Ask and look around. Among family and friends. No two persons have the same experience when it comes to menstruation. For some, it passes without pause. For others, it’s endless days of pain. The menstruation cycle involves a person’s brain, ovaries and uterus as they work in tandem, creating changes in skin, hair, bowels, existing chronic disease symptoms, migraines, headaches, libido, and more. “Sure, 80 per cent will not have any pain,” says Dr Kiran Coelho, a leading gynaecologist and an advocate of women’s reproductive health. “But 20 per cent have debilitating pain. Premenstrual tension is also so severe, that it’s sometimes classified as PMDD, or Prementrual Dysphoric Disorder. I often have to administer oral contraceptives [for pain relief], because otherwise some would have to be hospitalised every month,” she says.
In May 2022, the Spanish government approved a menstrual leave bill that grants workers the right to take paid sick leave due to severe menstrual pain. Japan has had this law since 1947, although it remains largely underutilised. In Singapore, there currently exists no such policy or law, although a survey conducted by period care brand Blood found that 71 per cent of 1000 women surveyed in Singapore admitted to feeling pressured to remain at their workplace when suffering from period pain.
“When people who are more empowered make space for more empowerment, it does trickle down to women who are not as empowered,” says Dr Tanaya Narendra, aka Dr Cuterus on Instagram, the very popular ‘millennial doctor’ spreading awareness about women’s reproductive and sexual health.
“The reason why periods hurt is because we release prostaglandin,” explains Dr Narendra. “It’s essentially juicing your uterus like a lemon. Squeeze your arm like this intermittently, for three days straight, and it’s going to hurt. I want people to care about period pain because it can be extremely painful for some.” Sometimes, the pain is an indication of endometriosis, a condition where tissue grows outside the lining of the uterus, resulting in excruciating pain. Most women remain unaware and don’t seek medical help. Often doctors themselves remain unaware. “I think the most recent estimate I read was that 11 per cent of the world population experiences endometriosis,” says Dr Narendra.
It can be argued that menstrual leave can be adjusted against existing medical leave. It can also be argued (and prominent women have tweeted as much) that menstrual leave simply ‘ghettoizes women’. Both cases miss the point that menstrual leave gives space to have conversations about women’s reproductive health, which continues to be stigmatised. Dr Coelho says practically, “Menstrual leave will create conversation around taboo topics. Around women and pain, that is largely ignored. We can avoid medical issues going undiagnosed because of it.”
Culturally, we are brought up taught about the usual inevitability of the menstrual cycle and the accompanying pain as a matter of fact. Menstruation might be the most normal process for certain human beings, but the experience cannot be generalised. By denying menstrual leave, equating it with general medical leave, or to think of menstrual leave as diminishing our capacity and productivity is playing into the same thinking that diminishes women’s pain across the world. Therefore, to assume that menstrual leave should be a matter of debate based on the experiences of any one woman is well… shortsighted.
This story originally appeared on Vogue India.