This is a big part of the problem: ‘all or nothing’; ‘gotta be in the office’. Sometimes people might be well enough to work from home but not well enough to get to the office for instance.

It’s also that even time off can be difficult to get, because of a lack of acknowledgement of variability in menstruation. I have seen way too many situations where a manager (or whoever is responsible for okaying time off) underestimates how bad it can be for some people, possibly because no-on close to them has bad periods, so they think that everyone who struggles is playing it up for time off work.

Something that really icks me out is that there have been a few times where I have been used as a comparator to shame colleagues; I have always been blessed with light and pain free periods, and when I was on hormonal contraception, they actually stopped entirely. This meant I never needed time off for menstrual reasons, and this was used to sort of say “well Ann presumably menstruates and just gets on with things, so why can’t you?”. Many of us have had the experience of asshole managers who micromanage employee sickness and are exhausting to deal with, but there’s a subset of those who are extra assholish around menstruation related sicknesses. Something I’ve seen once was someone who seemed to be tracking the periods of her employees, and would call up to query times if you had taken period related time off and it didn’t fit into her predictions. I can only assume that she was fortunate to have super regular periods, but many people who do suffer enough to need time off work can’t predict their periods to that degree of accuracy.

But as others have said, it’s not just about time off, but sometimes it’s small stuff like taking additional or longer bathroom breaks. Or, when someone has come back from a menstruation related sick day, jokes like “you feeling better? Great, just make sure you don’t bleed on the chair, haha”, to the entire office. Obviously that’s inappropriate and the kind of thing you’d report to HR, but it’d be less prevalent if people were less weird about menstruation in general.

In a way, I appreciate your being confused by this, because if more managers thought about this like you do, this wouldn’t be nearly as big of an issue. But way too many people make it weird.

A lot of people don’t get enough paid sick leave to cover 1-2 days off a month (maybe more depending on medical conditions like endometriosis). I know people that have to take unpaid sick days because of this, and others that take a lot of pain meds to be able to get through the work day. I’m fortunate that I do get more sick days than a lot of people in Canada but I still don’t get enough to cover a day every month plus any additional I need to take for appointments, migraines, illness, etc.

I also can see the stigma these workers receive when they’re so frequently absent from work, and a flexible work arrangement could help reduce that.

People can’t afford to just take unpaid sick leave all the time, and when they’re passed up for job opportunities because they’re “unreliable” then that also doesn’t improve their financial situations.

For most people who menstruate, they bleed for around 7 days but that’s not the number of days spent in pain, which are typically 1-3 days with varying levels discomfort. Peak discomfort may only be for a few hours when appropriately treated. Flexibility here might include working from home if an option, where you can be under a heat pack and well medicated, up to time off (partial days off here can be important!). People who need to take multiple days off a month for this 1) probably would do it anyway and maybe call it a headache or something else instead, and 2) may need further medical care and attention (that they may be able to receive if they aren’t spending all of their sick time on this one issue).