Menstrual leave in Portugal rewrites the rules of women's health It's time to set an example in Italy as well
In recent years, the topic of menstrual health has gained more visibility in public discourse, shedding light on an often-overlooked issue: the pain and discomfort caused by menstruation and its impact on daily life, particularly in the workplace. Portugal has made a significant breakthrough with the implementation, starting April 26, 2025, of Law No. 32/2025, which for the first time introduces paid menstrual leave for individuals diagnosed with endometriosis or adenomyosis.
Portugal’s menstrual leave model: an innovative and comprehensive law
The Portuguese menstrual leave law allows up to three days of absence per month from work or school for those with a certified clinical diagnosis of endometriosis or adenomyosis, without loss of pay and without the need to present a doctor’s note each time. A single medical diagnosis is enough to activate this right, marking a true shift in the approach to menstrual health. The law not only formally recognizes menstrual pain as a health and labor issue, but also expands public healthcare services. Portugal’s National Health Service is now required to ensure free diagnoses, accessible treatments, and reimbursement for medications related to the conditions. A particularly forward-looking aspect of the law is the inclusion of access to egg cryopreservation for affected individuals — a key support for reproductive health and family planning. Within 90 days of its approval, national health guidelines will be established to ensure consistent and correct application across the country.
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A tangible right that protects dignity and privacy
The Portuguese law also stands out for its protection of privacy and dignity: no medical certificate is required for each absence, which helps avoid constantly exposing one’s personal health condition. This is crucial, considering how menstrual pain has long been a taboo subject, confined to the private sphere and often ignored in the professional world. With this legal recognition, people with these conditions are no longer forced to choose between working through physical suffering or facing economic and social consequences for taking time off.
Challenges and criticisms
Despite its progressiveness, the law still faces challenges rooted in deep-seated cultural norms. First, it applies only to those with a certified diagnosis of endometriosis or adenomyosis, excluding many who suffer from debilitating menstrual pain without formal medical documentation. This can lead to unequal treatment and leaves many real needs unmet. Furthermore, experiences from countries where menstrual leave is already in place - such as Japan, South Korea, and Indonesia - show that actual usage is often low. Social stigma, fear of discrimination, and the perception of being seen as “weak” or “unreliable” can prevent individuals from exercising this right. In Portugal, prior to the law’s approval, critics warned that it might make employers less inclined to hire people of reproductive age, fearing added costs or absenteeism. For this reason, the law must be accompanied by awareness campaigns and a broader cultural shift in how women are viewed in the workforce.
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Beyond Portugal: menstrual leave around the world
Portugal isn’t the only country moving in this direction. Spain introduced a three-day leave in 2023 for those suffering from primary dysmenorrhea, while several Asian countries including Japan, South Korea, Indonesia, and Taiwan have long offered menstrual leave. However, even in those contexts, the right often goes underused due to the social and cultural biases previously mentioned. Meanwhile, Italy still has a pending bill under parliamentary discussion and a few pilot programs, but no official or structured policy in place yet.
Toward a new culture of menstrual health
Menstrual leave marks a significant achievement but is just a first step toward a more inclusive and equitable society. To make the law truly effective, it is crucial to fight stigma and discrimination, to educate and inform both workers and employers, and to extend access to those who suffer severe menstrual pain without a formal diagnosis. As stated by the Portuguese Presidency: “Recognizing the clinical and social specificities of often invisible and neglected conditions is a democratic duty.” Only then can we break the taboo and ensure health, dignity, and rights for all people who experience menstruation.