study looking at PMS presents evidence that high levels of stress strongly contribute to the severity and number of premenstrual symptoms in the subsequent cycle.
What this research shows us is that neglecting the biological effect of menstruation is the wrong way to deal with it. The good news is that the stress and productivity losses due to MRSs can be avoided.
When women are asked what they would like to change in their work setting during or before their menstruation, they often report more flexible working hours, tasks and working environment. This, they believe, would ease their symptoms, which would result in less stress and higher productivity as they could work in the way that suits them best.
One possibility that is sometimes provided by employers is to take menstrual leave, i.e. take day(s) off during menstruation. While this can be helpful for some, the issue at hand does not require a one-size-fits-all solution. Allowing for more flexibility such as working remotely or working less hours can be enough for some women. Merely implementing the possibility of taking days off does not leave much room for discussing other, minor rearrangements. Such individual arrangements could prevent productivity losses that occur due to presenteeism and absenteeism. Researching and implementing measures that help women to increase their productivity during and before their period can lead to a win-win-win situation.
The first winner - the employee
Being able to talk to someone at work about potential difficulties resulting from MRSs would already be a big win for women. Creating awareness and normalising the discussion about periods is essential to further work out possibilities to modify working conditions when necessary. Allowing women to structure their work setting more flexibly before or during their period can improve their well-being in several ways:
⦁ It enables women to have a better work-life balance. Since women will be able to work more productively, there is no need for overcompensation anymore. That way, their stress levels decrease which has a positive effect on their (hormonal) health. After all, strong (pre)menstrual symptoms can derive from gynaecological health conditions as well as from hormonal imbalances. Both are important to address, and a reduction of stress is absolutely essential for that.
⦁ Women that have difficulties with their MRSs at the workplace will be able to stay in their job and pursue their career, allowing them to be financially independent and productive. Besides the obvious benefit of financial security, this is important because two major contributors to good mental health are having a stable and sufficient income and feeling productive.
⦁ Not only the affected women but also their families will benefit from more flexible working conditions, both financially and emotionally. A poor work-life balance can cause women to feel overwhelmed with tasks related to their social and domestic surrounding. An increased earning potential leads to a higher household income and more financial security.
⦁ Ultimately, women will learn how to work with their cycle. Women's menstrual cycles do not only have the downside of potential bothersome symptoms regarding menstruation. Shifts in hormone levels also let women feel extra energetic and confident on days around ovulation. Exploiting the potential of each cycle phase can help women to thrive. Maisie Hill's book Period Power is a great guide that helps women keep track of their cycle and manage their hormonal health.
The second winner - the employer
Employers generally have an interest in acquiring skilled workers, retaining valuable employees, and maintaining high productivity. Creating a comfortable working environment for all employees is vital to achieve these objectives. Therefore, allowing for more flexible work conditions for women with acute MRSs can have a positive impact for employers:
⦁ Offering better employment conditions by acknowledging women's menstruation needs will facilitate attracting skilled female employees as it represents an inclusive working environment. This can be crucial for a woman's decision regarding her future workplace.
⦁ Employers will retain valuable employees. Employees that have worked in a certain position or team for several years are an enormous asset for employers. Usually, training new employees to be equally productive and to work independently takes several months and is very costly. By retaining these employees, costs related to (temporary) replacements are reduced substantially.
⦁ Productivity losses will be reduced. Employment studies show that while it may seem adequate to incentivise employees to reduce absenteeism, it can increase presenteeism which leads to even higher productivity losses. Allowing women to choose their preferred way of working when they are experiencing MRSs will lead to higher productivity, because both presenteeism and absenteeism are reduced. In addition, this leads to a higher commitment and motivation.
The third winner - society
Increasing menstruating women's opportunities at the labour market as well as their overall productivity would benefit society as it increases their contribution to the country's economic growth.
⦁ Reducing stress is an effective non-pharmaceutical way of preventing illness. Two pillars of economic growth, capital and labour, are depleted by morbidity and healthcare costs. As a result, keeping these at a minimum is advantageous for the economy.
⦁ Women that are able to work more in their preferred setting will pay higher income taxes. Additionally, women that are enabled to pursue their career will depend less on unemployment benefits and other governmental financial aid.
⦁ A higher earning potential increases the disposable income of affected households, leading to higher consumption. This will contribute to the growth of businesses, which creates new jobs and increases investments.
Making the workplace period friendly
Considering women's needs during menstruation is vital when implementing equal employment opportunities. A first step could be providing menstrual products in women's bathrooms, and assigning a quiet place where employees can take some time for themselves (especially in open offices). It is vital that employers encourage women to articulate their needs regarding their menstruation without fearing to be discriminated against. This is the only way to break the taboo around menstruation at the workplace. Understandably, this is a difficult thing to do. Therefore, employers can consider getting external help to become educated and to receive guidance in the process of making the workplace period friendly.
For many, menstruation is still a sensitive topic and not everyone wants to talk about it. However, embracing both the difficulties and the chances goes hand in hand with creating equal employment opportunities which is something worth striving for.
*Not all women menstruate and not everyone that menstruates identifies as a woman
© 2020 Katharina Eggert, All rights reserved.