During 2025, Portugal undertook a major legal breakthrough, introducing a measure that intersects health, labor, and gender equality: paid menstrual leave for women with endometriosis and adenomyosis. The law, which came into effect in April this year, grants these workers the right to three days per month of paid absence from work, paid for by the state and without the need for monthly certification, but subject to formal diagnosis by the Serviço Nacional de Saúde.
This seemingly simple regulatory intervention actually has deep roots: it is part of a constitutional framework that includes the principle of substantive equality (Article 13 of the Portuguese Constitution), the right to health protection (Article 64), and the right to just pay and rest (Article 59). No less relevant is the broader normative context in which the reform takes place: indeed, Portugal had already marked a significant turning point with the passage of Law No. 23/2025 against obstetrical violence, which introduced important protections for women’s dignity and autonomy in maternity and gynecological health care pathways. The Portuguese legislature’s choice is as courageous as it is consistent with some of the main guidelines of supranational law.
The measure, in fact, implements the World Health Organization’s recommendations on the management of menstrual pain and chronic gynecological conditions, and can also be read as an indirect application of the principle of “reasonable accommodation” provided for in Article 2(b) of Directive 2000/78/EC. When menstrual pain takes the form of a temporary functional disability, the state is required to take appropriate measures to ensure full employment inclusion by eliminating systemic and social barriers. The Portuguese case thus stands out in comparative attention as an example of law that looks at the specificities of the female body not as an exception to the norm, but as an integral part of a normality to be protected. The body, in this perspective, is not neutralized but recognized in its vulnerability and concrete needs. And it is precisely here that the contrast with the Italian reality emerges forcefully.
In Italy, at present, there is no specific legislative provision on menstrual leave. The only protections accessible to women with conditions such as endometriosis or adenomyosis fall under the general system of sick leave, or under the provisions of Law No. 104 of February 5, 1992, on assistance and disability. However, the application of these regulations is often uneven and burdensome for the female worker: the qualification of endometriosis as a disabling disease is not uniform across the country, the certification burden is high, and there is a lack of a clear framework that obliges companies to set up welfare tools related to menstrual health.
Despite two parliamentary attempts, in 2016 (bill C.3781) and 2022 (C.1700), the introduction of specific leave never reached the House floor. These were isolated initiatives, never supported by real public debate or cross-party political interest. In the meantime, however, other legislatures have moved.
Spain introduced paid menstrual leave for women with dysmenorrhea secondary to gynecological conditions in Law Orgánica 1/2023, fully covered by the social security system. Japan, for decades, has provided unpaid leave, although with little enforcement. Indonesia and South Korea also contemplate hybrid formulas of absence, with important differences between the public and private sectors. These models, while different in structure and degree of economic coverage, signal an evolving international orientation: menstrual health is becoming, in its own right, a legal and social justice issue.
In the Italian context, the absence of an organic discipline today represents a regulatory and cultural gap, all the more evident when read in light of our Constitutional Charter. Article 3 requires the removal of economic and social obstacles that prevent substantive equality; Article 32 recognizes the right to health as a fundamental right of the individual and an interest of the community; Article 37 protects women’s work and imposes conditions that allow the fulfillment of the family function and the full development of the person. In these articles, the possibility of founding a right to menstrual leave is already present in nuce: what is missing is the transition from potentiality to positive norm.
A number of rulings in Italian jurisprudence hint at growing attention to the female perspective in the world of work. The Constitutional Court, in Judgment No. 158 of 2007, recognized the legitimacy of special measures in favor of women to remove structural inequalities. The Supreme Court, in Judgment No. 27313 of 2020, affirmed that the family and personal needs of female workers can also be taken into account when organizing shifts and assessing indirect discrimination. These are still isolated but significant signs: they show how law can – and sometimes should – take charge of social transformations, taking on the body and concrete experience as sites for the production of legal meaning.
Menstrual pain, until now, has been experienced in silence: not named in contracts, ignored in codes, absent from courtrooms. The very word “menstruation” struggles to find a place in legal language, as if it did not belong in law. But law is also language, and what is not named, is not protected. Giving normative space to menstrual health is neither a concession nor a privilege: it is recognizing a reality shared by millions of people, who too often have felt invisible precisely where law should protect them. Looking at Portugal-and before that at Spain-it becomes clear how the introduction of menstrual leave is not a symbolic gesture, but a concrete choice of labor and health policy. It is a way to update labor law, which is still too much anchored in a masculine and linear paradigm, and to affirm a vision of the norm that is more adherent to real life.
The Italian legislature is today called upon to break a silence, to recognize that there are sufferings that are not visible but real, and that deserve full, explicit and dignified protection. It is not just a matter of instituting three days of paid absence, but of affirming a principle: that occupational well-being also passes through the care of women’s health, and that a system that ignores this dimension is, inevitably, partial. In law, listening is part of justice. And a law that knows how to listen to bodies, that knows how to name and protect them, is a better law. Because it is more just, and more humane.
