The urgent need to avoid double punishment for women

If we had to choose the world's greatest persistent taboo, menstruation would be very likely to take first place. In 2022, 1 in 5 employed women said they had already been teased or made fun of at work because of their period. Given that, on average, menstruating women menstruate 39 years in their lives, are we going to remain silent in the face of this?

Amélie* is 46 years old. She is now a project manager and consultant in Paris. Behind her beautiful American accent and her remarkable career lies a hidden pain. "Since always", she replies when I ask her how long endometriosis has affected her professional life. She has been working since she was 16. The verdict came in 2019: Amélie suffers from severe endometriosis. It is now estimated that this disease affects at least one woman in ten. It is characterised by the presence in the body of lesions made up of tissues that are physically similar to the endometrium, the mucous membrane that disintegrates during menstruation, but which behave differently in ways that are still poorly understood. These tissues can create lesions that potentially progress over time and adhesions between organs, due to factors that are still unknown. Endometriosis can be very painful during and outside the menstrual cycle, disabling and can cause fertility problems.  

Although it has been scientifically described for around a hundred years, only a few health professionals have a precise understanding of the condition. According to the Nezhat brothers, American endometriosis specialists, the errors and delays in diagnosis that surround endometriosis could constitute "one of the biggest mass misdiagnoses in human history. A mistake that would have exposed women to murder, insane asylums and poverty down the centuries". Today, there is no cure. For Amélie, endometriosis has become synonymous with thirty years of medical wandering and suffering at work. For other women, there is no diagnosis of endometriosis, but every month they go through menstruation, which brings with it a host of undesirable effects: hot flushes, backache, migraines and fatigue, to name but a few.

At work, crises and shame 

In 2020, researcher Alice Romerio published a groundbreaking study. I interviewed her to understand her approach."I had the impression that the way in which endometriosis was considered - as a problem in the public arena - was mainly centred around the issue of fertility, and that questions about other aspects of life with endometriosis were left in the shade (sexuality, violence, the medical course, for example).Work, for its part, was completely invisible", she explains. According to a recent survey, 53% of French people believe that companies have a role to play in helping and supporting people with endometriosis.  

The issue of the invisible suffering of menstruating women at work is also a frequent theme in the interviews I conduct with women.They describe hellish standing postures, attacks of pain during meetings, the need to go to the toilet very frequently, and the shame and silence that go with it."The worst was when the pain and paralysis from sciatica set in.I couldn't sit or stand.I was in a team that didn't know me following a merger.They called me a 'mythological slacker'," recalls Amélie.The suffering is also attested to by reference works: "Those of us who have endometriosis regularly talk about the difficulty we have in making our loved ones or our professional environment understand our condition.It can cause recurrent work stoppages and lead to considerable discrimination, humiliation and sexist prejudice, not least because it is still rarely regarded as a real illness".

Naively, I ask Alice Romerio how she analyses the fact that some studies on the cost of endometriosis calculate it in "hours of lost productivity"."We look at it from the companies' point of view rather than that of the patients, and at the fact that people's professional careers have been put on hold because they have had to take time off work, because they have handed in a file late or because they have lost clients", she explains. The result?Careers held back, taboos maintained, pay cuts and increasing gender discrimination, to name but a few.In the office, Amélie prefers to blame a headache, because "at least it's accepted by everyone".When the attacks start, she chooses to huddle up against a cold wall in a solitary place to seek some relief.


6 billion dollars a year 

65% of women believe that endometriosis has a negative impact on their well-being at work. There may be women around you, among your colleagues, who also press their stomachs or backs against the cold wall of the toilet. They are in no way "lazy mythos", but are trying to protect themselves from unfavourable measures that are far removed from the equality between men and women that should prevail in the world of work. Last February, Spain made the headlines: Parliament had just passed a law creating menstrual leave, a first in Europe. It's a subject that is only timidly making its way into the discussions of HR departments and managers on the Old Continent. Although it is just another occupational health issue, it is now clear that the taboo surrounding menstruation is holding back progress. Elsewhere, Japan, South Korea, Indonesia and Zambia have adopted it long before us.

A study published in Australia in 2019 estimated the cost of endometriosis to society at more than $20,000 per woman per year, specifying that the majority of costs were linked to lost productivity. Based on the typical prevalence attributed to endometriosis (1 in 10 women), the research team estimated that endometriosis costs more than six billion dollars each year. Menstruation, on the other hand, is estimated to cost around 3,800 euros for each person who menstruates in their lifetime. A patriarchal legacy? Absolutely. A capitalist measure? Perhaps. Endometriosis, pre-menstrual syndrome, menopause, even abortion, pregnancy or the risk of natural pregnancy termination... The main aim would be to prevent women from suffering a double penalty: being discriminated against (even more) because of suffering due to menstruation.

*The first name has been changed at the request of the person concerned.