Workplace wellbeing programmes have expanded significantly over the past decade. Mental health days, ergonomic assessments, employee assistance programmes, menopause support. These are now standard features of a competitive benefits offering. But one area remains conspicuously absent from most HR strategies: menstrual health.
This is not a niche issue. Approximately 50% of the workforce will experience menstruation and menopause during their working lives. Period pain and heavy bleeding affect over 75% of menstruators at some stage, according to a global scoping review of workplace menstruation and menopause policies published in 2025. Meanwhile, CIPD research found that two-thirds (67%) of employers said there is no menstrual health support available in their organisation. That gap between prevalence and provision is where HR leaders have the most ground to make up.
Why the Silence Persists
Menstruation is still treated as a private matter in most professional environments. A CIPD study found that 49% of menstruators never tell their manager when an absence is related to their menstrual cycle. Separately, 32% of men surveyed said they believe it is unprofessional to talk about periods at work. These attitudes create a feedback loop: employees stay silent, managers assume there is no issue, and policies never get written.
The consequences are measurable. A 2025 Queensland-based study found that before workplace-supplied menstrual products were introduced, 94.7% of menstruating workers had experienced menstruation at work without access to products, leading to mental distress. Two-thirds of participants reported having experienced leakage at work because of inadequate supplies. Over 60% said they deliberately chose clothing to hide potential stains rather than asking for support.
These are not dramatic edge cases. They are the quiet, routine experiences of people who menstruate in workplaces that have simply never thought about what they need.
The Business Case Is Already Clear
HR leaders often need to present a business case before securing budget for new initiatives. On menstrual health, the numbers speak for themselves.
The large-scale Dutch study published in BMJ Open, which surveyed over 32,000 menstruators, found that presenteeism linked to menstrual symptoms accounted for an average of 23.2 days of reduced productivity per person, per year. That translates to nearly 9 full days of lost output annually once you factor in the degree of impairment. In a workforce of 200 employees where half menstruate, that is roughly 900 days of diminished performance each year that most organisations are not even tracking.
Add to this the costs associated with conditions like endometriosis, which affects 1 in 7 to 1 in 10 menstruators and is estimated to cost tens of thousands per person annually in lost productivity. Then consider retention. In unsupportive environments, menstruators are more likely to reduce their hours, stall their career progression, or leave the workforce altogether. The cost of doing nothing is not zero. It compounds over time.
What a Good Menstrual Health Strategy Looks Like
There is no single policy that fixes everything. Effective menstrual health strategies tend to combine practical provisions, flexible arrangements, and cultural change. Based on the most current evidence and workplace pilots, here are the components that matter most:
- Free period products in bathrooms. This is the lowest-hanging fruit and arguably the most immediately impactful step. The Queensland study found that when products were supplied, workers reported improved concentration, reduced anxiety and better emotional wellbeing. It costs very little relative to its effect.
- Flexible work arrangements. Remote work options, adjusted start times, or the ability to take short rest breaks without formal approval processes. These do not need to be labelled as “menstrual accommodations” to be effective. Many organisations already have flexible work policies; the task is ensuring they are genuinely accessible during high-symptom days.
- Manager training. This is where most strategies fall down. Managers are the gatekeepers of workplace culture, and if they are uncomfortable discussing cyclical health, employees will not raise it. Training does not need to be lengthy or complex, but it does need to happen. It should cover the basics of menstrual cycle phases, common symptoms, and how to respond when an employee discloses a need.
Beyond Leave: Why Education Matters More Than Policy Alone
Menstrual leave has dominated the headlines since Spain’s 2023 legislation made it the first European country to introduce paid time off for incapacitating periods. But the data from Spain’s first year tells a cautionary story. Fewer than 1,600 claims were made across the entire country in 11 months. Researchers attributed the low uptake to the requirement for a doctor’s note, the stigma of disclosure, and a widespread fear among employees that using the leave would mark them as less capable.
This pattern is not unique to Spain. In Japan, where menstrual leave has existed since 1947, fewer than 1% of eligible workers use it. South Korea shows similarly low figures. The lesson is consistent: standalone leave policies, without accompanying cultural and educational work, do not shift outcomes meaningfully.
What does shift outcomes is education. When managers and colleagues understand the biology of the menstrual cycle, the conversation changes. Symptoms stop being perceived as excuses and start being understood as a predictable part of human physiology. When organisations invest in fertility awareness and cyclical health literacy, they create environments where people feel safe to communicate their needs without fear of judgment or career penalty.
This is where trained educators and coaches play a critical role. Menstrual health education in the workplace is still a relatively new field, but it is growing rapidly. Practitioners who can deliver evidence-based sessions on topics ranging from cycle tracking to hormonal balance are increasingly in demand from HR teams looking to go beyond tick-box initiatives.
It is also worth noting that menstrual education benefits everyone in a workplace, not only those who menstruate. When male managers and colleagues gain a basic understanding of cyclical physiology, they are better equipped to support their teams, reduce friction around absences, and contribute to a culture where health conversations are normalised rather than avoided.
Getting Started: A Practical Checklist for HR Leaders
For HR professionals who want to act but are unsure where to begin, the following sequence tends to work well:
- Audit what exists. Review current sick leave, flexible work and wellbeing policies. Do any of them explicitly or implicitly accommodate menstrual health needs? If not, identify where small adjustments could make a difference. Speak to employees anonymously if possible. The gap between what HR assumes people need and what they actually need is often wider than expected.
- Start with products and facilities. Supply free menstrual products in all bathrooms. Ensure there are clean, private facilities with adequate disposal options. These steps require minimal budget and send an immediate signal that the organisation takes this seriously.
- Invest in education before drafting policy. Run a workshop or bring in a speaker before writing a standalone menstrual health policy. Education builds the cultural foundation that makes policy effective rather than performative.
The goal is not to create a separate category of “menstrual employees.” It is to build a workplace that accounts for the full range of human experience, including the biological realities that affect roughly half the people in it. Organisations that do this well will see the benefits in engagement scores, retention data and, ultimately, in the quality of work their teams produce.
The workplace has changed enormously in recent years. Hybrid models, mental health awareness, neurodiversity support. Each of these shifts began with a recognition that the old way of doing things was leaving people behind. Menstrual health is the next frontier. For HR leaders willing to act, the evidence is there, the tools exist, and the workforce is waiting. The organisations that move first will not only do right by their people. They will set the standard that others scramble to follow.
