Multiple Regions Require Medical Proof for Menstrual Leave to Certify “Severe Dysmenorrhea” or “Excessive Menstruation” – Is This Reasonable? Are There Better Solutions?
Recently, the topic “Multiple regions clarify female employees can take menstrual leave” has become a trending topic again. Currently, 20 provinces and cities, including Beijing, Shanghai, Zhejiang, and Yunnan, have explicitly stated in local regulations that female workers can take menstrual leave, with the rest period generally being 1-2 days, and up to 3 days at most. However, the “painless” implementation of menstrual leave still faces several pain points.
Viewpoint 1: This kind of universal policy relying entirely on subjective judgment essentially enhances the privileges of women employed within the state system while compressing the employment space for women outside it. As for a better solution, I think it would be more practical to allow patients with severe dysmenorrhea to apply for disability certification.
Viewpoint 2: When I was young, people from my grandmother’s generation often called menstruation “routine leave” (例假, lìjià). I didn’t understand why but just followed the habit. Later, I learned that in their time, it actually meant taking leave… I’m not sure if it was “customary leave” or “special case leave”. Regardless of individual physical differences, turning the question of whether one can take leave for menstruation into “proving how severe the pain is or how heavy the flow must be to qualify for leave” is absurd. The act of “bleeding” itself should warrant rest. Half the world’s population bleeds monthly. If any other part of the body bled persistently like this, even without pain, any humane workplace should give you leave to bandage it. Instead of setting up a menstrual leave policy fraught with complications – where some people are in agony but can’t get a sick note without a pathological diagnosis, some exploit loopholes, and inconsistencies arise depending on the job type – it would be better to implement a blanket rule: one day off per month for all women who haven’t reached menopause. Society wouldn’t collapse because of it.
Viewpoint 3: The state gets the good reputation, but the losses are borne by businesses. Businesses aren’t fools. Labor laws have been around for decades, yet overtime work is still rampant.
Viewpoint 4: Unreasonable. If you’re unwell, take sick leave. Creating this specific thing, how many companies would still be willing to hire women? The state sector can do whatever it wants internally, but leave businesses out of it. Businesses have to calculate costs. Maternity leave alone has already put women at a significant disadvantage when job hunting. Instead of figuring out how to balance the interests of men and women, or businesses and employees, they keep singling women out for this and that.
Viewpoint 5: Unreasonable, very unreasonable. The design of menstrual leave is flawed. Vague concepts and mandatory medical proof requirements violate the principle of welfare leave. It doesn’t solve the problem; instead, it creates new hassles and wastes medical resources. If you’re going to grant this leave, just grant it straightforwardly. Simply stipulate that female employees are entitled to 1-3 days of menstrual leave per month, paid at either full salary, 80%, or 50%. Employees will naturally assess whether they need it or if it’s worth taking when requesting leave. Creating this vague concept just creates obstacles and wastes medical resources. This reminds me of when I first started working. Annual leave was only 5 days, but the company offered one day of paid sick leave per month, totaling 12 days a year. You just needed a simple certificate from the community health center. Initially, I felt embarrassed taking sick leave. I wasn’t sick. I didn’t know what reason to give. Later, I noticed some colleagues took their monthly sick leave without fail, regardless of whether they were ill, just to use up the entitlement. I realized: if it’s a company benefit, why not use it? After that, I took sick leave without hesitation when needed. The boss never said anything; work wasn’t that busy, and the pay wasn’t high anyway. Later, I changed jobs. The new company also had paid sick leave, but I never used it. I no longer felt the need to use sick leave, nor did I dare take it casually. The company didn’t require clocking in/out; if something came up, you just informed your manager. Plus, there was 10-15 days of annual leave, which was sufficient. Of course, the main reason was the workload was heavy. Even without clocking in, the work itself demanded your presence to solve problems. Even if you took leave, the work was still there; no one else would cover it. Unless you had a serious illness, like being down with COVID for a week during the pandemic, paid sick leave became useful. Though I recall not even formally taking leave for that week back then. Paid sick leave truly became an unusable benefit. The original intent of any leave, especially welfare leave, is to benefit those who need it. Therefore, it should be granted straightforwardly to those who need it, without setting up various obstacles and demands for proof.
Viewpoint 6: The best solution would be for the state to directly provide subsidies to female employees suffering from dysmenorrhea. This way, companies wouldn’t worry about people exploiting the leave, and employees wouldn’t need to obtain proof. Everyone wins, haha! So, I think the recent childcare subsidy policy is the most effective – just giving money directly is best, avoiding all these convoluted processes in between. Actually, menstrual leave is essentially intended as a benefit for female employees. But since the cost of this benefit is borne by the company, some form of company control is unavoidable. Without controls, every female employee might claim menstrual leave, making management difficult for the company. Plus, for older female employees, you don’t know if they’ve reached menopause – you can’t ask them to prove it… So, the current requirement in many regions for medical proof for menstrual leave has a reasonable side: it helps prevent misuse, ensuring only those with genuine severe dysmenorrhea or menorrhagia can take leave, and lets the company know the employee truly needs rest for health reasons, avoiding excuses for laziness. Moreover, a medical checkup allows women to better understand their health; any gynecological issues can be detected and treated early. However, the unreasonable aspects are the awkwardness and perceived lack of humanity. Dysmenorrhea is uncomfortable enough; going to the hospital for proof means registering, queuing, and exhausting oneself further. Menstruation is private; some women might feel uncomfortable discussing it in detail with a doctor. Also, in an emergency where the pain is unbearable only when it hits, getting proof immediately might be impossible. Of course, there could be better methods, depending on how companies manage things and their willingness to be humane. For example, companies could implement more flexible leave systems: employees verbally inform their manager to take leave first and supplement proof later, or use other forms of proof like past medical records or medication purchase receipts. Employees could also self-record their menstrual symptoms (e.g., pain level, duration) and periodically submit summaries to the company as leave justification. Furthermore, humanely managed companies could raise awareness about dysmenorrhea among managers and colleagues, fostering understanding and making leave requests smoother.
Viewpoint 7: Is this even up for debate? Is this worth reporting? Worth discussing? Isn’t this common sense? Without medical proof, would just saying “I have cramps” be enough? Then it wouldn’t be menstrual leave; it would become privilege leave. No one should have privileges; it’s impossible. People question everything, always looking for devious angles. Requiring proof for genuine dysmenorrhea is the simplest, most essential thing, indispensable forever. Otherwise, it becomes “say one word and get a day off.”
Viewpoint 8: The policy’s intent is good, but I’m not optimistic. Dysmenorrhea is a highly subjective experience lacking an objective medical gold standard. Even if a doctor provides proof, there’s huge individual variation and room for manipulation. From a management perspective, requiring medical proof is an attempt to control the boundaries of the rule, which is reasonable. Because without any threshold, menstrual leave could easily be abused, disrupting normal work operations. After all, businesses need to ensure productivity; they’d rather err on the side of caution than let opportunists slip through. This is the crux: the rule itself also makes it difficult for those truly needing rest due to severe dysmenorrhea. What’s unreasonable is the system itself, compounded by the differing stances of businesses and employees. In reality, female employees suffering the worst pain might lack the strength to even walk, yet they must drag themselves to the hospital to register, queue, see a doctor – all just for a piece of paper. In major city hospitals, appointments might need booking days in advance. Even if you get a same-day slot, spending hours navigating the hospital while in pain is counterproductive. Furthermore, different doctors have inconsistent standards for judging “severe dysmenorrhea.” Some may be cautious, only issuing proof if there’s clear organic pathology. This means women with equally severe pain might get completely different results depending on the doctor. Worse, you might be sweating and saying you can’t bear it, but a doctor glancing at your history, seeing no organic issues like endometriosis, might just wave you off to “go home and drink hot water.” In such cases, getting proper medical advice is lucky, let alone proof. Conversely, requiring proof fosters grey-area practices. For example, having a relative who’s a hospital department head; slip them a carton of cigarettes, ask for a favor, and a proof slip might be easily obtained. In this scenario, rules are only for those without connections; those with connections always find loopholes. Companies won’t play the good guy either. Scrutinizing medical proof is one thing; shifting the cost of menstrual leave onto employees is another – e.g., increasing overall performance pressure, cutting other benefits, etc. Units within the state system might seem more regulated, but unwritten rules exist. One must read between the lines; sometimes rules are rules, sometimes rules are rigid, but human connections and power are flexible. Ultimately, this menstrual leave policy is like an unfinished prototype: wanting to support women but setting a high barrier; wanting to prevent abuse but potentially excluding those truly in need. It will only devolve into this: those in excruciating pain can’t get proof or leave; those with connections get proof easily for an occasional lazy day. Trust between business and employee grows thinner, replaced only by cold processes and calculations. If you ask me, a different approach is needed. For example, directly grant female employees a fixed number of “physiological days” per year (e.g., a few days), no proof needed, based on trust and self-assessment, to be used when genuinely needed – like annual leave. Exceeding these days could be treated as unpaid leave, balancing business and employee interests. If someone still tries to exploit it, colleagues and managers would notice after a few times; workplace reputation is far more effective than any medical proof. But implementing this in today’s work environment is difficult. Bosses fear employees taking advantage; employees fear bosses retaliating. No one wants to take the first step towards trust.
