That this House has considered e-petition 732342 relating to statutory menstrual leave.
It is a pleasure to serve under your chairmanship, Mr Mundell. Please let me thank Michelle, who is sitting in the Public Gallery with her daughter, for creating the petition that has brought us to the debate today. I am honoured to be leading on this issue. Some may ask why a man is leading a debate on women’s health. They may think that endometriosis and adenomyosis are somewhat awkward to speak about in public and that such women’s issues should be reserved for conversations behind closed doors, out of earshot of embarrassed male peers, but that is exactly why we are here today—because women’s health is not just a women’s issue. It is a workplace issue, an economic issue and, importantly, an equality issue.
Endometriosis and adenomyosis are conditions that cause chronic pain as a result of the excess growth of tissue similar to the lining of the womb in areas outside the womb. That results in a range of symptoms, from inflammation to severe pain, fatigue and in some cases infertility. These can be cyclical conditions, with some women feeling disabled for one week a month. Conversely, others experience such pain almost constantly. In the UK, 1.5 million women suffer from endometriosis, and 40% of them suffer additionally with adenomyosis. Both conditions have significant impacts on educational engagement and workplace participation, productivity and progression. Combined, they cost the UK economy more than £8 billion a year. That includes health costs and, of course, loss of work.
However, it is crucial to understand that the loss of time in the workplace has not just economic ramifications. Not being able to go to work can impact one’s self-esteem and individual identity. Twenty-three per cent of women have taken time off work because of period health issues, and one in six with endometriosis leaves the workplace entirely, because of their condition. Even following surgery, many women feel pressured to return to work before they have fully recovered. Despite all the impacts, only one in 10 women believes that her employer provides support for menstruation and menstrual health.
Even receiving a diagnosis of endometriosis in the first place is frustratingly difficult, with the average waiting time being nine years and four months. In half of cases, patients report their symptoms to the GP 10 times or more, and 52% of patients end up visiting A&E at least once.
My first awareness of endometriosis was through my wife, Leah, who lived with the condition from the age of 12 to her 30s. For Leah, obtaining a diagnosis was a long, exhausting and frustrating process. She was told numerous times to simply get on with it or to go and take a paracetamol. Like so many others, she found that her pain and struggle were constantly and continuously dismissed as heavy periods. But endometriosis meant that, as a young adult, Leah had to miss out on school. She lived 12 miles away and could not get home in time if she was having a heavy episode. For fear of embarrassment, she simply chose not to go to school, heavily impacting her education at the time.
Throughout her teens, later in her 20s and even after having two children, Leah suffered the debilitating impact of endometriosis. She would often be close to fainting with the pain, but suffered in silence. Eventually we found a GP who was prepared to do something about it, and Leah was referred to a specialist. Following several procedures, her issues with endometriosis subsided. However, that is not to say that it was straightforward: unfortunately, following a partial hysterectomy, Leah suffered a significant haemorrhage at home, and it was only due to emergency surgery at our local hospital that she survived. Even after diagnosis, there are risks with treatment. Endometriosis has to be recognised as a significant and complex condition. My wife was failed by a system that lacked, and still lacks, a full understanding of the symptoms of endometriosis, and by a culture that overlooks how menstrual health can dominate and affect daily life.
The Department for Work and Pensions “Keep Britain Working” initiative has been crucial in recognising the impact of health on people’s working lives. However, as many colleagues will agree, we have so much more to do. We must include menstrual health, including endometriosis and adenomyosis, in both existing and future agendas, reaffirming the importance of women’s health in the workplace. To do so, we must challenge the related stigma and reflect on policy.
To challenge the stigma, we must strive to understand that endometriosis and adenomyosis are systemic, chronic health conditions that can derail somebody’s life. The lack of awareness of that fact, combined with a taboo surrounding menstrual health, accentuates the suffering of patients, making them feel as though they have nowhere to turn and no shoulder to lean on. With other conditions that affect a similar number of women, such as type 2 diabetes, no such taboo or silence exists. There is a positive acceptance and understanding of the difficulties faced by those with type 2 diabetes—and rightly so. We must replicate that acceptance and understanding in our attitude towards menstrual health.
Following conversations with Endometriosis UK, I support the expansion of the endometriosis-friendly employer scheme and the national workplace endometriosis and adenomyosis pledge, which allow businesses to commit to employer action plans that promote open dialogue, training and understanding of these health issues. Incorporating seemingly little things—such as toilet access, break rotations or even the size ranges of uniforms —into a national framework of practical workplace adjustments can greatly improve the workplace experience of menstrual health, including endometriosis and adenomyosis. As Dr Jasmine Hearn and her colleagues at Manchester Metropolitan University highlight, improving awareness and tackling stigma in this way are key to ensuring justice for women with menstrual health concerns. However, as stated earlier, only one in 10 women believe that their organisation provides support for menstruation and menstrual health conditions. We must increase that number dramatically, and the promotion of the endometriosis-friendly employer scheme is a powerful means to do so.
However, a change in culture alone is not enough; weusb need concrete policy to ensure that workplace accommodation is legally binding. This is where statutory menstrual leave could play a vital role. The Employment Rights Act 2025 ensures that large employers must publish gender equality action plans—a great step in the right direction—but it stops short of directly mentioning reproductive or menstrual health. The Act has made significant progress in supporting menopausal health in the workplace, but we must now expand this to menstrual health more broadly, including endometriosis and adenomyosis. An option would be to give those diagnosed a legal entitlement like that in Portugal, where up to three days of leave per month is permitted. Here, a diagnosis would allow women the flexibility and legal right to have time off work when they are suffering most.
It is important, however, to recognise that endometriosis, adenomyosis and menstrual healthcare are vastly nuanced. A single catch-all policy to address the workplace experience could risk overlooking such complexity with menstrual and reproductive health. We must also recognise that getting a diagnosis in the first place is still a major issue with endometriosis and adenomyosis. Again, the average diagnosis takes nine years and four months, meaning that only 15% of those with endometriosis symptoms have the formal diagnosis that would allow them access to such statutory menstrual leave.
For statutory menstrual leave to work as the petition intends, we must match it with significant improvements in early intervention, diagnosis and GP training on symptoms. This debate marks an opportunity to help ensure that the impact of these conditions on women’s health is no longer ignored. There is an argument for statutory menstrual leave, and for it to sit alongside wider measures that foster awareness and an understanding mindset. We must also challenge the stigma around women’s health by breaking taboos and championing justice for those who, all too often, suffer in silence.
Michelle told me that the petition is not about her; it is about her daughter and all those who will have to battle endometriosis and adenomyosis in the future. By challenging the stigma and reflecting on policy, we can champion the employment rights of those with menstrual and reproductive health complications today and in the future, effecting transformative changes to many people’s lives. I thank everybody for attending this debate, and I look forward to hearing Members’ views.
It is a pleasure to serve under your chairship, Mr Mundell. I thank my hon. Friend the Member for Colne Valley (Paul Davies) for speaking with such compassion and insight, and for sharing Leah’s journey—one I am afraid many will recognise. I am chair of the all-party parliamentary group on endometriosis, which is launching an inquiry into endometriosis in the workplace on 21 April, and I invite colleagues from across the House to attend the event that will be held. We want to hear directly from women and employers about their experiences, including what is or is not working, and about what has to change if we are to better support women to remain in the workplace.
As we have heard, Endometriosis UK operates an endo-friendly employer scheme with certification. Last November, my office signed up to that scheme, which offers guidance and support to run an endo-friendly workplace. I also wrote to my local councils and chamber of commerce to invite them to do the same. I ask all Members to consider signing up and leading by example in their own communities.
Too many women have had their pain dismissed as normal, struggled silently at work or had their careers derailed because a workplace simply was not designed with their health in mind. As a result, one in six women with endometriosis has ended up leaving the workplace—an entirely unacceptable and largely avoidable situation.
It was being elected to this place that made me persist in seeking support for my symptoms, which limited my ability to fully participate in my responsibilities as a parliamentarian—the fatigue and the menstrual flooding, and the constant worrying and planning about what I was wearing and where I would be at any given time. As it turned out, I have adenomyosis, which was discovered only at the ripe old age of 49, as I come to the end of my reproductive life. So I understand the stress, pain and worry that affect millions of women in this country today.
It is a pleasure to serve under your chairmanship, Mr Mundell. I am pleased to take part in this debate and to stand with the 149 women in Sherwood Forest and the 109,000 people in total who signed this petition.
Painful periods are often dismissed as something that women should simply put up with—an inconvenience that is not that bad and happens only once a month—but for thousands of women across the UK, that could not be further from the truth. Every day, women live with chronic pain and exhaustion caused by conditions such as endometriosis. While the petition focuses on endometriosis and adenomyosis, it is important that we also include other, often overlooked conditions that cause severe menstrual symptoms, such as polycystic ovary syndrome. Around one in eight women in the UK have PCOS, and one in 10 have endometriosis. Some, like me, live with both.
Introducing menstrual leave in the UK would be life-changing for so many women. It would allow them to prioritise their health without fear of losing income or facing repercussions at work. Just as importantly, it would send a clear message to employers that women’s health must be taken seriously.
The reality is that women are still not equal in the workplace. They are expected to work through intense pain and fatigue, and remain just as productive, regardless of how unwell they are. Many women worry about the consequences of taking too much sick leave, including lost pay and being penalised or viewed negatively at work. By enshrining menstrual leave in law, we can ensure that employers are unable to penalise women for managing long-term health conditions. It would also create an opportunity to improve awareness and understanding of the real impact that conditions like endometriosis and PCOS have on people’s lives. While symptoms vary, and some women may experience few or none, others suffer severe, debilitating pain that affects their ability to work, study and live their daily lives. For example, PCOS can involve fatigue, pain, irregular cycles and significant mental health impacts, affecting the ability to work.
It is a pleasure to serve under your chairmanship, Mr Mundell. I declare an interest: I have adenomyosis. It took more than 30 years for it to be diagnosed. The average diagnosis time is nine years and four months. For ethnically diverse communities, it is over 11 years.
My story is not unusual. From the age of 14, I repeatedly went to the GP saying, “This isn’t normal.” That is like the 47% of sufferers who visited their GP more than 10 times before a diagnosis, while 70% visited more than five times. We all know what they were told: “You’re making a fuss about nothing”, “It’s normal”, and as we just heard from my hon. Friend the Member for Sherwood Forest (Michelle Welsh), “All you need is a hot water bottle and some painkillers.”
Like so many other young women—80% of them—I was put on the contraceptive pill before any further investigation, and well before I was sexually active. This continued for many years. I once convinced a doctor that the pain was so bad that I should have some kind of exploratory surgery, so they did exploratory surgery looking for endometriosis. They did not look for adenomyosis. After that, I really was told that I was making it up, because they could not find anything.
When I gave birth to my first child, I was in labour for 30 hours. A midwife at the other end of the phone kept saying to my husband, “If she’s able to nap, she’s clearly not having contractions.” I could nap during contractions because I had spent more than 30 years having to sleep with adenomyosis. I learned to have a very high pain tolerance. That baby was delivered in A&E because we got to the hospital so late. Even after being able to describe the pain of my periods being worse than the pain of contractions, not least because they were continuous and did not go away and come back like contractions, I was told that I was exaggerating and that it could not possibly be that bad. They told me that there was nothing they could do other than keep me on the contraceptive pill, which seemed to do nothing.
You will not be surprised to hear me say, Mr Mundell, that it is a pleasure to serve under your chairmanship. I thank my hon. Friend the Member for Colne Valley (Paul Davies) for the way in which he introduced this debate, and other hon. Members for the excellent speeches that followed.
I recently met a constituent who lives in Chesser and has adenomyosis. During our meeting, she told me about the debilitating impact of the condition on her personal life and her work life, and it was a real insight for me. On some days, her pain is so severe that she struggles to walk or move around her home, even to reach the toilet. She also reminded me just how common endometriosis and adenomyosis are: given that around 10% of menstruators suffer from one of the two conditions, there could be thousands of people in Edinburgh South West who currently suffer from the regular and excruciating pain that they cause.
Although my constituent now has an employer who understands and accommodates her health needs and allows her to work from home or take leave for her condition, that has not always been the case. She recounted the degrading experience of having to explain her health issues in detail to a former employer, just for taking time off. Despite that, she was still given a written warning. It is such inconsistency among employers that motivated her to sign the petition and to meet me to ask, very politely, that I attend this debate on her behalf.
As we have already heard, up to one in six women with endometriosis have to leave the workplace due to their condition. For some women, that will be because they really cannot work due to the pain they suffer. Sadly, for other women, who can work and want to work, it may come down to a lack of accommodating workplaces. We have to be honest about that situation and say that it is discrimination.
I recognise the Government’s position that the provisions of the Equality Act 2010 should ensure the flexibility that is required for women affected by these conditions to take leave or for adjustments to be made for them. However, laws are only useful if they are respected and enforced. None the less, I hope that the reforms introduced in the Employment Rights Act 2025, including statutory sick pay, will ensure that further accommodations can be made.
Nine years—apologies. It took just over nine years for a diagnosis to take place, given the pain we have heard about. We have heard in this debate about the real human impact that delay causes. That must be impacting our economy too, so I hope the Government will commit to studying the effect of these conditions on the economy, and perhaps that will justify action in this domain.
It is a pleasure to serve under your chairmanship, Mr Mundell. I thank my hon. Friend the Member for Colne Valley (Paul Davies) for his opening remarks, and for his compassion and solidarity. He is absolutely right that every man should have a say in these issues and challenge them. As well as the fact that nearly half the global population will menstruate at some point in their lifetime, and on any given day 850 million people across the world are menstruating, we are all here because a woman somewhere had a menstrual cycle, so it is a concern for absolutely everybody.
For something so universal, menstruation remains shrouded in coded language, embarrassment and unnecessary shame. We call it “the time of month”, “the painters are in”, “my cousin has come to stay”—anything but what it actually is. We pass around tampons and pads as if they are some sort of contraband that no one should see. That evasion is not accidental: it is the product of centuries of conditioning that told women their bodies were problems to be managed in silence and shame.
Listening to my fellow hon. Friends speaking about their own experience, all I keep thinking is that, if young women had been flagged when they had painful periods, things would have been different for a lot of the conditions we are talking about, certainly in terms of the length of time to diagnosis. I am really pleased to contribute to this debate and support statutory menstrual leave, not as a radical policy but as a practical, compassionate and long-overdue step towards a fairer and healthier working society.
We already see where progress has been made and where things have been championed in this House. I congratulate my hon. Friend the Member for Erith and Thamesmead (Ms Oppong-Asare) on the ten-minute rule Bill she introduced recently and her consistent campaigning for improved endometriosis care. I also congratulate my hon. Friend the Member for Bathgate and Linlithgow (Kirsteen Sullivan) on her work as the chair of the APPG on endometriosis. All that work matters and it is making a difference.
My hon. Friend is making a very powerful point. Does she agree that the impact on women’s mental health is rarely spoken about? Women feel ignored and dismissed, but they are living in constant pain and the anticipation of it, which just wears them down. The mental health point is rarely acknowledged but must be addressed.
My hon. Friend is absolutely right. I say that as someone who lives with endometriosis and constantly experiences that pain, thinking about what I can and cannot do, and what I will be able to manage this week or that week. I know what it is to sit in a meeting, stand through our many votes and carry on a role that demands my full presence when my body is screaming otherwise. I know from listening to other Members and so many different women speaking about it that I am far from alone.
It is not a competition of who receives more health funding, but we have to say that men have won consistently. When my hon. Friend the Member for Milton Keynes Central (Emily Darlington) was speaking, I looked up some figures for the amount of investment into things such as Viagra. Everyone should look at them when they can; they are shocking in comparison with what is spent on certain things in men’s and women’s health. Let us be honest about what that under-investment has cost us: endometriosis alone affects around 1.5 million people in the UK, taking an average of nearly nine years to diagnose, as we have heard. That is not a gap in the system, but a failure of the system; it is a failure rooted in a long-standing tendency to deprioritise women’s pain.
Statutory menstrual leave would allow someone to take time off when they were genuinely unable to work due to menstruation, without fear of judgment, without risking their job security and without having to lie about why they are absent. Crucially, it would also begin to normalise the conversation and to challenge the stigma rather than reinforce it, because the answer to workplace discrimination is never to remain invisible.
As we have heard, menstrual leave policies already exist across the globe: in Japan, South Korea, Taiwan, China, Indonesia, Zambia, Mexico and, most recently, Portugal. They are not fringe experiments, but functioning workplace policies in countries with vastly different cultures and economies. The evidence that this is workable is already there. Here at home, our Employment Rights Act has introduced major reforms, including a day one right to sick pay. Menstrual leave would sit naturally alongside those changes if we were to implement it; it is consistent with the direction of travel and is the next logical step.
It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Colne Valley (Paul Davies) for introducing the debate and I congratulate the lead petitioner on securing more than 109,000 signatures on their petition. That number should stick in all of our minds, because it sends a clear signal that this issue has been ignored for far too long and that the people affected by it are exhausted by the neglect they are feeling.
One of the women affected, a constituent of mine, wrote to me ahead of this debate. She talked about how endometriosis has shaped her life through pain, exhaustion and suffering for far too long. From a young age, she knew that her symptoms were not normal, enduring irregular cycles, severe clotting, chronic pain and debilitating symptoms that were too often dismissed or ignored. She was told that she may never have children, and although she was fortunate enough to have two, she told me that her condition worsened, bringing miscarriages, severe blood loss, iron deficiency, IBS and relentless pain.
My constituent said that, time and again, she would visit the GP, hospitals and specialists, and she was often told—as we have heard many times today—to simply manage the pain. Women with endometriosis are expected to suffer in silence, while their health, careers, families and quality of life deteriorate around them. She told me that she was not asking for miracles; she was asking to be heard, to be taken seriously and to receive the care that she deserves.
My constituent’s testimony is not exceptional; it is representative, and it is backed up with data. Last year, Endometriosis UK found that the average wait time for a diagnosis has now reached nine years and four months. That has gone up significantly in the last six years. During those nine years, the condition progresses, fertility is affected, and women are forced to manage debilitating pain in workplaces, education and at home. Shockingly, 83% of respondents to Endometriosis UK’s survey were told by a healthcare practitioner prior to their diagnosis that they were making a fuss. On top of that, women wait an average three and a half years after first noticing symptoms before seeking medical help at all, largely because severe period pain has been thoroughly normalised in our society. That women wait such a long time before they get their diagnosis is simply not acceptable. We also need to think about women from ethnically diverse communities, whose average time to diagnosis is even longer, at 11 years. The House should find that inequality unacceptable.
It is a pleasure to serve under your chairmanship, Mr Mundell. I thank everyone for their powerful and often personal contributions today. First, I want to recognise Michelle Dewar, the tenacious campaigner behind today’s petition for menstrual relief. She is a great champion for women suffering with endometriosis and adenomyosis, and I congratulate her on securing over 100,000 signatures—not an easy task, but it showcases the strength of feeling from many on this important topic.
Endometriosis is a condition where endometrial tissue, similar to the lining of the uterus, grows in other places such as the ovaries and fallopian tubes. One in 10 women of reproductive age suffer with it, making it the second most common gynaecological condition in the UK. Common symptoms include chronic pelvic pain and heavy menstrual bleeding, making normal activities difficult. It predominantly affects women during their reproductive years. Adenomyosis, an often overlooked condition, has similar symptoms, but is where the lining of the womb starts growing into the muscle in the wall of the womb. It is commonly diagnosed in women over the age of 30, but can also affect younger women, as we heard today. Similar to endometriosis, it affects one in 10 women, with nearly 70% of women waiting over five years to get a diagnosis.
Michelle’s own journey with endometriosis began 24 years ago, causing her to miss school every month from the age of 14. Shockingly, it was not until she was 23, nine years later, that she received a diagnosis. Unfortunately, as we have heard today, her story is far from uncommon, with many women not receiving a timely diagnosis. It takes on average eight years and 10 months from the first GP visit to get a diagnosis.
Women’s symptoms are often dismissed and normalised, leaving them to struggle on with their pain, without treatment, without understanding and without support. The lack of understanding and knowledge of what constitutes a normal period or menstrual cycle also delays women seeking help and can leave family and friends uncertain how to provide support. No woman or girl knows what a normal level of period pain is without input from others, and lack of awareness leads to her not being well equipped to advocate strongly for herself with medical practitioners. We also need to recognise that there is still embarrassment and stigma around talking about periods, which can add to the challenge of getting adequate medical care when something is not right.
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Menstrual leave has gathered support at just the right time, as many of the provisions of the Employment Rights Act 2025 have just come into force. We recognise that the workplace needs to change and that women should not be disadvantaged due to health conditions. The women’s health strategy refresh in England and phase 2 of the Scottish women’s health plan present opportunities to correct the trend that has led to endometriosis and menstrual health being under-researched, undertreated and under-recognised, and diagnosis wait times increasing to a decade or more for some women. I would be grateful if the Minister could assure us that endometriosis waiting times will be the utmost priority in the women’s health strategy refresh.
Although endometriosis affects around one in 10 women, it does not affect everyone in the same way. Some need intermittent time off during flare-ups; others, especially when properly supported, can work consistently, but need flexibility, reasonable adjustments and job security if their symptoms worsen. Prior to this debate, I looked into other countries that have menstrual leave. What that means in practice varies considerably. Vietnam offers a half-hour paid break every day during menstruation; Spain gives up to five days of paid leave for severe menstrual pain, subject to a doctor’s approval; and Portugal allows workers suffering severe and disabling menstrual pain to take up to three consecutive days of paid leave, dependent on the employee providing a medical note confirming incapacitating pain due to endometriosis or adenomyosis.
Legislation that provides for menstrual health is not necessarily a silver bullet, particularly when it relies upon a diagnosis. That would be the opposite of progress. Women with endometriosis do not need a one-size-fits-all policy; they need flexibility, fairness and protection. Too many workplaces automatically trigger action once someone hits an arbitrary number of absences, which is deeply discriminatory. Absence management systems need to change to recognise the chronic and episodic nature of conditions such as endometriosis and adenomyosis, and the accompanying mental physical fatigue from living with persistent pain.
Critically, employees need endometriosis to be treated for what it is: a long-term, whole-body health condition, not a series of isolated sick days. Menstrual leave can be an essential part of the support package, but building stronger rights to flexible work, reasonable adjustments and protection from workplace penalisation is central to any solution. To improve outcomes for women with endometriosis, we need answers that recognise the reality of the condition and help women to stay in work, progress in work and be treated with dignity at work.
That was the reality for me: passing out at sixth-form college in the toilets on a regular basis, experiencing extreme pain to the point where I could not even stand up, suffering migraines, sickness and vomiting, and doing my GCSEs when I could barely see out of my eyes. PCOS and similar conditions are chronic and multi-system, meaning that they do not affect just one part of the body or happen for a short period; they are lifelong conditions that require ongoing management and support, yet they are rarely recognised in workplace support frameworks.
I am pleased that the Government have introduced the menopause action plan. I ask the Minister to go further and introduce a menstruation action plan so that workplaces can start to reflect better the lives of women and the range of conditions they face, and ensure an understanding of the effect of the pain and suffering. Portugal and Spain already have such policies; the UK should too.
Another crucial part of this debate is diagnosis. Menstrual leave alone will not fully support women if it can take years for them to receive an accurate diagnosis. I had to wait over 18 years for my diagnosis, all while trying to manage the symptoms by myself. GPs told me to take paracetamol and put a hot water bottle on my stomach, when I could not even stand up. A diagnosis cannot solve everything, but it unlocks access to the right treatments, and gives women the evidence they need to request reasonable adjustments in the workplace. It gives women an opportunity to do what is right for themselves. Until women’s pain is taken seriously—medically and professionally —true equality at work will remain out of reach for so many.
It was not until I got to the other end with my reproductive health, when I had to go for several scans for menopause ahead of getting treatment for perimenopause, that the scanner said to me, “Oh, you have adenomyosis. That must be really painful,” as an offhand comment. I was bowled over. I said, “What is that? I’ve never even heard of it.” I had heard of endometriosis, but I had no idea what adenomyosis was. She said, “Oh, it’s similar, but it’s growing in your muscle lining.” I could not believe it; I was shocked that from the beginning to the end of my reproductive years—all those years of pain—I never once got a proper diagnosis.
How did that impact my working career? I used to wish my period would start on a weekend, so that I would not have to miss work—I can see some nodding heads. I used to organise my work tasks around my expected period: I would do all the work that took concentration on days I knew would be good days, so that on the bad days I did not have to be productive. I missed about a day of work a month, which used to terrify me at the beginning of my career. I did not feel that I could talk to my bosses about it—I did not have the words to do so—and I had doubts from those doctors telling me that it was not as bad as I thought.
I also want to share April’s story. She is only 24 and she has been going through this for the past 10 years. Her periods were so painful that she vomited. It is like that for many of us: doctors would say, “Take a paracetamol,” and I would say, “That’s great, but I can’t keep it down. I will literally vomit it back up.” April had a Mirena intrauterine device fitted for her symptoms, but she wanted to get it removed. I was shocked by this story: she was told that the strings of her IUD had been cut too short to remove without surgery. When April asked why that was the case she was told:
“We cut the strings short for our younger patients, because we don’t want their boyfriends to find sex with them uncomfortable.”
April had to undergo surgery under general anaesthesia to remove her IUD. She says that, at every stage,
“A decision about my own body—my contraception, my ability to access the removal of my IUD—was shaped around the comfort of a hypothetical male partner.”
She was single at the time.
That is what we are all put through. At no point were any of us told that painful periods are not normal—I am not talking about discomfort; I am talking about pain—even though we know that to be the case. Each and every one of us should know that from the start. This relates to the fact that women’s health information is being shadow-banned online. Over the past year, 95% of women’s health educators were targeted for shadow-banning. That means that people who are trying to get this kind of health information out there are having their posts either blocked or downgraded because of their content. I do not mean to be rude, but that does not seem to happen to posts about erectile dysfunction.
Educators are told by big tech that it has been quietly restricting or hiding women’s health content that contains educational terms like “periods”, “menopause”, “vagina” and “endometriosis” under the guise of safety or because those terms are too sexualised. How are we supposed to create an environment in which not only we as women but our bosses, colleagues and partners, who might be male, all understand that painful periods are not normal, and that the pain is real?
We are seeing improvements in these areas, and I know that we are all looking forward to the women’s health strategy, which many of us have had long conversations about with the Ministers involved. We hope that it will bring about further real progress, but right now, I have a 15-year-old daughter who has all the same symptoms that I had, with all the same pain. I have told her all my tricks, including the use of irritable bowel syndrome medication to reduce some of the cramping—if people in the Public Gallery do not know about that one, it works really well—but our GP says that she is too young to start having such discussions. She is doing her mock GCSE exams this week. I wish her the best of luck, because she has studied really hard, but she is terrified that she will get her period this week and it will mess up those mock GCSEs.
I have given just a few examples; I know that women in the Public Gallery could give many more. We hear the same story over and over, and it all stems from this fallacy that periods are meant to be painful. Painful periods are not normal and we need to repeat that to every woman we know, including every female team member we know and every GP or consultant we know, to make real change happen.
I hope that the Minister will give some guarantee today that the Government will look at menstrual leave schemes abroad to inform the evidence-based best practice that we need in the UK. I also hope that the Government will do what they can to support businesses or organisations that decide to introduce such practice in the interim, simply because it is the right thing to do. I must be honest and say that I had not heard of the endometriosis-friendly employer scheme before, so it would also be interesting to hear what the Government are doing to support that scheme.
The data from the schemes implemented abroad show that they are unlikely to be abused. Although the petition we are discussing today relates to the scheme in Portugal, the introduction of a similar menstrual leave policy in Spain has not led to an avalanche of sick days being taken as a result. Although I know there have been some concerns about how easy it is to access that scheme, the Spanish allowance has been used just 1,550 times. It will hardly have a significant impact on the Spanish economy, but it will be a huge benefit to the women who are able to access it.
Equally, such schemes can help employees avoid having repeatedly to justify in detail absences that they require. With the Portuguese system of requiring only one initial confirmation of diagnosis, employees will likely be spared uncomfortable and degrading conversations with superiors and work colleagues about this medical condition.
I hope the Government will look to the positive impact of those schemes abroad and build up best practice for the UK. I want to make one last point: when I spoke about this debate on my Facebook page, many women who responded said that they were keener for GPs to be better informed about the condition, and for diagnosis to happen much quicker. I could not believe it took just over nine months for a diagnosis to take place—
Scotland became the first country in the world to legislate for free menstrual products, and across the UK we rightly abolished VAT on sanitary products in 2021, finally ending the so-called tampon tax. Steps like those matter, but they are not the end of the journey—not by a long way. Here is the truth: we have made it cheaper to menstruate, but we have not made it safe to admit that someone is struggling because of it.
Menstrual stigma continues to socially condition people to conceal their pain, push through it and stay silent at work. The cost of that silence is not abstract; for those living with endometriosis, dysmenorrhoea, adenomyosis or premenstrual dysphoric disorder, that silence means working through debilitating pain or losing earnings when they cannot, and in some cases losing jobs altogether. Those are real conditions. They are painful and often severe, and they exist within a system where female reproductive health has been chronically under-researched, underfunded and far too often dismissed.
The policy also offers vital protection for those who are too often overlooked, including transgender men and non-binary and gender-diverse people who menstruate. For many, disclosure of menstrual status can expose them to discrimination or worse. A clear statutory framework would provide safety, privacy and the reassurance that their needs were seen and protected by law.
There are those who argue that menstrual leave would undermine women in the workplace, and that employers would discriminate against people who menstruate when hiring. I take that concern seriously, but that argument has been made against every single piece of workplace equality legislation in history: it was made against maternity leave, it was made against equal pay, and it was made against flexible working. In every case, the answer was not to abandon the protection, but to make the legal framework strong enough to prevent the discrimination. That is what we have to do here too.
The ultimate goal is job security, wellbeing and genuine equality. Menstrual leave alone will not get us all the way there, but it is a serious, evidence-backed and compassionate step in the right direction. I urge this House to take it.
This is not just a health crisis. Endometriosis UK estimates that the economic loss to the UK from absenteeism due to severe period pain, heavy periods, endometriosis, fibroids and ovarian cysts is about £11 billion a year. The case for investment in women’s health and women’s support is not just moral; it is economic.
I wanted to touch on a point that Members have made multiple times about the arbitrary hit points for absence in absence management systems. When I was working in the private sector, we had a very similar system: if someone hit three absences within a defined period of time, they would go through an investigation and a disciplinary meeting—just like that. Although there may be mitigations for long-term conditions, the stress of the idea of going through an investigatory meeting because of their long-term condition adds to the cycle of women not wanting to go to their doctor or talk to professionals about what they are experiencing. They have been told for so long to just get on with it and manage the pain, and the absence management system in this sector does not help at all.
The Government’s response to the petition acknowledges the hardship that women are facing, but the action they talk about falls short. Ministers point to the Equality Act, reasonable adjustments and the Employment Rights Act, specifically on flexible working. I want to be clear that the Liberal Democrats support the right to day one flexible working, and we are glad to see these changes coming into force, we think, in April next year. Flexible working genuinely helps people to manage conditions such as endometriosis, and employers should be actively engaged in using it, but it relies on individual employers, and it cannot be a substitute for proper medical care or compensate for decades of misdiagnosis.
Before women can be properly supported in the workplace, they need to be diagnosed, and before they can be diagnosed, healthcare professionals need training. Time and resources need to go into being able to recognise and act on the symptoms. When over half of women with endometriosis are forced to attend A&E before receiving a diagnosis, we know that there is a failure in primary care, and that is adding to the pressure on our hospitals.
We need to invest in GPs and other healthcare professionals to ensure that anyone with long-term conditions such as endometriosis has access to named GPs who know their history and can provide continued support. We also need to make sure that people are actually able to receive a GP appointment and be seen when they need it; far too often, they are unable to do so.
I want the Government to commit to a new target to bring down substantially the average endometriosis diagnosis time, working towards the one year or less by 2030 target that Endometriosis UK is calling for. I also want them to put in place a proper awareness campaign and ensure that National Institute for Health and Care Excellence guidelines are fully implemented across the primary care sector, with standardised referral pathways in place. The Government must also take seriously the role of mental health support, which, after years of pain and dismissal, many women will require. Such mental health support is currently severely lacking.
The petitioners and individuals who signed the petition —100,000 across the country and the many more they represent—are not asking for the impossible. They are asking to be heard, taken seriously and to receive the care that they need. I urge the Minister to match that urgency with her response today.
Recognising the challenges women face in their engagement with the healthcare system, in 2022 the then Conservative Government published the women’s health strategy for England, a 10-year programme committed to improving women’s health. The strategy seeks to address disparities in women’s healthcare and the under-representation of women in medical research. One of the strategy’s eight priority areas is menstrual health and gynaecological conditions, including greater awareness, earlier diagnosis and better treatment of endometriosis and adenomyosis.
As we have heard many times today, all aspects of the lives of women struggling with those conditions and enduring awful pain every month are impacted. It affects their relationships, their overall wellbeing and also their careers, and such debilitating conditions impact on earnings in the long term. Office for National Statistics data published last year shows a drop in monthly earnings among women aged 25 to 54 diagnosed with endometriosis from one to five years after diagnosis, compared with the two-year period before being diagnosed with the condition. Average pay decreased each year post diagnosis, culminating in a £130 monthly reduction in the four to five years post-diagnosis period. Although it is likely that different factors contribute to this change, it is none the less worrying that there is such a statistically significant drop in earnings post diagnosis.
Prompt diagnosis of these conditions is vital and the roll-out of community diagnostic centres will help immensely. Many of my own constituents stand to benefit from the recently opened community diagnostic centre in the Belfry in Redhill, which will deliver much needed extra capacity to perform diagnostic scans. That is exactly the kind of practical measure that can help women to get answers more quickly when their symptoms and pain suggest that something is wrong.
When a woman is suffering symptoms that mean that she is unable to work, the current option available to her is to take sick leave. That option is available to any employee with any condition or illness that leaves them unable to work. It is a broad, non-discriminatory entitlement available across almost all conditions. From 6 April this year, following recent changes by this Labour Government, when a person is unable to work due to ill health, they are entitled to statutory sick pay from the first day of illness. It is also relevant to note that statutory sick pay is now available to all eligible employees, regardless of their earnings.
The current approach to statutory sick pay therefore allows any woman who requires two to three days off every month due to endometriosis or adenomyosis to take the time she needs with sick pay. For that reason, the introduction of a specific menstrual leave is unnecessary as statutory sick pay already delivers what is being asked for. Statutory sick pay is the better mechanism to use, because it does not discriminate or restrict provision to highly specific conditions. Lupus, rheumatoid arthritis, Crohn’s disease, and ulcerative colitis are just a few examples of conditions that are equally debilitating and involve regular flare-ups—so it is entirely right that they are covered too.