Women with endometriosis and adenomyosis now have workplace protections in Portugal, marking another step forward in recognizing these painful conditions. The country’s Law 32/2025 gives workers up to three days of paid menstrual leave each month when severe symptoms make work impossible.
What Spain’s Experience Reveals About Menstrual Leave Policies
These aren’t just painful periods. According to the World Health Organization, endometriosis affects 1 in 10 women worldwide and happens when tissue like the womb lining grows in the wrong places in the body. Adenomyosis occurs when this tissue grows into the muscle wall of the womb. Both cause severe pelvic pain, heavy bleeding, nausea, and exhaustion that can make working impossible during episodes.
Spain led the way in 2023 as Europe’s first country to recognize severe period pain as grounds for paid menstrual leave in the workplace. Workers can take three to five days off, but Spanish government data shows only 1,559 people used this benefit in almost a year across the entire country. That’s an average of 4.75 employees per day in a workforce of over 21 million.
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Why This New Approach Could Succeed Where Spain Struggled
The policy requires a doctor’s note and pays only 75% of the salary. Workers need a diagnosed medical condition like endometriosis to qualify. Since endometriosis takes years to diagnose on, many women never become eligible. Those who do get diagnosed must share personal medical information with their employers. These barriers help explain why research shows 40% of women with painful periods skip taking time off work, worried their employers will view them as unreliable.
Portugal learned from Spain’s experience and chose a different approach. While Spain covers all severe period pain, Portugal focuses specifically on diagnosed endometriosis and adenomyosis. This treats medical conditions rather than symptoms, which may encourage more women to seek help. The law took effect on April 26, 2025, requiring only a doctor’s note when workers first request leave for Endometriosis and Adenomyosis.
How the New Law Transforms Healthcare Beyond the Workplace
Research shows many women wait 7 to 12 years before doctors identify endometriosis. Recent 2025 studies from the University of Oxford found genetic links between endometriosis and autoimmune diseases like rheumatoid arthritis, while clinical trials are testing new imaging techniques using molecular markers that could reduce diagnosis time. This delay helps explain Spain’s limited usage since women cannot access help for undiagnosed conditions.
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Portugal’s law creates change beyond workplace leave
The National Health Service must establish new guidelines by June 25, 2025, covering diagnosis, treatment, and medication costs for endometriosis and adenomyosis patients. This addresses the problem from multiple angles.
The economic case is strong. Studies show women with endometriosis earn less money over time and leave jobs more often than others. Businesses lose skilled employees while dealing with more sick days and reduced productivity. Supporting these women benefits everyone.
Portugal joins a growing international movement. Japan started menstrual leave (called seirikyuuka) in 1947, followed by Indonesia, South Korea, Taiwan, Vietnam, and Zambia. Australia’s Queensland state recently introduced 10 days annually for public healthcare workers dealing with endometriosis and menopause.
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How Employers Are Adapting to the New Reality
Employers are adapting to the change. Companies must update their policies while protecting worker privacy and following the new law. Many are going further by offering flexible work options like working from home during difficult episodes. This shows businesses recognize the value of supporting their workers.
Employment critics warn that “if menstrual leave becomes commonplace or even mandatory, menstruators will be perceived as less desirable, higher risk hires. It has the potential to impact opportunities for upward mobility. And there are privacy issues,” since employees must share personal medical information to qualify. Supporters counter that by saying hiding medical conditions forces women to suffer in silence or take unpaid sick days anyway.
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Why Advocates See This Model as the Right Solution
Advocacy groups celebrate Portugal’s focused approach. Endometriosis UK says these conditions should be treated like any chronic illness, not dismissed as normal women’s problems. They believe specific policies work better than general period leave because they recognize the medical reality.
In Jersey, Reform Jersey politician Deputy Carina Alves called for similar legislation after sharing her endometriosis journey. Diagnosed at 19, she underwent several procedures and thought she was cured, only to have symptoms return two years later. For years, she had hidden her pain and made excuses for missing work or events.
Her advocacy gained momentum after an endometriosis awareness event, where she reflected on supporting constituents facing similar struggles. “I wish something like this had been available to show my family, friends, and colleagues what it is like to live with this condition when I was younger,” Alves said. Stories like hers show why this movement matters.
Portugal Shows the Future of Women’s Health at Work
Portugal’s approach to leave for Endometriosis and Adenomyosis offers hope for the future. By requiring medical diagnosis, the law treats these conditions as serious health issues deserving workplace protection. Success will depend on whether Portuguese women feel comfortable using the policy and whether it sees higher usage than Spain’s version.
Portugal’s model combines practical support with healthcare improvements, creating a template other countries can follow. The law shows that societies can evolve to better support women’s health needs while building more inclusive workplaces for everyone.
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