A new policy in southwestern China’s Yunnan province granting women up to two days off for severe period pain has reignited widespread debate over menstrual leave.

Introduced in early November, the measure allows women suffering from severe menstrual pain, or dysmenorrhea, to take up to two days off during their cycle with a doctor’s note. Part of a broader effort to enhance labor protections for women, it also encourages employers to provide additional benefits, such as a hygiene allowance of at least 35 yuan ($5) or the equivalent in products.

The announcement has sparked widespread debate online, with the topic of “menstrual leave” trending on social media platforms like Weibo, where it has garnered over 100 million views.

The debate has exposed a stark gap between the policy’s existence and its real-world implementation. Many women expressed surprise, saying they had never heard of menstrual leave, while others were deterred by procedural barriers, such as the requirement for a doctor’s note, and fears of workplace stigma.

Although menstrual leave has been available since the 1990s, awareness remains low, and implementation uneven. In competitive industries, where taking time off is often frowned upon, many women hesitate to apply out of concern it might harm their career prospects.

In workplaces across the country, menstruation is often treated as a private matter, leaving many women to endure discomfort in silence or manage it discreetly. Some resort to painkillers to get through their workday, while others feel pressured to use their annual leave to rest, forfeiting days that could otherwise be spent on personal or leisure activities.

For Zoey Zhang, the hurdles to taking menstrual leave often render the policy meaningless. Zhang, a 27-year-old working in the fast-paced internet industry in the southern tech hub of Shenzhen, has never used the benefit, which is unpaid at her company. She finds the requirement for a doctor’s diagnosis highly impractical.

“How am I supposed to go to the hospital when I’m doubled over in pain? And what’s the point of going when I’m well enough to leave home?” she told Sixth Tone. “The impracticality of these requirements has made the policy only exist on paper.”

She added that her workplace’s competitive culture makes it difficult to even take annual leave, let alone leave for period pain. She fears that such policies could backfire, giving employers more reasons to discriminate against female employees, particularly in sectors like hers, where layoffs are common.

“Even if the policy became more accessible, I’d worry about how it might reinforce negative gender stereotypes,” she said. “It’s not worth the risk of being seen as less capable or uncommitted because of something like period pain.”

The groundwork for menstrual leave was established in 1993, allowing women with dysmenorrhea to take one or two days off with a doctor’s note. Since then, cities including Beijing, Shanghai and provinces such as Shaanxi and Jiangsu have introduced similar measures.

However, restrictions remain: five provinces limit eligibility to women in physically demanding jobs, and 11 require medical certification to qualify.

Period pain is widespread, with over half of menstruating women experiencing discomfort for one or two days each month. A 2021 white paper on Chinese female health found that one-third of women endure moderate pain, while 10% suffer from severe pain that significantly impacts their physical and emotional well-being.

Societal stigma around menstruation often leaves women reluctant to address their needs, says Cece Zhang, a Shanghai-based entrepreneur who promotes menstrual leave at her health startup. “Some women still feel embarrassed about something as basic as taking a sanitary pad out in public,” she said.

Cece noted that raising awareness is a major hurdle, as many employees are unaware of their options. “I’ve started discussing menstrual leave during onboarding, but even then, some hesitate to use it — either because they feel it’s unnecessary or they’re unsure when it applies.”

However, she added that younger employees, especially from Gen Z, are more confident about exercising this right.

For many employers, concerns about potential misuse and increased labor costs hinder the adoption of menstrual leave, according to Zhang Xue, a lawyer at the Beijing Yingke Law Firm’s Shenzhen office.

One employer told local media that allowing female employees to take two days off each month for menstrual discomfort could add up to 24 days a year — creating significant labor gaps if multiple employees take leave simultaneously.

“Female workers may already require time off for childbirth or a second child. Adding menstrual leave only increases labor costs, which could lead companies to favor hiring male employees,” the employer added.

Addressing these challenges requires a coordinated effort, asserts Zhang, the lawyer. She added that the government must refine legislation and improve oversight to make menstrual leave practical and enforceable. “Employers should support female employees’ needs, while society must work to dismantle stereotypes and foster respect for women’s rights,” she said.

Amid rising social awareness, some employers are taking innovative steps to address the issue.

For Guan Qing’ao, a 26-year-old employee in Beijing, the urgency for change became clear after a severe menstrual episode left her writhing in pain at work, suffering from nausea, dizziness, and vomiting. Her colleagues eventually had to rush her to the hospital.

The crisis prompted her company to introduce menstrual leave, allowing women to take one day off by submitting a screenshot from an app that tracks their menstrual cycle.

The process prioritizes privacy, with requests handled confidentially by the administrative team — visible only to the employee and administrator, not direct supervisors, Guan explained.

“Everyone was thrilled. It felt like an unspoken issue was finally being addressed head-on,” she said. “Menstruation is a natural biological process, like eating or sleeping. It deserves open discussion and systematic solutions. The company’s decision made us feel truly supported and respected.”

Editor: Apurva.

(Header image: PCH-Vector/Getty Creative/VCG)