EXPLAINER: How common is menstrual leave globally?

AI Illustration

The recent directive by the Nairobi County Government granting its female employees two days of paid menstrual leave each month has ignited fresh debate and discussion not only in Kenya, but globally.

This move by Nairobi places it among a growing, yet still relatively small, cohort of regions and nations exploring how best to support women in the workplace during their menstrual cycles.

Menstrual leave — a formal workplace entitlement that allows people to take time off for disabling period pain or other menstrual symptoms — exists in only a handful of countries, and its real-world impact has been mixed.

At its core, menstrual leave acknowledges that for many women, menstruation is not merely an inconvenience but can be a debilitating experience accompanied by severe pain, fatigue, and other symptoms that make regular work difficult, if not impossible.

While the concept has existed for decades in some parts of the world, its global prevalence remains sporadic, marked by a patchwork of successes, challenges, and ongoing resistance.

Nairobi’s directive, announced by Governor Johnson Sakaja, represents a significant moment for workers’ rights in Africa.

“Female employees will be entitled to two days of paid menstrual leave every month, without any deduction from their annual leave,” Sakaja declared, emphasising the county’s commitment to supporting its female workforce.

The move aims to address the silent suffering many women endure, often forcing them to work through severe discomfort for fear of being perceived as weak or less committed.

The implementation of this policy in Nairobi will be closely watched. Advocates hope it will set a precedent for other counties and even national governments across Africa, a continent where cultural norms often discourage open discussion about menstruation.

The idea of menstrual leave is far from new. Some countries have had policies in place for decades, while others are only beginning to grapple with the concept.

Japan

Japan is one of the earliest adopters, having introduced menstrual leave — known as seirikyuuka — as far back as 1947.

This post-World War II labour law recognised the physical toll menstruation could take on women working in factories and other demanding environments.

However, while the entitlement is enshrined in law, its use has declined significantly over the years.

Data from Japan’s Ministry of Health, Labour and Welfare shows that fewer than one per cent of eligible women take menstrual leave.

Indonesia

Indonesia introduced menstrual leave in its labour law in 2003, allowing female employees up to two days of paid leave per month if they experience pain during menstruation.

However, as in Japan, implementation has been inconsistent.

Many companies require medical certificates, creating additional barriers, while others simply fail to comply with the law.

Spain

In a landmark decision in February 2023, Spain became the first European country to introduce paid menstrual leave.

The law allows women experiencing debilitating periods to take up to three days of paid leave per month, with the possibility of extension, subject to a doctor’s note.

The move was celebrated by women’s rights advocates as a progressive step. Spain’s Equality Minister, Irene Montero, hailed the law as “a great step forward for the equality and health of women.”

Zambia

Zambia has had “Mother’s Day” — a monthly day of menstrual leave — enshrined in its labour laws since 1996.

Unlike in some other countries, implementation has often been cited as relatively successful, with many women regularly using the entitlement.

This success is partly attributed to greater cultural acceptance of the leave and less stigma attached to its use.

What works, what doesn’t

Global experiences with menstrual leave offer valuable insights into effective implementation and common pitfalls.

Countries with higher uptake tend to have clear, unambiguous policies that are well communicated to both employers and employees. Z

ambia’s “Mother’s Day,” for example, is explicitly defined and widely understood, making it easier for women to access the entitlement without confusion.

Cultural acceptance also plays a critical role. In workplaces where menstruation is openly discussed and not treated as a taboo, women are more likely to use menstrual leave without fear of judgement.

Educational initiatives and visible leadership support have been shown to reduce stigma and normalise menstrual health as a legitimate workplace issue.

Policies that do not require medical certificates for short-term menstrual leave have also proved more effective.

Requiring a doctor’s note for a routine biological process can create unnecessary financial and logistical barriers, particularly for low-income workers.

Conversely, stigma and discrimination remain the most significant challenges. Even where policies exist, many women are reluctant to take menstrual leave out of fear of being perceived as less productive or unreliable.

“Many women are afraid that taking menstrual leave will negatively impact their career progression or lead to discrimination from employers,” observes Dr Okamura.

Weak enforcement and low awareness further limit impact. In countries such as Indonesia, where the law exists but is poorly enforced or communicated, many employees remain unaware of their rights.

Employer resistance has also hindered implementation, often driven by misconceptions that all women will take the leave every month — a fear evidence suggests is largely unfounded.

Finally, policies that pressure women to prove their level of suffering through excessive documentation or invasive questioning have been counterproductive, deterring access rather than promoting dignity.

The path forward

For menstrual leave to be truly effective, it must be supported by robust educational campaigns to de-stigmatise menstruation and ensure both employers and employees understand the policy. Strong enforcement mechanisms are essential to prevent the entitlement from existing only on paper.

Equally important is visible leadership commitment to creating workplaces where women feel safe and supported when using menstrual leave.

Flexibility remains key, recognising that menstrual experiences vary widely and that a one-size-fits-all approach may fail to meet individual health needs.