Paid Period Leave is a Canadian social program paid for by the government to allow menstruators compensated time off to recover from their periods.
W H Y
Menstrual pain can be debilitating and can severely impact the quality of life. For some, the extreme overall, whole-body symptoms prevent them from going to work, school, or having a social life.
Having a low quality of life can lead to anxiety, depression, isolation, and shame.
With paid period leave, a menstruator can recover knowing that their job won’t be lost.
Up to 90% of menstruators describe their period pain as moderate to severe
There is no “cure” for painful periods and endometriosis
A study done in 2005 found that 51% of menstruators said their activities were limited because of period pain, and 17% reported that they missed school or work
Period leave is implemented in several countries, including Spain (most recent), Italy, Japan, South Korea, China, Taiwan, and Zambia.
Companies like Nike, Zomato, and Modibodi support paid period leave
Suffering through pain is not normal, even if it is period pain. If someone is having this experience it should be acknowledged that they are sick, which warrants sick leave. In the workplace many patients are reprimanded for taking off this many sick days so it is imperative (not marginalising) to designate period leave for these individuals.
Dysmenorrhea can only be managed with three options: NSAIDs, HBC (hormonal birth control), and Opioids. However, alternative methods like herbals and cannabis exist.
Many women and people born with a uterus require the use of opioids for their pain management. Not only does this suggest the level of pain would disrupt work tasks, but that the patient is not legally able to use the medications they need while at work.
Many menstruators have heavy bleeding, requiring them to change their menstrual products several times during the day. This is disruptive to the person and everyone around them. It is also uncomfortable - due to stigma - to leave a meeting for this reason.
Many mensturators leak - this is both frustrating and embarrassing to have to endure this at work.
Will women be marginalised? No. Paid period leave is a social program paid for by the federal government. It is not up to the employer to implement paid period leave. Rather, the employer should simply support an employee needing menstrual recovery time. Period leave can be taken discreetly and need not be a sensitive issue. In 2018, a study conducted in the Netherlands looked at productivity loss caused by menstruation and menstrual-related symptoms (i.e. period pain). Here are the results! 1. Absenteeism (period leave): A total of 13.8% (n=4514) of all women reported absenteeism during their menstrual periods with 3.4% (n=1108) reporting absenteeism every or almost every menstrual cycle. 2. The mean absenteeism related to a woman’s period was 1.3 days per year. 3. Presenteeism (being at work during menstruation): A total of 80.7% of the respondents reported presenteeism and decreased productivity, a mean of 23.2 days per year. 4. An average productivity loss of 33% resulted in a mean of 8.9 days of total lost productivity per year due to presenteeism. 5. Notably, 67.7% (n=22 154) of the participants wished they had greater flexibility in their tasks and working hours at work or school during their periods. What were the conclusions of the study? “Menstruation-related symptoms cause a great deal of lost productivity, and presenteeism is a bigger contributor to this than absenteeism” https://lnkd.in/eRsKVppX
What is period pain? There are two types of period pain. Primary dysmenorrhea (period pain) and secondary dysmenorrhea (period pain that stems from a pathology like endometriosis). https://www.glowm.com/section-view/item/9 https://www.femade.ca/pelvic-pain “Primary dysmenorrhea is the cramping pain that comes before or during a period. This pain is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. Prostaglandins cause the muscles and blood vessels of the uterus to contract. On the first day of a period, the level of prostaglandins is high. As bleeding continues and the lining of the uterus is shed, the level goes down. This is why pain tends to lessen after the first few days of a period.” https://www.acog.org/womens-health/faqs/painful-periods
What is the gender pain gap? The gender pain gap is when women –or people who identify as women- in pain have a long history of being disregarded compared to men. Studies over the last two decades have demonstrated that women in pain are perceived as anxious, rather than in pain, and are prescribed pain medications less frequently than men. https://core.ac.uk/reader/56360785?utm_source=linkout The gender pain gap refers to the bias against women when it comes to the assessment and treatment of pain. Simply put, women in pain are often not taken as seriously as men in pain. This directly affects those who have painful, debilitating periods. This gender pain gap isn’t just an inconvenience; it has serious and potentially harmful consequences for women and menstruators. When doctors downplay women’s health concerns, it leads to suffering due to untreated pain, misdiagnoses, delayed or inadequate treatment, and incorrect medicine doses…not to mention the frustration of not being believed (aka gaslighting). https://my-aima.com/blogs/news/what-is-the-gender-pain-gap-why-is-a-woman-s-pain-not-studied-as-closely-as-a-man-s
Gender pain gap affects? Doctors Have Been Downplaying Menstruator (Women’s) Health Concerns for a Long Time Now Evidence of doctors dismissing women’s pain is not just anecdotal; a growing body of research highlights the gender pain gap. A recent review highlighted several studies that show women in pain tend to be perceived as hysterical, emotional, or having psychological rather than physical causes for their pain (Samulowitz et al., 2018). Sexist stereotypes that menstruators are too emotional or tend to exaggerate may be responsible for the tendency of doctors to incorrectly dismiss women in pain. Gender stereotypes result in psychotherapy being more often prescribed for women in pain while the medication is prescribed for men in pain (Zhang et al. 2021). Another possible cause for the gender pain gap is the lack of research funds invested in women’s health. Common issues like period pain and ovarian pain are simply neglected. Until the past few decades, clinical studies have been based largely on men. It should be no surprise then that when it comes to untreated pain, conditions specific to menstruators are poorly understood. https://my-aima.com/blogs/news/what-is-the-gender-pain-gap-why-is-a-woman-s-pain-not-studied-as-closely-as-a-man-s
Examples of gender pain gap? One study found that in the emergency room, women wait an average of 65 minutes before being treated with analgesics, while men wait only 49 minutes, even when presenting an equal severity of acute abdominal pain (Chen et al., 2008). When menstruators do get treatment, they are less likely to receive opiates. This suggests that women’s pain is not deemed to be as severe as men’s pain. A study comparing the treatment of men and women after a specific type of heart surgery concluded that female patients were significantly more likely to be administered sedatives, while male patients were more likely to receive pain medication (Calderone, 1990). Yet another study showed that women experienced a greater delay in diagnosis after the onset of symptoms for 6 out of 11 types of cancer (Din et al. 2015). As is the case for many other types of disparities, women and menstruators of colour are particularly likely to suffer because of the gender pain gap. A review of two decades of published research in the US found that black patients were 22% less likely than white patients to be treated with pain medication and 29% less likely to receive opioids (Meghani et al., 2012). The bottom line is that menstruators have trouble getting equal treatment even when they report more intense pain, more frequent pain, and a greater duration of pain (Hoffman and Tarzian, 2001). Thankfully, there’s a new initiative that aims to close the gender pain gap, starting with period discomfort. https://my-aima.com/blogs/news/what-is-the-gender-pain-gap-why-is-a-woman-s-pain-not-studied-as-closely-as-a-man-s
Primary Dysmenorrhea? Facts and stats from The International Federation of Obstetrics and Gynecology, Global Women’s Medicine. Primary dysmenorrhea usually begins a few hours before or just after the onset of menstruation. The cramps are most severe on days 1-3 of menstruation. Characteristically, the pains are spasmodic in nature and strongest over the lower abdomen, but they may also radiate to the back and the inner aspects of the thigh, and they are often described as labour-like pains. The cramp is commonly accompanied by one or more systemic symptoms, including nausea and vomiting (89%), fatigue (85%), diarrhea (60%), lower backache (60%), and headache (45%). Nervousness, dizziness, and in some severe cases, syncope and collapse can be associated with primary dysmenorrhea. Lasting a few hours to 1 day, the symptoms seldom persist for more than 2–3 days. The first line of treatment is non-steroidal antiinflammatory drugs (NSAIDs) which often help reduce inflammation and decrease pain.
Causes of Primary Dysmenorrhea? The uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger uterine muscle contractions. Research has shown that the menstrual blood of those with painful periods often express different levels of biomarkers that would increase cramping and pain associated with menses, namely prostaglandin PGF2a and leukotrienes which are both inflammatory mediators.(this is from the femade site) https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938
Endometriosis? Sometimes called Secondary Dysmenorrhea. Defined by Femade, Endometriosis is when tissue similar to the uterine lining - the endometrium - grows outside the uterus. Globally, this disease affects 1 in 10 women and those assigned female at birth, though the data suggests that numbers are even higher than this. Patients may develop endometriosis before reproductive age, though the onset of menstruation certainly accentuates the presence of the disease as main symptoms include heavy bleeding, irregular cycles, painful menstruation (dysmenorrhea), cramping, and painful sex. Endometriosis can grow on any organ in the body, typically in the lower abdomen but can spread as far as the lungs and diaphragm. Though there are 4 stages of endometriosis, the severity and location of endometriosis is not correlated with the degree of pain a patient will experience. The majority of patients will experience cyclic pain accompanying their periods. However, if the disease is on an organ and affects its functionality, cyclic pain may become chronic pain. https://www.femade.ca/endometriosis
Causes of Endometriosis? The cause is unknown due to a lack of funding and research on women’s (vaginal) health. If a patient does not respond well to NSAIDS, it tends to point to secondary dysmenorrhea which is painful menstruation due to the presence of a stimulus/disease such as endometriosis and/or adenomyosis. At that point a patient should undergo further testing including imaging such as ultrasound, and should be referred to a specialist for medical management.