Menstrual health is a normal part of working life for millions of women and others who menstruate, but it is still mostly missing from formal policies in higher education. UK universities employ almost 400,000 staff in academic and professional services roles (Higher Education Statistics Agency, 2024), but reproductive health is rarely included in workforce policies or wellbeing plans. That distinction matters.
Why does this gap persist, and what does it mean for those managing menstrual health at work?
Menstrual health can involve a range of symptoms, including fatigue, pain, migraines, mood changes and concentration difficulties. For many women and others who menstruate, these symptoms occur monthly over decades of working life and can influence workplace wellbeing and performance.
Despite this, menstruation is often treated as a private matter between an individual employee and their line manager or absorbed into general wellbeing language rather than addressed through a clear organisational policy.
A persistent policy blind spot
Recent research from the Equality, Diversity and Inclusion Caucus (EDICa) highlights the structural nature of this issue. Drawing on an evidence review, 55 interviews with researchers, and co-design workshops with organisations across the research and innovation sector, the study pinpoints important challenges faced by employees who manage menstruation and related conditions at work (Cocco et al., 2024). For example, the evidence reviews found that most workplace research focuses on menopause rather than menstruation, and that workplaces take a medicalised approach, focusing on “symptom management and its impact on productivity’’ leaving everyday menstrual health comparatively under-examined in organisational policy and practice (Cocco et al., 2024).
A small number of universities have begun to introduce menstrual health policies. Institutions such as King’s College London and the University of Strathclyde have published guidance recognising menstrual health as a workplace issue. However, the overall picture across the sector remains uneven.
Product provision schemes and “period dignity” initiatives are welcome developments, but they are not the same as formal policy. In the absence of clear institutional guidance, support commonly depends on the discretion and awareness of individual managers. What one manager considers reasonable, another may not.
Some governments have begun to address menstrual health through public policy. For example, Scotland’s Period Products (Free Provision) (Scotland) Act 2021 requires public bodies, including educational institutions, to make menstrual products freely available to anyone who needs them.
Menstrual health and workplace performance
The absence of a formal policy does not mean the issue lacks impact.
Research indicates that menstrual symptoms are extremely common and can influence daily functioning. A large study of 1,800 women in Spain, 72.6% reported menstrual pain, with almost 40% stating that symptoms impacted their everyday lives and over a third indicating they would need time off work because of discomfort (Leon-Larios et al., 2024).
In another study employees continue working during symptomatic phases of the menstrual cycle, while experiencing physical discomfort such as fatigue, bloating, anxiety, depression, reduced concentration, etc. (Okamoto et al., 2024). The study shows that work performance declines significantly, particularly among those with more severe symptoms. The issue is therefore not simply one of absenteeism. In many cases, employees remain at work despite symptoms, resulting in presenteeism (working while unwell). While this may protect short-term productivity, it does little to sustain performance or long-term wellbeing.
Universities frequently operate under the assumption of steady productivity. These expectations shape workload allocation, performance standards and everyday academic practice. When menstrual health is not acknowledged inside these systems, employees are left to manage symptoms privately within environments that were not designed with these realities in mind.
Informal solutions in practice
In practice, staff usually rely on informal arrangements to manage these realities. I remember working on a teaching team where several colleagues co-taught large lectures. When someone needed a short break or was managing difficult symptoms, they would ask the group to change the teaching session slightly or swap part of it with a colleague. Others would step in without hesitation.
It worked because the team had flexibility and trust, but the arrangement depended entirely on goodwill rather than institutional policy. Informal support like this can be valuable; however, it also highlights how much responsibility currently falls on individual teams rather than organisational structures.
An overlooked dimension of EDI
The EDICa study also highlights how menstrual health intersects with wider dimensions of equality. Experiences of managing menstruation at work can be shaped by disability, neurodivergence, race, cultural expectations, as well as gender identity (Cocco et al., 2024).
Researchers described additional barriers for those managing long-term health conditions or coping with cultural stigma surrounding menstruation. These findings reinforce the idea that menstrual health is not simply a medical issue, but one shaped by workplace culture and organisational design.
Moving from awareness to organisational practice
Encouragingly, real change does not necessarily require complex new frameworks. The EDICa research finds a number of practical interventions organisations can implement to improve support for those managing menstrual health at work. These recommendations are reflected in both the published research and a recent professional workshop delivered by the same organisation including:
- training for line managers and HR on reproductive health
-
clearer organisational policies outlining available adjustments. For example, flexible working arrangements that allow employees to manage symptoms while sustaining productivity
-
development of a menstruation toolkit (practical resources to support menstrual health)
-
improved workplace facilities and access to appropriate hygiene provisions
- inclusion of male colleagues in awareness initiatives to reduce stigma and develop a more caring workplace culture
- greater recognition of presenteeism, ensuring that reduced performance linked to menstrual symptoms is acknowledged rather than overlooked
- develop and publish menstrual health action plans, in line with emerging UK expectations for larger employers to formalise support for gendered health issues.
A moment for policy development
HE has shown that it can respond to emerging workplace issues when there is sufficient recognition of their impact. The development of menopause policies across the sector is one example of this.
Menstrual health presents a similar opportunity.
As universities update their reproductive health policies, giving similar attention to menstruation is a logical next step. This would not mean major changes to the organisation. It would simply acknowledge a normal part of working life that affects many people in the academic community.
The real question is whether higher education is ready to treat menstrual health as a workplace issue, or if it will keep leaving staff to handle it on their own.
References
Cocco, C., Sang, K., Morgan, C., Wedgwood, B., & Ali, N. (2024). Recommendations for improving support for researchers managing menstrual health. Heriot-Watt University. https://doi.org/10.17861/ZPJJ-N584
Higher Education Statistics Agency. (2024).
Higher education staff statistics: UK higher education workforce. https://www.hesa.ac.uk
Leon-Larios, F., Silva-Reus, I., Puente Martínez, M. J., Renuncio Roba, A., Ibeas Martínez, E., Lahoz Pascual, I., Naranjo Ratia, M. C., & Quílez Conde, J. C. (2024). Influence of menstrual pain and symptoms on activities of daily living and work absenteeism: A cross-sectional study. Reproductive Health, 21(1), 25. https://doi.org/10.1186/s12978-024-01757-6
Okamoto, M., Matsumura, K., Takahashi, A., Kurokawa, A., Watanabe, Y., Narimatsu, H., & Yoshida, H. (2024).
The association between menstrual symptoms and presenteeism: A cross-sectional study for women working in central Tokyo. International Journal of Environmental Research and Public Health, 21(3), 313. https://doi.org/10.3390/ijerph21030313