Time of the month. Aunt Flow. The curse. Code red. More than 50 slang terms for a woman’s period allow society to make light of it or avoid talking about it directly. The menstrual cycle is a taboo subject, especially in the workplace.
For many women, however, the menstrual cycle takes a significant toll on their mental well-being and work productivity each month, which makes it a serious workplace issue.
Is Premenstrual Syndrome even real?
Unfortunately, symptoms associated with the menstrual cycle often aren’t taken seriously. For instance, up to 25% of reproductive-aged women experience clinically significant emotional and physical symptoms each month before their periods—or premenstrual syndrome (PMS). Yet some argue that PMS-related mood changes aren’t even real. Instead, they claim that PMS is merely a way for women to excuse their volatile behavior or for men to dismiss a woman’s valid emotions.
In this environment, it’s easy to see why women don’t feel safe speaking up about their menstrual struggles. Indeed, a survey of more than 2,000 UK women aged 18 to 60 found that just 20% of women always tell their managers when their absence is related to their menstrual cycle. Nearly half (49%) never tell their manager.
Menstruation-related symptoms affect most women negatively at work
PMS aside, the majority of women are negatively affected at work by menstruation symptoms, the UK study showed. Of the 79% of respondents who had menstruation symptoms at work, two-thirds experienced a negative impact.
- About one half of respondents had low mood (47%), were irritable (52%) or had fatigue (49%).
- Approximately one quarter had anxiety (25%), forgetfulness (23%), or loss of confidence (22%), and
- Nearly one third of respondents had difficulty concentrating (31%).
Menstrual cycle disorders take an even bigger toll on women and the workplace
For some women and their workplaces, the toll is even greater. These are the women who experience menstrual-related disorders, such as premenstrual dysphoric disorder (PMDD), a more severe form of PMS, or polycystic ovary syndrome (PCOS).
PMDD is emotionally devastating for many women
Women with PMDD, approximately one in 20 of menstruating age, speak consistently of anxiety, hopelessness, a sense of worthlessness, anger, irritability, an inability to sleep, feeling out of control, erratic behavior, relationship conflicts, depression, and difficulty concentrating, among other debilitating mental and physical symptoms. These symptoms show up for one or two weeks each month.
To receive a PMDD diagnosis from a gynecologist or psychiatrist, a woman must suffer from both physical and mood symptoms that disrupt their daily lives and relationships. Unfortunately, due to stigma and trivialization of menstrual-related symptoms, many women wait years for an accurate PMDD diagnosis, which may make negative emotions even worse.
Polycystic ovary syndrome is associated with stress and affective disorders
PCOS is more common than PMDD, affecting up to 15% of women in child-bearing age. A hormone disorder, PCOS causes irregular menstrual periods and is the predominant cause of infertility.
Women with PCOS may also suffer from obesity due to insulin resistance, and acne and excess hair growth due to high levels of androgens, or male hormones. What’s more, studies have shown that women with PCOS may have significantly elevated serum levels of the stress hormone cortisol, suggesting that stress could play a role in the development and effects of PCOS.
Unsurprisingly, living with PCOS symptoms can significantly affect one’s self-esteem and mental well-being. In fact, women with PCOS are up to 4 times more likely to have an affective disorder than women without PCOS.
The impact of PMDD and PCOS on work productivity
A survey of 1,000+ North American people with PCOS showed that PCOS symptoms negatively affect employment for a significant proportion of those with the disorder. The study showed that
- 50% of women with PCOS miss work because of the condition, and the presence of moderate or severe anxiety doubled the risk of missing work.
- 72% said PCOS negatively affects the quality of their work.
- 51.5% said they felt PCOS held them back in their professional lives.
People with PMDD also may have several work challenges, such as trouble remembering deadlines, staying on task, maintaining their quality of work, and sustaining a regular work schedule due to symptoms such as insomnia, anxiety, and headaches.
Employers can do more to support women with menstrual issues
Although there’s growing awareness about the negative impact of menstrual issues on work productivity, few employers offer targeted support. For example, in the UK, roughly 12% of organizations provide support for menstruation and menstrual health, such as offering free period products, paid sick leave, and paid time off for medical appointments.
In addition to your EAP and other health and benefits, consider offering the following types of support to support the mental health and well-being of your workforce:
- Flexible work environments and work hours when possible. The good news is an estimated 68% of US employers offer some form of flexibility in work location.
- 24-7 online access to mental health screenings—such as the Patient Health Questionnaire-9, a screening for depression symptoms, and Generalized Anxiety Disorder-7, a screening for anxiety symptoms. Calm Health, a secure, HIPAA-compliant platform, offers online access to a screening that is a combined version of the PHQ-9 questionnaire and the GAD-7.
- Navigation resources to help employees access appropriate mental health support, such as therapists through their employee assistance program (EAP) or a crisis response line. Calm Health provides links to specified programs from within the app and directs employees to appropriate resources based on their responses to the screening and self-reported goals and interests.
- Access to mindfulness programs. Practicing mindfulness has been shown to be a promising intervention for alleviating stress associated with PMDD and PCOS and for helping people regulate emotions associated with these conditions. A wide range of mindfulness content—breathing exercises, meditations, wisdom, soundscapes, movement, and music—are available in the Calm and Calm Health apps.
- Sleep support. The Calm and Calm Health apps offer a library of Sleep Stories, sleep meditations, soundscapes, and programs from sleep experts to help people fall asleep faster and stay asleep.
- Condition-specific, evidence-based digital mental health support. Your Menstrual Cycle: Tools for Self-Care is a Calm Health program that helps people learn evidenced-based tools for better self-care. The program was developed by Dr. Juli Fraga, a psychologist with deep subject matter expertise in women’s health concerns and trauma.
Employers can also work to create safe spaces
In the face of menstrual taboo and stigma, employers also can work to foster a culture in which women feel safe to discuss the negative impact they experience from menstrual challenges. Employee resource groups and manager training on empathy and mindfulness are two strategies employers can consider.
