The pain you don't always call in sick for

Once a month, millions of women across the globe wake up knowing the day ahead will be shaped by the discomfort or pain of menstruation.

Menstrual cramps can range from a dull ache to debilitating pain, severe enough to force a person to miss work or classes. Yet many women still feel the expectation to carry on as if nothing is wrong.

While South Korea is among a relatively small number of countries that legally recognize menstrual leave, many women say taking it remains far easier in theory than in practice.

Lee Seo-hyun, 29, who has worked at a food and beverage startup for two years, said she has never taken menstrual leave, describing the idea as feeling like “walking on eggshells.”

“My immediate supervisor is a man, and my job involves visiting bakeries and cafes across Seoul to check how our products are selling, so it’s hard to take a day off every month,” she said.

Instead of taking leave, Lee schedules important meetings or field visits around her cycle whenever possible and rarely leaves home without painkillers.

“Everyone at the company is busy, and I don’t want my coworkers to think I’m using it as an excuse to take time off. My cramps are milder than what some other women experience, so when the pain gets bad, I take painkillers and try to get through the day,” she said.

Lee’s experience reflects a broader workplace culture in which many women hesitate to take menstrual leave for fear of being judged by colleagues or of being perceived as less professional or less committed to their jobs.

Under Article 73 of the Labor Standards Act, female employees are entitled to one day of unpaid menstrual leave each month upon request. Employers who refuse the request may face a fine of up to 5 million won ($3,400), while employees whose requests are refused can file a complaint with a regional labor office.

The law, however, leaves considerable room for discretion. It does not specify how severe menstrual pain must be before an employee can take menstrual leave, nor does it require employees to provide proof of their symptoms or even that they are menstruating, according to labor attorney Choi Hye-in.

“People understand it on an intellectual level. But there is still a sense that it’s something women are simply expected to endure on their own,” Lee said.

A 2018 survey cited by the Korean Statistical Information Service found that some 64.4 percent of 604 companies with at least 100 employees offered menstrual leave. Yet among 2,347 female employees at the assistant manager level or above, 19.7 percent reported having taken it, suggesting that menstrual leave remains widely underused.

In 2023, Spain introduced paid menstrual leave for women experiencing menstrual pain, becoming the first European country to adopt such a policy.

Spain’s then-Equality Minister, Irene Montero, wrote on X that the measure would give women experiencing “incapacitating menstrual pain” a legal right to up to five days of paid leave.

“Women’s health, bodies and time matter. It is time to stop hiding menstruation, working through the day on painkillers and pretending the pain does not exist,” she wrote.

The workplace in Korea, however, has been slower to catch up, partly because of long-standing concerns over the potential misuse of menstrual leave.

While critics have pointed to cases in which employees take menstrual leave despite mild symptoms or use it to extend long weekends, attorney Choi said such cases should not overshadow the purpose of the policy.

“Women shouldn’t have to question whether they are actually ‘sick enough’ to be out of the office when they are on that day. The very fact that they are asking themselves that question discourages them from using a legal right,” she said.

Huh Chang-deog, a sociology professor at Yeungnam University, echoed that, noting that the stigma surrounding menstrual leave remains a major barrier.

“Many women still hesitate to discuss it openly or take leave, fearing negative stereotypes or being seen as seeking special treatment,” he said. “That perception often stems from a lack of understanding of biological differences rather than the policy itself.

Huh emphasized that greater awareness of sex-based differences is key to building a more inclusive corporate environment.

“Just as society recognizes that different groups may need different forms of support, we also need a better understanding of women’s biological experiences. That understanding is essential to creating a more considerate and inclusive society,” Huh said.

While workplace culture often discourages women from taking menstrual leave, the experience can be somewhat different on university campuses, where menstrual absence policies are more common.

When severe menstrual cramps made the hour-long commute to campus impossible one morning last year, Joo Da-hyun, a 24-year-old student at Yonsei University in Seoul, used her university’s menstrual absence policy for the first time. Yonsei is among a handful of universities, including Seoul National University and Korea University, that allow menstrual absences or offer flexible attendance policies.

“The pain wasn’t bad enough to send me to the emergency room, but even after taking painkillers, I knew I wouldn’t be able to sit through class,” she said.

Joo said Yonsei’s process is simple. Students only need to submit an absence form to their professors via email, with no medical certificate required.

Applying for the absence is easy, but deciding whether to use it is not, according to Joo.

“I sometimes worry that people think students are taking advantage of the system, which makes me wonder whether they will believe I am telling the truth,” Joo said.

Joo added that she feels more comfortable requesting an absence from female professors than from male professors, unsure whether they would “fully understand” the severity of menstrual pain.

While most professors have approved her requests, some have denied them, particularly during exam periods when absence requests tend to increase among her peers. She added that while her male classmates are generally understanding in person, discussions on online communities often describe the policy as unfair because it applies only to women.

“University was the first place where I felt menstrual pain was treated as a legitimate health issue rather than something women were expected to endure. I think there is still room for improvement, but society is becoming more understanding,” Joo said.

Ewha Womans University, despite being a women’s university, implemented menstrual absences only recently, starting in the second semester of the 2025 academic year.

“In response to students’ repeated requests, the school decided to introduce the policy to better protect their health,” a senior university official told The Korea Herald.

Korea introduced menstrual absences for female students in elementary, middle and high schools in 2006, allowing them to miss class without affecting their attendance records. The policy followed a recommendation from the National Human Rights Commission of Korea urging the Education Ministry to implement the measure.

Previously, absences due to menstrual pain were recorded as sick leave or other types of absence. Students unable to take exams for menstrual reasons received only 80 percent of their previous exam score, which raised concerns about discrimination against female students.