Rethinking Reproductive Health at Work: A Policy Pathway to Gender Equity
Globally, reproductive health in the workplace still remains a taboo subject. A team of researchers at Western Sydney University are challenging this. Today’s post spotlights research by Danielle Howe, Dr Michelle O’Shea, Dr Sarah Duffy, A/Prof Mike Armour , outlining a pathway toward greater gender equity in the workplace.
Globally, women and gender-diverse people are working through pain, fatigue, and stigma linked to menstruation, menstrual disorders, menopause, and chronic conditions like endometriosis. Yet, overwhelmingly workplace policies and practices are built around an ideal and disembodied worker unaffected by these bodily realities.
Recent data shows the economic cost of neglecting reproductive health at work. In Australia, the annual economic impact of menstrual symptoms and related conditions is estimated to exceed AUD 14 billion; with endometriosis symptoms accounting for AUD 9.7 billion of that total – mostly through lost productivity at work. The issue is not economic alone. When workers conceal symptoms, push through pain, or take unpaid leave, it reveals the deeper structural and cultural inequities underpinning how labour, health, and care are valued.
A growing recognition, but fragmented responses
Policymakers and employers are increasingly addressing the long-overlooked issue of reproductive health in the workplace. In our 2023 global scoping review of 66 workplace policies and interventions, we found a growing interest in supporting workers managing menstruation, menstrual disorders, and menopause. Despite this interest most policies remain piecemeal; designed in isolation, often without evidence, and are rarely evaluated.
Guidelines supporting workers managing menopausal symptoms dominated, particularly in the UK and Europe, where trade unions and federations have positioned menopause as an occupational health and safety issue. In contrast, few policies addressed menstrual disorders like dysmenorrhea or chronic conditions such as endometriosis, despite their prevalence and impact. When policies existed, they focused on additional leave entitlements rather than broader structural adjustments that can assist employees to remain engaged in work like flexible work, education, or manager training.
Additionally, there is little evidence on how workplace policies are designed or evaluated. Meaning there is limited understanding of why certain policy measures are adopted, if employees are accessing them and whether they make a difference for the employee or workplace.
The promise and pitfalls of menstrual leave
Menstrual leave is often applauded as a progressive policy solution, with Spain’s 2022 law heralded as a landmark for gender equity. However, early data suggest very few workers have used it. Fear of stigma, career repercussions, and workplace discrimination deter uptake.
In our 2025 paper, we argued that policies offering only additional leave risk reinforcing outdated stereotypes. They implicitly frame menstruation and related conditions as problems of the body as conditions best managed by absence (e.g. sick leave), which can have reputational and career progression implications, rather than as signals of workplaces failing to accommodate health needs. Without cultural change, these policies can reproduce the very inequalities they seek to fix.
A more effective approach is to recognise that the issue lies not with individuals, but with workplace systems that are not yet designed to support the health and participation of all employees (largely women and gender diverse peoples). Flexible work arrangements, codesigned policies, and education for managers and staff can support symptom management while reducing stigma. These strategies, when embedded in organisational culture, have been shown to improve both wellbeing and productivity.
From individual adaptation to structural accountability
At the heart of this debate is where the responsibility lies. Too often, managing reproductive health at work is left to the individual to plan, hide, or push through. Reframing reproductive health and wellbeing as a workplace and policy issue redistributes that responsibility, making it one of structural accountability rather than personal resilience.
In the UK, the experience of menopausal symptoms amounts to a disability under the Equality Act 2010, requiring employers to make reasonable adjustments. Endometriosis can also qualify as a disability under both UK and Australian discrimination and employment law. Positioning reproductive health within an occupational health and safety frameworks moves the onus from workers to employers. This approach must be applied carefully as it risks pathologising menstruation and other reproductive health issues reinforcing gendered notions of frailty. The challenge is to balance recognition of health needs with efforts to normalise reproductive health as part of working life.
The evidence gap
Perhaps the most striking finding across both of our studies is how little we know about what works. Few interventions globally have been systematically evaluated. Without data on uptake, outcomes, or unintended consequences, policymakers and advocates are left to act on assumptions rather than evidence.
Evaluation and transparent reporting should underpin and be central to new initiatives. . Building a robust evidence base will help refine policies over time and ensure resources are directed toward strategies that improve gender equity at work.
Building inclusive workplaces for real bodies
Reproductive health policy is not simply about providing extra days off. It is about reimagining what fair, inclusive, and sustainable work looks like when we account for the bodies and lives that constitute workplaces.
When designed and evaluated thoughtfully, reproductive health policies can act as powerful levers for gender equity. They challenge the outdated ideal of the disembodied ideal worker, acknowledge the value of care, and ensure that all employees have the right to participate fully in work.
The path forward lies in codesigning, evaluating, and learning from what works; and in recognising that gender equity at work begins with policies built for everybody.
Moderator: Dr. Cadhla O’Sullivan