It Matters—PERIOD!

By Isabel Molina, RN, MSN, PMHNP-BC

Periods are a paradox. For something that is so biologically essential, they feel like an impossible hurdle to overcome every single month. If you’ve ever been curled up in pain, battling brain fog while trying to meet a deadline, or explaining to someone why “pushing through” just isn’t an option, you’ll know what I mean. At one point in my life, I resented being a woman because of it. How can the world expect so much from us when even existing feels like an Olympic sport during that time of the month? This not only affects individual women but also has a significant impact on workplace equity, a crucial issue for policymakers to consider.

Now, as a mental health nurse practitioner and aesthetic injector, I’ve had the privilege of connecting with countless women. What I’ve learned shocked me—not just because of the severity of what many endure but because of how little we talk about it. Heavy bleeding that keeps women housebound. Premenstrual dysphoric disorder (PMDD) that feels like a monthly mental health crisis. These aren’t rare exceptions; they’re unaddressed realities for millions. The good news? Some countries are finally waking up to the need for change.

Menstrual Leave Policies Around the World:

These nations are leading the charge, proving that menstrual health is a workplace issue:

• Spain: In 2023, Spain became the first European country to implement paid menstrual leave for women experiencing severe pain. Costs are covered by the state, and leave duration is based on medical advice.

• Taiwan: Women receive three days of paid menstrual leave annually, without affecting other leave entitlements. These days are paid at half the regular daily wage.

• Zambia: Under the "Mother’s Day" policy, women can take one fully paid day off each month without requiring prior notice or medical documentation.

• Indonesia: Labor laws allow women two days of menstrual leave per month, though implementation is inconsistent.

• South Korea: Women are entitled to one day of menstrual leave per month. It’s paid in the public sector but typically unpaid in private settings.

• Japan: Since 1947, Japanese law has permitted women to take unpaid menstrual leave if they experience difficulties working during their period. Employers cannot penalize them for doing so.

These policies aren’t perfect, but they offer a much-needed foundation. They recognize what’s been dismissed for far too long: women need support to perform at their best.

The Struggle Is REAL:

Let’s break down the facts. Menstruation isn’t just “a bad cramp” for many women:

Dysmenorrhea (Painful Periods):

• Affects 50-90% of menstruating women.

• Severe cases impact daily activities for 10-15% of women. 

• Heavy Menstrual Bleeding (Menorrhagia):

• Affects 10-30% of reproductive-age women globally.

• Often leads to fatigue, anemia, and missed workdays. 

  
  

Premenstrual Dysphoric Disorder (PMDD):

• Affects 3-8% of menstruating women worldwide.

• Symptoms include severe mood swings, anxiety, and depression, significantly impairing relationships and work productivity. (American Psychiatric Association, DSM-5, 2013)

For millions, menstruation isn’t just an inconvenience—it’s a debilitating experience. And yet, the global narrative often frames it as something women must silently endure.

The Global Cost of Ignoring Menstrual Health The economic and social impact is staggering:

• Productivity Loss:

  • Up to 20% of women report missing work or school due to menstrual pain or heavy bleeding.

  • On average, menstrual-related disorders account for 9 days of lost productivity per woman annually. (BMJ Global Health, 2019)

• Healthcare Costs:

  • Managing conditions like dysmenorrhea and PMDD contributes to billions in healthcare expenses worldwide.

These statistics tell a clear story: ignoring menstrual health isn’t just bad for women—it’s bad for economies, workplaces, and society as a whole.

The Mental Health Connection: PMDD and Beyond

Women with PMDD are particularly vulnerable. The condition, marked by severe emotional and physical symptoms, is linked to:

• A 35-50% higher risk of postpartum depression compared to women without PMDD.

• Postpartum anxiety and obsessive-compulsive symptoms, creating a cycle of ongoing mental health struggles. 

These aren’t isolated challenges—they’re systemic issues that demand systemic solutions.

What Needs to Change:

1. Global Adoption of Menstrual Leave Policies Paid menstrual leave, as seen in Spain and Taiwan, must become a global standard. This isn’t about giving women “special treatment”; it’s about workplace equity and dignity.

2. PMDD Screening and Education

3. Early diagnosis of PMDD can prevent long-term mental health impacts. Public health campaigns should teach women to recognize symptoms and seek help.

4. Invest in Menstrual Health Research

5. Despite progress, research into menstrual disorders remains underfunded. Policymakers must prioritize funding for treatments that address women’s needs comprehensively. More research is needed to fully understand and effectively address the impact of menstrual health on women's lives and the economy. Normalize Conversations About Menstrual Health

6. Stigma fuels silence. The more we talk openly about these challenges, the more we empower women to advocate for their needs.

Without Women, The World Stops

Our bodies carry humanity forward—literally. Yet, we’re expected to bear immense physical, mental, and emotional burdens with little acknowledgment or support. That must change.

Menstrual health isn’t just a women’s issue—it’s a global priority. By embracing policies that support women during their periods, we can create a fairer, healthier, and more equitable world. It’s time to take action—PERIOD.