Front & Female Asks: Are menstrual and menopause leave policies a good thing?

The once taboo topic of menopause is definitely being discussed more broadly within the community and beginning to influence workplace practices. Supporting women in this key demographic with appropriate workplace leave policies is going to be a new and important challenge for business. 

I see health education and knowledge as a key area for workplaces to develop so that women can understand this transitory life stage, reach out for individual help and also be signposted to further professional medical support if needed. Designing leave policies that acknowledge menopause and provide an open and supportive climate will assist women in their menopause journey.

One FemTech Association Asia pillar is advisory, consulting companies regarding their employee health and well-being strategies for women. Governance is an important part of a comprehensive corporate health and wellness framework; however, it is imperative that employees engaging with menopause (and also menstrual, fertility and maternity) leave policies do not experience discrimination. For example, Alicia A. Grandey shared in Research: Workplace Stigma Around Menopause Is Real (Harvard Business Review) that women navigating menopause may face diminished perceptions of leadership unless they discuss their experiences with “menopause openly”. Menopause is a medical condition and should be treated as such. Inclusive medical leave policies can minimise potential bias towards an individual employee by fostering open corporate dialogue about varying needs in the workplace.

To bolster leave policies, we suggest companies build more inclusive benefits packages, flexible work arrangements, employee education and awareness programmes; and senior leadership can demonstrate commitment to inclusivity and promotion of benefits uptake through company values and communications (or by taking leave themselves where relevant to lead by example). Most importantly, companies should monitor and assess the effectiveness of integrated company leave policies and inclusivity initiatives based on direct employee feedback (e.g. collected via Employee Resource Groups, or ERGs). In turn, employee performance, retention and recruitment can be strengthened by inclusive leave policies and holistic health programmes.

We know that menopause affects 100 percent of 50 percent of the workforce. Symptoms can start as early as your 30s and continue well into your 50s. Women can experience menopause symptoms for up to 10 years and possibly longer. This means that women will have to experience these symptoms whilst performing both in life and in the workplace. This can present as hot flashes in a meeting, sweat dripping from your forehead, poor concentration and inability to find the right words. Women are self-electing out of the workplace for fear of not being able to cope with meetings or big tasks, or for fear that colleagues will not understand.

We only just seem to have achieved recognition of maternal and paternal benefits, nursing rooms and a decent maternity leave package, and yet here we are having to fight again for a supportive workplace and understanding work environment.

What can workplaces do? Have a menopause policy. One that allows women to work flexible hours, a medical coverage plan that pays for doctors, hormone consults and hormone treatment (or other) that a woman wants. The cultural taboo needs to be ripped apart and women need to be able to not feel ashamed to talk about what is yet another totally normal and unavoidable stage of life.

Menstruation and menopause leave policies would bring to the forefront the issues and problems women experience in relation to their periods or menopause. The physical and emotional problems related to these two life cycles can be demystified and openly addressed.

The downside to these leave policies is that it medicalises menstruation and menopause. It may also put women at a disadvantage as employers may choose not to hire too many women on their teams if the women are able to take monthly leave. It may backfire and create discrimination against women as periods become looked upon as a "disease". There would also be less privacy as women will have to share with others about the timing of their cycles. 

We have to remember that having periods is normal. But it only becomes abnormal when the discomfort and symptoms become a hindrance to the activities of daily living. Hence it may be that simple sick leave is adequate.

Not all women experience periods in the same way. I have suffered agonising periods for the last 15 years or so—and they worsened after children. The pain, nausea, vomiting and excessive bleeding make it impossible to complete normal daily tasks. Whilst I typically work through these symptoms, I don’t believe women should have to. There should be better and faster diagnoses of underlying issues, which can include PCOS or endometriosis, and then leave given in parallel with these conditions.

Women experience natural hormonal changes throughout their lives, and while these shifts vary among individuals, some women find the associated physical and emotional symptoms quite challenging. This can impact a woman's overall well-being and work performance significantly.

Should women facing these hormonal changes be penalised by taking traditional sick leave, or is there a more suitable solution available?

Organisations can raise awareness and reduce the stigma around women's health conditions and their effects in the workplace by:  

• Offering education and training to promote organisational values that empower women to seek support in the workplace
• Implementing reasonable accommodations, such as providing sanitary products in restrooms, regulating temperatures, and allowing suitable attire
• Establishing a Women’s Health Policy that delineates a comprehensive strategy for menstruation and menopause, including health benefits, guidelines for sick leave related to these conditions should they wish to offer it, flexible working arrangements, which can decrease absenteeism, access to experts, and resources, so that women are able to advocate for their health confidently.

While there is no legal obligation for an organisation to have a specific policy for menstruation or menopause leave, there is a duty of care. The above can increase employee well-being and foster a sense of belonging so that organisations retain female talent.

Just like any other policies in the world, it depends. While menstrual leave might seem unfamiliar or peculiar to many of us in Hong Kong, it has been around for quite some time. In fact, our East Asian neighbours, Japan and South Korea, have both incorporated menstrual leave into their laws, granting employees the right to take leave during their menstrual cycles. A great step in building inclusive and supportive workplaces and breaking menstrual stigma. However, the reality is harsh. Since menstrual leave is often unpaid, only a small number of employees are willing to utilise it.   

Another concern is that these policies may inadvertently reinforce stigmas surrounding menstruation and perpetuate the notion that menstruators are weaker and less productive. In practice, some companies offer limited paid sick leave without requiring a doctor's certificate, and many menstruating workers (myself included) use it as de facto menstrual leave. This might in fact be a very good first step for companies to support individuals faced with challenges around menstruation, before society is ready for menstrual leave. After all, the success of menstrual leave policies depends on fostering a culture that embraces menstruation positively and promotes gender equity, in which the needs of menstruators are recognised and respected. Only by achieving this can menstrual leave policies be implemented without further perpetuating menstrual taboos and gender stereotypes.

We do not need menstrual or menopause leave policies. What we need is to talk more about period problems and menopausal changes. Take away the stigma, allow that open conversation and improve the workplace environment to help women suffering with these issues.

A woman having period cramps or heavy bleeding should not be suffering alone every month. Her workplace should have policies in place which allow her to get proper medical advice. She may need leave to deal with clinic visits, but this would lead to her handling her period issues better. A happier woman, a happier workplace.

Similarly, with the menopausal changes. Is the work place conducive to that woman going through the change? Are there policies such as flexible work hours, work from home policies, changing the working desk to a more conducive area, etc. to help ease her symptoms? We need to emphasise more on workplace adjustments to help women in the menopausal transition and provide adequate healthcare that covers menopause.

Unfortunately, in Malaysia, menopausal health is not covered by insurance companies. There is no insurance coverage for hot flushes, night sweats, sleeping disorders and joint pains, which are a few amongst many other symptoms of menopause. The treatment here may range from counselling, lifestyle changes or even hormone replacement therapy (in certain women) which may cost only between MYR100–150 per month (approximately USD20-30). But insurance companies regard hormones as taboo and do not even want to consider coverage. She would have to cover it herself.

Paramount is that mindset change at the workplace. Find solutions to problems, adapt and work with those who are experiencing health changes, both men and women. Having supportive policies is vital. A change in the health insurance policies should be the next step and it would help if it stems from employers wanting that benefit for their employees in need.

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