I beg to move, That this House has considered e-petition 732342 relating to statutory menstrual leave. It is a pleasure to serve under your chairmanship, Mr Mundell. Please let me thank Michelle, who is sitting in the Public Gallery with her daughter, for creating the petition that has brought us to the debate today. I am honoured to be leading on this issue. Some may ask why a man is leading a debate on women’s health. They may think that endometriosis and adenomyosis are somewhat awkward to speak about in public and that such women’s issues should be reserved for conversations behind closed doors, out of earshot of embarrassed male peers, but that is exactly why we are here today—because women’s health is not just a women’s issue. It is a workplace issue, an economic issue and, importantly, an equality issue. Endometriosis and adenomyosis are conditions that cause chronic pain as a result of the excess growth of tissue similar to the lining of the womb in areas outside the womb. That results in a range of symptoms, from inflammation to severe pain, fatigue and in some cases infertility. These can be cyclical conditions, with some women feeling disabled for one week a month. Conversely, others experience such pain almost constantly. In the UK, 1.5 million women suffer from endometriosis, and 40% of them suffer additionally with adenomyosis. Both conditions have significant impacts on educational engagement and workplace participation, productivity and progression. Combined, they cost the UK economy more than £8 billion a year. That includes health costs and, of course, loss of work. However, it is crucial to understand that the loss of time in the workplace has not just economic ramifications. Not being able to go to work can impact one’s self-esteem and individual identity. Twenty-three per cent of women have taken time off work because of period health issues, and one in six with endometriosis leaves the workplace entirely, because of their condition. Even following surgery, many women feel pressured to return to work before they have fully recovered. Despite all the impacts, only one in 10 women believes that her employer provides support for menstruation and menstrual health. Even receiving a diagnosis of endometriosis in the first place is frustratingly difficult, with the average waiting time being nine years and four months. In half of cases, patients report their symptoms to the GP 10 times or more, and 52% of patients end up visiting A&E at least once. My first awareness of endometriosis was through my wife, Leah, who lived with the condition from the age of 12 to her 30s. For Leah, obtaining a diagnosis was a long, exhausting and frustrating process. She was told numerous times to simply get on with it or to go and take a paracetamol. Like so many others, she found that her pain and struggle were constantly and continuously dismissed as heavy periods. But endometriosis meant that, as a young adult, Leah had to miss out on school. She lived 12 miles away and could not get home in time if she was having a heavy episode. For fear of embarrassment, she simply chose not to go to school, heavily impacting her education at the time. Throughout her teens, later in her 20s and even after having two children, Leah suffered the debilitating impact of endometriosis. She would often be close to fainting with the pain, but suffered in silence. Eventually we found a GP who was prepared to do something about it, and Leah was referred to a specialist. Following several procedures, her issues with endometriosis subsided. However, that is not to say that it was straightforward: unfortunately, following a partial hysterectomy, Leah suffered a significant haemorrhage at home, and it was only due to emergency surgery at our local hospital that she survived. Even after diagnosis, there are risks with treatment. Endometriosis has to be recognised as a significant and complex condition. My wife was failed by a system that lacked, and still lacks, a full understanding of the symptoms of endometriosis, and by a culture that overlooks how menstrual health can dominate and affect daily life. The Department for Work and Pensions “Keep Britain Working” initiative has been crucial in recognising the impact of health on people’s working lives. However, as many colleagues will agree, we have so much more to do. We must include menstrual health, including endometriosis and adenomyosis, in both existing and future agendas, reaffirming the importance of women’s health in the workplace. To do so, we must challenge the related stigma and reflect on policy. To challenge the stigma, we must strive to understand that endometriosis and adenomyosis are systemic, chronic health conditions that can derail somebody’s life. The lack of awareness of that fact, combined with a taboo surrounding menstrual health, accentuates the suffering of patients, making them feel as though they have nowhere to turn and no shoulder to lean on. With other conditions that affect a similar number of women, such as type 2 diabetes, no such taboo or silence exists. There is a positive acceptance and understanding of the difficulties faced by those with type 2 diabetes—and rightly so. We must replicate that acceptance and understanding in our attitude towards menstrual health. Following conversations with Endometriosis UK, I support the expansion of the endometriosis-friendly employer scheme and the national workplace endometriosis and adenomyosis pledge, which allow businesses to commit to employer action plans that promote open dialogue, training and understanding of these health issues. Incorporating seemingly little things—such as toilet access, break rotations or even the size ranges of uniforms—into a national framework of practical workplace adjustments can greatly improve the workplace experience of menstrual health, including endometriosis and adenomyosis. As Dr Jasmine Hearn and her colleagues at Manchester Metropolitan University highlight, improving awareness and tackling stigma in this way are key to ensuring justice for women with menstrual health concerns. However, as stated earlier, only one in 10 women believe that their organisation provides support for menstruation and menstrual health conditions. We must increase that number dramatically, and the promotion of the endometriosis-friendly employer scheme is a powerful means to do so. However, a change in culture alone is not enough; we need concrete policy to ensure that workplace accommodation is legally binding. This is where statutory menstrual leave could play a vital role. The Employment Rights Act 2025 ensures that large employers must publish gender equality action plans—a great step in the right direction—but it stops short of directly mentioning reproductive or menstrual health. The Act has made significant progress in supporting menopausal health in the workplace, but we must now expand this to menstrual health more broadly, including endometriosis and adenomyosis. An option would be to give those diagnosed a legal entitlement like that in Portugal, where up to three days of leave per month is permitted. Here, a diagnosis would allow women the flexibility and legal right to have time off work when they are suffering most. It is important, however, to recognise that endometriosis, adenomyosis and menstrual healthcare are vastly nuanced. A single catch-all policy to address the workplace experience could risk overlooking such complexity with menstrual and reproductive health. We must also recognise that getting a diagnosis in the first place is still a major issue with endometriosis and adenomyosis. Again, the average diagnosis takes nine years and four months, meaning that only 15% of those with endometriosis symptoms have the formal diagnosis that would allow them access to such statutory menstrual leave. For statutory menstrual leave to work as the petition intends, we must match it with significant improvements in early intervention, diagnosis and GP training on symptoms. This debate marks an opportunity to help ensure that the impact of these conditions on women’s health is no longer ignored. There is an argument for statutory menstrual leave, and for it to sit alongside wider measures that foster awareness and an understanding mindset. We must also challenge the stigma around women’s health by breaking taboos and championing justice for those who, all too often, suffer in silence. Michelle told me that the petition is not about her; it is about her daughter and all those who will have to battle endometriosis and adenomyosis in the future. By challenging the stigma and reflecting on policy, we can champion the employment rights of those with menstrual and reproductive health complications today and in the future, effecting transformative changes to many people’s lives. I thank everybody for attending this debate, and I look forward to hearing Members’ views.

It is a pleasure to serve under your chairship, Mr Mundell. I thank my hon. Friend the Member for Colne Valley (Paul Davies) for speaking with such compassion and insight, and for sharing Leah’s journey—one I am afraid many will recognise. I am chair of the all-party parliamentary group on endometriosis, which is launching an inquiry into endometriosis in the workplace on 21 April, and I invite colleagues from across the House to attend the event that will be held. We want to hear directly from women and employers about their experiences, including what is or is not working, and about what has to change if we are to better support women to remain in the workplace. As we have heard, Endometriosis UK operates an endo-friendly employer scheme with certification. Last November, my office signed up to that scheme, which offers guidance and support to run an endo-friendly workplace. I also wrote to my local councils and chamber of commerce to invite them to do the same. I ask all Members to consider signing up and leading by example in their own communities. Too many women have had their pain dismissed as normal, struggled silently at work or had their careers derailed because a workplace simply was not designed with their health in mind. As a result, one in six women with endometriosis has ended up leaving the workplace—an entirely unacceptable and largely avoidable situation. It was being elected to this place that made me persist in seeking support for my symptoms, which limited my ability to fully participate in my responsibilities as a parliamentarian—the fatigue and the menstrual flooding, and the constant worrying and planning about what I was wearing and where I would be at any given time. As it turned out, I have adenomyosis, which was discovered only at the ripe old age of 49, as I come to the end of my reproductive life. So I understand the stress, pain and worry that affect millions of women in this country today. Menstrual leave has gathered support at just the right time, as many of the provisions of the Employment Rights Act 2025 have just come into force. We recognise that the workplace needs to change and that women should not be disadvantaged due to health conditions. The women’s health strategy refresh in England and phase 2 of the Scottish women’s health plan present opportunities to correct the trend that has led to endometriosis and menstrual health being under-researched, undertreated and under-recognised, and diagnosis wait times increasing to a decade or more for some women. I would be grateful if the Minister could assure us that endometriosis waiting times will be the utmost priority in the women’s health strategy refresh. Although endometriosis affects around one in 10 women, it does not affect everyone in the same way. Some need intermittent time off during flare-ups; others, especially when properly supported, can work consistently, but need flexibility, reasonable adjustments and job security if their symptoms worsen. Prior to this debate, I looked into other countries that have menstrual leave. What that means in practice varies considerably. Vietnam offers a half-hour paid break every day during menstruation; Spain gives up to five days of paid leave for severe menstrual pain, subject to a doctor’s approval; and Portugal allows workers suffering severe and disabling menstrual pain to take up to three consecutive days of paid leave, dependent on the employee providing a medical note confirming incapacitating pain due to endometriosis or adenomyosis. Legislation that provides for menstrual health is not necessarily a silver bullet, particularly when it relies upon a diagnosis. That would be the opposite of progress. Women with endometriosis do not need a one-size-fits-all policy; they need flexibility, fairness and protection. Too many workplaces automatically trigger action once someone hits an arbitrary number of absences, which is deeply discriminatory. Absence management systems need to change to recognise the chronic and episodic nature of conditions such as endometriosis and adenomyosis, and the accompanying mental physical fatigue from living with persistent pain. Critically, employees need endometriosis to be treated for what it is: a long-term, whole-body health condition, not a series of isolated sick days. Menstrual leave can be an essential part of the support package, but building stronger rights to flexible work, reasonable adjustments and protection from workplace penalisation is central to any solution. To improve outcomes for women with endometriosis, we need answers that recognise the reality of the condition and help women to stay in work, progress in work and be treated with dignity at work.

It is a pleasure to serve under your chairmanship, Mr Mundell. I am pleased to take part in this debate and to stand with the 149 women in Sherwood Forest and the 109,000 people in total who signed this petition. Painful periods are often dismissed as something that women should simply put up with—an inconvenience that is not that bad and happens only once a month—but for thousands of women across the UK, that could not be further from the truth. Every day, women live with chronic pain and exhaustion caused by conditions such as endometriosis. While the petition focuses on endometriosis and adenomyosis, it is important that we also include other, often overlooked conditions that cause severe menstrual symptoms, such as polycystic ovary syndrome. Around one in eight women in the UK have PCOS, and one in 10 have endometriosis. Some, like me, live with both. Introducing menstrual leave in the UK would be life-changing for so many women. It would allow them to prioritise their health without fear of losing income or facing repercussions at work. Just as importantly, it would send a clear message to employers that women’s health must be taken seriously. The reality is that women are still not equal in the workplace. They are expected to work through intense pain and fatigue, and remain just as productive, regardless of how unwell they are. Many women worry about the consequences of taking too much sick leave, including lost pay and being penalised or viewed negatively at work. By enshrining menstrual leave in law, we can ensure that employers are unable to penalise women for managing long-term health conditions. It would also create an opportunity to improve awareness and understanding of the real impact that conditions like endometriosis and PCOS have on people’s lives. While symptoms vary, and some women may experience few or none, others suffer severe, debilitating pain that affects their ability to work, study and live their daily lives. For example, PCOS can involve fatigue, pain, irregular cycles and significant mental health impacts, affecting the ability to work. That was the reality for me: passing out at sixth-form college in the toilets on a regular basis, experiencing extreme pain to the point where I could not even stand up, suffering migraines, sickness and vomiting, and doing my GCSEs when I could barely see out of my eyes. PCOS and similar conditions are chronic and multi-system, meaning that they do not affect just one part of the body or happen for a short period; they are lifelong conditions that require ongoing management and support, yet they are rarely recognised in workplace support frameworks. I am pleased that the Government have introduced the menopause action plan. I ask the Minister to go further and introduce a menstruation action plan so that workplaces can start to reflect better the lives of women and the range of conditions they face, and ensure an understanding of the effect of the pain and suffering. Portugal and Spain already have such policies; the UK should too. Another crucial part of this debate is diagnosis. Menstrual leave alone will not fully support women if it can take years for them to receive an accurate diagnosis. I had to wait over 18 years for my diagnosis, all while trying to manage the symptoms by myself. GPs told me to take paracetamol and put a hot water bottle on my stomach, when I could not even stand up. A diagnosis cannot solve everything, but it unlocks access to the right treatments, and gives women the evidence they need to request reasonable adjustments in the workplace. It gives women an opportunity to do what is right for themselves. Until women’s pain is taken seriously—medically and professionally—true equality at work will remain out of reach for so many.

It is a pleasure to serve under your chairmanship, Mr Mundell. I declare an interest: I have adenomyosis. It took more than 30 years for it to be diagnosed. The average diagnosis time is nine years and four months. For ethnically diverse communities, it is over 11 years. My story is not unusual. From the age of 14, I repeatedly went to the GP saying, “This isn’t normal.” That is like the 47% of sufferers who visited their GP more than 10 times before a diagnosis, while 70% visited more than five times. We all know what they were told: “You’re making a fuss about nothing”, “It’s normal”, and as we just heard from my hon. Friend the Member for Sherwood Forest (Michelle Welsh), “All you need is a hot water bottle and some painkillers.” Like so many other young women—80% of them—I was put on the contraceptive pill before any further investigation, and well before I was sexually active. This continued for many years. I once convinced a doctor that the pain was so bad that I should have some kind of exploratory surgery, so they did exploratory surgery looking for endometriosis. They did not look for adenomyosis. After that, I really was told that I was making it up, because they could not find anything. When I gave birth to my first child, I was in labour for 30 hours. A midwife at the other end of the phone kept saying to my husband, “If she’s able to nap, she’s clearly not having contractions.” I could nap during contractions because I had spent more than 30 years having to sleep with adenomyosis. I learned to have a very high pain tolerance. That baby was delivered in A&E because we got to the hospital so late. Even after being able to describe the pain of my periods being worse than the pain of contractions, not least because they were continuous and did not go away and come back like contractions, I was told that I was exaggerating and that it could not possibly be that bad. They told me that there was nothing they could do other than keep me on the contraceptive pill, which seemed to do nothing. It was not until I got to the other end with my reproductive health, when I had to go for several scans for menopause ahead of getting treatment for perimenopause, that the scanner said to me, “Oh, you have adenomyosis. That must be really painful,” as an offhand comment. I was bowled over. I said, “What is that? I’ve never even heard of it.” I had heard of endometriosis, but I had no idea what adenomyosis was. She said, “Oh, it’s similar, but it’s growing in your muscle lining.” I could not believe it; I was shocked that from the beginning to the end of my reproductive years—all those years of pain—I never once got a proper diagnosis. How did that impact my working career? I used to wish my period would start on a weekend, so that I would not have to miss work—I can see some nodding heads. I used to organise my work tasks around my expected period: I would do all the work that took concentration on days I knew would be good days, so that on the bad days I did not have to be productive. I missed about a day of work a month, which used to terrify me at the beginning of my career. I did not feel that I could talk to my bosses about it—I did not have the words to do so—and I had doubts from those doctors telling me that it was not as bad as I thought. I also want to share April’s story. She is only 24 and she has been going through this for the past 10 years. Her periods were so painful that she vomited. It is like that for many of us: doctors would say, “Take a paracetamol,” and I would say, “That’s great, but I can’t keep it down. I will literally vomit it back up.” April had a Mirena intrauterine device fitted for her symptoms, but she wanted to get it removed. I was shocked by this story: she was told that the strings of her IUD had been cut too short to remove without surgery. When April asked why that was the case she was told: “We cut the strings short for our younger patients, because we don’t want their boyfriends to find sex with them uncomfortable.” April had to undergo surgery under general anaesthesia to remove her IUD. She says that, at every stage, “A decision about my own body—my contraception, my ability to access the removal of my IUD—was shaped around the comfort of a hypothetical male partner.” She was single at the time. That is what we are all put through. At no point were any of us told that painful periods are not normal—I am not talking about discomfort; I am talking about pain—even though we know that to be the case. Each and every one of us should know that from the start. This relates to the fact that women’s health information is being shadow-banned online. Over the past year, 95% of women’s health educators were targeted for shadow-banning. That means that people who are trying to get this kind of health information out there are having their posts either blocked or downgraded because of their content. I do not mean to be rude, but that does not seem to happen to posts about erectile dysfunction. Educators are told by big tech that it has been quietly restricting or hiding women’s health content that contains educational terms like “periods”, “menopause”, “vagina” and “endometriosis” under the guise of safety or because those terms are too sexualised. How are we supposed to create an environment in which not only we as women but our bosses, colleagues and partners, who might be male, all understand that painful periods are not normal, and that the pain is real?