For generations, people experiencing severe menstrual pain have often been expected to work through it quietly. In 2025, Portugal took an important step toward changing that expectation.
Portugal introduced a legal right to paid menstrual leave for eligible workers with endometriosis or adenomyosis. The policy recognizes a reality that many people already understand: menstrual pain can sometimes be disabling, and treating it as a legitimate health issue is not the same as treating menstruation itself as an illness.¹
Portugal’s Law No. 32/2025 allows a worker experiencing severe, disabling menstrual pain caused by diagnosed endometriosis or adenomyosis to take up to three consecutive days of justified paid leave per month.¹
To qualify, the worker must provide their employer with medical documentation confirming the condition and associated disabling pain. This documentation does not need to be renewed every month.¹
The law took effect on April 26, 2025, and also created corresponding justified absences for students with these conditions.¹
Importantly, this is not a universal menstrual leave policy for anyone experiencing period pain. Eligibility is tied specifically to medically confirmed endometriosis or adenomyosis and severe, incapacitating symptoms.
The legislation is broader than its menstrual leave provision. It also calls for measures intended to improve timely diagnosis and access to appropriate testing, specialist consultations, and treatment within Portugal’s public health system.¹
Additional provisions address medication coverage and fertility preservation, including access to egg cryopreservation for eligible patients.¹
This matters because endometriosis is a chronic condition that affects an estimated 5% to 10% of reproductive-aged women and is commonly associated with pelvic pain, painful periods, pain during intercourse, fatigue, and infertility.² Adenomyosis can also cause heavy bleeding, severe cramping, chronic pelvic pain, and significant disruption to daily life.³
Severe menstrual symptoms do not stop when the workday begins.
Research involving women with endometriosis across 10 countries found that the condition substantially affected both quality of life and work productivity. Much of the productivity loss occurred through presenteeism, meaning employees continued working but were less able to perform effectively because of pain and other symptoms.⁴
A large study of nearly 33,000 women examining menstrual symptoms more broadly found that presenteeism accounted for considerably more lost productivity than absenteeism. Many participants reported working while experiencing symptoms but functioning below their usual capacity.⁵
More recent population-based evidence also indicates that women with endometriosis experience more sick days, reduced work ability, lower productivity, and more working years lost than women without the condition.⁶
These findings suggest that the choice is not simply between working and staying home. Without appropriate support, many people may remain at work while experiencing pain, fatigue, heavy bleeding, nausea, bowel symptoms, or difficulty concentrating.
A policy that formally recognizes disabling menstrual pain may help validate symptoms that have historically been minimized or dismissed.
It can also encourage more open conversations about endometriosis, adenomyosis, and menstrual health. When employers understand that severe period pain may signal an underlying medical condition, employees may feel more comfortable seeking care instead of assuming they must simply tolerate it.
However, policy alone cannot eliminate menstrual stigma. Research on menstrual health policy warns that poorly designed programs may unintentionally reinforce the belief that menstruating employees are less capable or dependable.⁷
Some workers may also hesitate to disclose a diagnosis to their employer because of privacy concerns, fear of judgment, or worries about career consequences.
Portugal’s policy represents progress, but it does not support everyone living with debilitating menstrual pain.
Because leave requires a confirmed diagnosis, people who are still navigating lengthy diagnostic pathways may not qualify. This is especially important for endometriosis, which is frequently diagnosed only after years of symptoms and repeated healthcare visits.²
The policy also focuses on leave rather than the full range of workplace accommodations that may help employees remain engaged when they are able to work. Depending on the individual, useful supports may include:
Menstrual leave should therefore be viewed as one option within a broader workplace health strategy, not as a substitute for timely diagnosis, treatment, flexibility, or respectful workplace culture.
Portugal is part of a growing international conversation about menstrual health at work. Spain introduced a national menstrual leave framework in 2023, while menstrual leave policies have existed in countries including Japan, South Korea, Indonesia, Taiwan, and Zambia in different forms.⁸
Whether other countries adopt Portugal’s model remains uncertain. Still, the law raises an important question: should someone with severe, medically documented menstrual pain have to choose between their health, their income, and their employment?
Portugal’s 2025 menstrual leave law does not suggest that every period requires time away from work. It recognizes that endometriosis and adenomyosis can produce severe, disabling symptoms that deserve appropriate medical and workplace support.
Real progress will require more than leave alone. It will also require earlier diagnosis, accessible treatment, flexible workplaces, privacy protections, and a culture in which menstrual pain is taken seriously.
For women and people who menstruate everywhere, Portugal’s decision sends a powerful message: working through disabling pain should not be considered the price of participating in public, academic, or professional life.
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