Maria Elena's period can sometimes be a pain. The 20-year-old has anemia, and menstruating often leaves her feeling weak. Sometimes, she even passes out. "Normally, I can deal with it, but there’s certain days when even talking to someone is hard," the Los Angeles-based freelance writer tells SELF. "It would be better to have that time off than just being at work and making it worse for everyone else."

But that was difficult when her prior jobs only offered a certain number of sick days. "I have taken sick days for my period before," she says. "I had a job a few years ago at Disneyland and we had a certain amount of sick days. It was kind of unfortunate because everyone got the same amount of days, and I would have to use them for my period. When I got the flu, I didn’t have as many sick days left."

Last week, UK social enterprise company Coexist announced they're creating a "period policy," which will allow women employees to take time off while menstruating. The news sparked a debate among women: Should a menstrual leave policy be a regular thing in offices? Japan has had a nation-wide plan in place since 1947, according to the Atlantic, and Taiwan, South Korea, Indonesia, and parts of China have similar policies, too. Off the bat, the idea of "paid menstrual leave" in the workplace might sound like a brilliant idea—but it's not that simple.

According to the American Congress of Obstetricians and Gynecologists, more than half of women who menstruate experience some pain for one to two days each month. Pain associated with menstruation is called dysmenorrhea, and, for 20 percent of women, it can be severe enough to interfere with daily activities, according to the American Academy of Family Physicians. It falls into two categories: primary dysmenorrhea and secondary dysmenorrhea. The first is more common, and consists of cramping in the lower part of the abdomen around the time of menstruation. It's caused by prostaglandins, a natural chemical made in the lining of the uterus, which triggers the uterus to contract. For some women, the cramping can feel as painful as passing a kidney stone.

Secondary dysmenorrhea is a "disorder in the reproductive system," according to the ACOG, and may begin later in life. Some of the conditions that fall under this category include endometriosis, adenomyosis, and fibroids. Actress and writer Lena Dunham recently opened up about her painful experience with endometriosis—a condition where the lining of the uterus grows elsewhere in the body—and it's even kept her from working.

"So many women with this disease literally don't have the option of time off and I won't take it for granted," she wrote in an Instagram post explaining why she took a recent leave from work because of the condition. It's estimated that 6 to 10 percent of women in the U.S. who are of reproductive age have endometriosis. Pain relievers and birth control can often ease the pain of dysmenorrhea, though secondary dysmenorrhea sometimes requires surgery.

It's the side-effects and often debilitating nature of menstruation that has many women, like Elena, pro-menstrual leave. Elena argues that women get migraines, the flu and other ailments that require a sick day just like men, but a woman's period is a monthly occurrence that men don't deal with, and it calls for a couple extra days off.

"I don’t think it would hurt for a few days more a year," she says. "Women all over the world have to deal with their period."


"If we insist that one group or another has an extra set of costs associated with their employment then we’ll end up seeing the wages of that group fall relative to groups that don’t have those associated costs," he writes. "The provision of paid menstrual leave will act in exactly this manner."

Worstall estimates that if one day off a month is added for menstrual leave, "we would expect female wages to fall by 1/22 or 1/23 relative to those of men (or of post-menopausal women)."

Then, there's the question of if women will actually take the time off. In Japan, a fear of "social stigma" causes many women to just request regular time off rather than menstrual leave, fearing the attention of their male co-workers, the Guardian reports. Menstrual taboo is a serious issue across the world, and many women don't like talking about their period unless they're with a healthcare provider.

Katy Waldman, a writer for Slate, argues in her opinion piece, titled "Thanks, But We Will Pass On Paid Menstrual Leave," that companies should accommodate women with a fair sick-leave policy that has enough days off for menstruating and non-menstruating employees, rather than predetermined "menstrual leave" days, which could unnecessarily "pry" into the pants of women.

"We definitely don’t deserve the added attention to—or annoyingly reverent theorizing around—our ovaries. They will be fine!" she writes. "Give us plenty of paid sick leave for those days when we 'are hunkered down under four blankets in soul-crushing pain,' as one of my colleagues puts it."

Amelia Costigan, director of nonprofit Catalyst—which works to accelerate progress for women in the workplace—says a menstrual leave policy isn't a great idea. She calls the policy benevolent sexism, and, while it's designed to help women, it would actually undermine their ability to compete in the workplace. She suggests companies should provide ample flex time, and there shouldn't be a need to explain why women or men are using it.

"When you start using the 'why' then people start getting judgment," she tells SELF. "If somebody has to manage their personal life that’s their personal life, and an organization should trust that person is going to get the work done and they’re accountable for it."

So, are menstrual leave policies a good idea? It's unclear. Women deserve to take time off when they're not feeling well—whether it's from their period or the flu—and have the sick days to accommodate for both. They also need more flex days, period, so they can have enough personal days for any host of reasons, like doctors appointments or their kids falling ill. But, women shouldn't have to sacrifice equality in the workplace. It all depends on the type of policy, how it would work in an office—would you have to announce it's menstrual leave to your entire team?—and how the employer would treat women under such a plan. Either way, the debate around this gets people talking about how much periods can affect women. That's a good start to lessening the stigma around the topic.

And, policy or not, Elena argues that women will still take the time off they need.

"Whether we get [menstrual leave] or not I’m still going to take the time off anyways," she says. "Whether you put it on paper and say this is going to happen or not, women are still going to be taking that time off."

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