Menstrual Health at Work: The Luteal Phase, Reasonable Adjustments and the Reality of What Is Practicable

There is a growing conversation on social media about menstrual health at work. Some of that conversation is long overdue. For many people, periods, heavy bleeding, pain, fatigue, migraines, mood changes, anxiety, embarrassment, fear of leaking, endometriosis, adenomyosis, polycystic ovary syndrome (POS) and premenstrual dysphoric disorder (PMDD) have been quietly managed in workplaces for years. Often with very little discussion. Often with very little understanding. Often with people simply trying to get through the working day without drawing attention to themselves. So let me be clear from the beginning. Menstrual health deserves to be taken seriously at work. But serious does not mean simplistic. And support does not mean that every request automatically becomes a “reasonable adjustment” without proper discussion, evidence, context or consideration of what is / might be reasonably practicable. That is where I think the conversation needs to mature. The current focus on the luteal phase One of the areas currently getting a lot of attention on social media is the luteal phase. The luteal phase is the part of the menstrual cycle that happens after ovulation and before the next period starts. For some people, this phase may bring noticeable physical, emotional or cognitive changes. These can include tiredness, low mood, irritability, anxiety, reduced concentration, disturbed sleep, headaches, bloating or increased sensitivity to stress. For some people, these symptoms are mild. For others, they are disruptive. For a smaller number, symptoms may be severe and may be linked with conditions such as premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). The National Health Service (NHS) describes premenstrual syndrome as the name for symptoms women can experience in the weeks before their period, and notes that a small number of women may experience more severe symptoms known as premenstrual dysphoric disorder. (nhs.uk) [Accessed 07/08/2026]. The Royal College of Nursing describes premenstrual dysphoric disorder as a complex hormone-based mood disorder and a severe form of premenstrual syndrome, with symptoms that can start in the luteal phase, one to two weeks before a period. (The Royal College of Nursing) [Accessed 07/08/2026]. That matters. Because when someone says, “I struggle during my luteal phase,” they may not be talking about a minor preference or a passing inconvenience. They may be describing a recurring pattern that affects energy, concentration, mood, sleep, pain, confidence, attendance or performance. That should not be mocked. It should not be trivialised. But it should also not be converted automatically into a workplace conclusion without further discussion. Social media can raise awareness — but it can also flatten the issue Social media can be very useful in helping people name experiences they previously felt ashamed of. It can help people realise they are not alone. It can encourage people to seek medical advice, speak to their employer, or ask for support. That is positive. But social media also has a habit of flattening complicated issues into simple slogans. A real health issue can quickly become: “Employers must adjust to my cycle.” “Women should not have to work in the luteal phase.” “This is automatically a reasonable adjustment.” “The workplace must adapt.” But workplace health is rarely that simple. There is a difference between: 

• raising awareness
• asking for support
• seeking flexibility
• discussing work impact
• considering medical guidance
• considering disability
• requesting reasonable adjustments
• deciding what is reasonably practicable

 Those things are connected, but they are not identical. That distinction matters for employees. It matters for managers. It matters for Human Resources (HR). It matters for Occupational Health (OH). And it matters for organisations trying to do the right thing without making poor, inconsistent or unsustainable decisions. Menstrual health can affect work The Chartered Institute of Personnel and Development (CIPD) has reported that more than two-thirds of women surveyed said menstruation symptoms had a negative impact on their work, and that over half had been unable to attend work at some point because of menstruation symptoms. The same research also found that nearly half did not tell their manager the real reason when their absence was related to their menstrual cycle. (CIPD) That tells us something important. People are affected. But people may not feel safe, comfortable or confident enough to say what is really happening. That silence can lead to poor decisions. A manager may see repeated short-term absence without understanding the pattern. Human Resources may focus on triggers and procedures. The employee may feel embarrassed, judged or disbelieved. The organisation may miss an opportunity to support someone earlier. That is why menstrual health needs better workplace conversations. Not gossip. Not assumptions. Not awkward silence. Better conversations. But “reasonable adjustment” has a specific meaning The phrase reasonable adjustment is being used more frequently in public conversations. Sometimes it is used correctly. Sometimes it is used very loosely. In the United Kingdom (UK), reasonable adjustments are linked to disability. The Advisory, Conciliation and Arbitration Service (Acas) explains that reasonable adjustments are changes an employer makes to remove or reduce a disadvantage related to someone’s disability, and that what is reasonable depends on the situation. Acas also says employers should consider whether an adjustment will remove or reduce the disadvantage, whether it is practical, whether it is affordable, whether it could harm anyone’s health and safety, and whether it changes the basic nature of the job. (CIPD) The UK Equality Act 2010 definition of disability involves a physical or mental impairment that has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. Government guidance is clear that whether someone meets that definition involves consideration of the facts and is ultimately a legal question. (CIPD) That does not mean employers should wait for a tribunal before offering support. It does not mean managers should dismiss menstrual health. It does not mean employees need to suffer in silence. But it does mean that workplace support should be explored properly. A person may have menstrual symptoms that are difficult but short-term. A person may have a diagnosed condition. A person may be under investigation. A person may have symptoms that recur every cycle. A person may have symptoms that are severe enough to raise disability considerations. A person may need temporary flexibility. A person may need formal Occupational Health (OH) guidance. A person may need a practical conversation rather than a legal argument. These are different situations. They need thoughtful handling. The luteal phase does not affect everyone in the same way One of the risks in the current social media conversation is the suggestion that the luteal phase affects all women in the same way. It does not. Some people may notice very little change. Some may experience mild premenstrual symptoms. Some may experience significant changes in mood, energy, sleep, pain or concentration. Some may experience severe symptoms linked with premenstrual dysphoric disorder, premenstrual syndrome or another health condition. Some people’s symptoms may be predictable. Others may find they vary from cycle to cycle. This is why blanket assumptions are unhelpful. It is not sensible to say: “Everyone should work differently during the luteal phase.” But it is also not sensible to say: “It is just a period. Get on with it.” The better question is: “What is happening for this person, in this role, in this workplace, and what support may be reasonable and practicable?” That is a more mature workplace health conversation. The role of Occupational Health Occupational Health can be very helpful where menstrual health is affecting work. Occupational Health can help translate health impact into workplace considerations. For example, Occupational Health may comment on: 

• whether symptoms are likely to affect attendance
• whether symptoms may affect concentration, fatigue, pain, mobility or safety
• whether flexibility may support attendance or performance
• whether a phased approach or temporary adjustment may be helpful
• whether further medical input may be appropriate
• whether the situation may need review

 But Occupational Health does not run the business. Occupational Health does not decide what is operationally possible. Occupational Health does not make the legal decision about disability. Occupational Health provides guidance. The employer still needs to consider the employee’s needs, the role, the team, the service, the risks, the costs, the available options and what is reasonably practicable. That is where many organisations struggle. They receive an OH Report. They read the recommendations. Then some organisations either treat the recommendations as instructions, or they might ignore (some of) them because they feel difficult. Neither is good enough. The question should be: “What has been recommended, what does it mean in this workplace, what can we do, what can we not do, and why?” Compassion does not mean agreeing to everything This is where the conversation can become uncomfortable. If someone is experiencing difficult menstrual symptoms, the workplace should respond with respect. But respect does not mean automatic agreement. A request still needs to be explored. For example, someone might ask for: 

• flexible start times during part of their cycle
• working from home (WFH) when symptoms are severe
• access to suitable toilet and washing facilities
• short breaks when pain or bleeding is difficult
• temporary changes to duties
• reduced travel during severe symptom days
• adjustment to uniform requirements
• flexibility around medical appointments
• review of absence triggers where disability may be relevant
• Occupational Health (OH) referral
• risk assessment where symptoms, medication, fatigue or safety are relevant

 Some of these may be straightforward. Some may be possible in one workplace but not another. Some may work in an office role but be much harder in a safety-critical, care, manufacturing, hospitality, driving, lone-working or public-facing role. Some may be temporary. Some may be sustainable. Some may have an impact on colleagues. Some may require a different option entirely. This is not about saying “no”. It is about thinking properly before saying “yes”, “no”, or “not that, but perhaps this”. The Ninety-Six Somersaults™ question This is where the Chattervation Ninety-Six Somersaults™ analogy helps. Imagine a role requires 100 somersaults. At the moment, the employee can manage 4. The missing 96 do not disappear. They still need to be considered. Can some be removed? Can some be done differently? Can some be delayed? Can some be shared? Can some be supported with equipment, timing, flexibility or planning? Can the gap be managed temporarily? Can the role still function? What happens to the team? What happens to service delivery? What happens to safety? What happens to fairness? What has been tried? What has been ruled out? What has been documented? And when will it be reviewed? This analogy is not about reducing a person to their limitations. It is about making the invisible gap visible. When menstrual health affects work, the same thinking applies. If someone is asking for flexibility during the luteal phase, the organisation should not simply dismiss it as a whim. But the organisation also cannot pretend the work disappears. The work, the role, the team and the business reality still need to be considered. That is not prejudice. That is practical workplace health decision-making. Employees need to be heard — and employers need usable information Employees should not have to disclose intimate medical details unnecessarily. Health information is personal. Menstrual health can feel especially sensitive. But if support is being requested, the organisation needs enough work-relevant information to consider the request properly. Occupational Health (OH) involvement might assist. That work-relevant information might include: 

• what symptoms affect work
• whether there is a pattern
• how often symptoms are likely to affect attendance or performance
• whether the impact is predictable or unpredictable
• what has helped before
• what support is being requested
• whether the request is temporary or ongoing
• whether medical advice or Occupational Health input may help
• whether there are safety issues linked to pain, fatigue, medication, concentration or mobility

 This is not about forcing someone to prove they are struggling. It is about helping the workplace make a better decision. The employee brings knowledge of their own experience. The manager brings knowledge of the role. Human Resources brings knowledge of policy and process. Occupational Health may bring clinical workplace guidance. The organisation brings knowledge of operational reality. Good decisions need all of those perspectives. Practicality is not the enemy of compassion There is a phrase I think we need to use more often: Practicality is not the enemy of compassion. A manager asking, “How would this work in the role?” is not automatically being dismissive. Human Resources asking, “Do we need Occupational Health (OH) advice?” is not automatically creating barriers. An employer considering the impact on the team is not automatically ignoring the employee. And an employee raising menstrual health concerns is not automatically being difficult. The difficulty often comes when people stop communicating. The employee feels judged. The manager feels anxious. Human Resources worries about precedent. The organisation worries about operational impact. Nobody wants to say the wrong thing. So, the conversation becomes either too blunt or too vague. That is why Chattervation focuses on better conversations, better evidence and better decisions. What organisations should do Organisations do not need to overreact to every social media trend. But they should pay attention when a real workplace health issue is being discussed. A sensible approach to menstrual health at work would include: 

1. Use plain language
   Do not make people decode policy jargon. Explain what support exists and how to ask for it.
2. Train managers to respond respectfully
   The first response matters. Dismissive, embarrassed or awkward responses can shut people down.
3. Focus on work impact
   Managers do not need unnecessary medical detail. They need to understand how the issue affects work.
4. Use Occupational Health when needed
   Especially where symptoms are recurring, severe, complex, safety-related or linked with possible disability considerations.
5. Consider options from all angles
   Employee need, role requirements, team impact, business need, cost, safety, fairness and sustainability all matter.
6. Document the thinking
   Not just the final answer. Record what was discussed, considered, agreed, declined and why.
7. Review
   Menstrual health conditions and work demands can change. Adjustments should be reviewed rather than left untouched.

 What employees can do Employees also have an important role. Where menstrual health is affecting work, it can help to prepare before raising it. Helpful questions include: 

• What is happening?
• How does it affect my work?
• Is there a pattern, such as symptoms during the luteal phase?
• What support might help?
• What have I already tried?
• What information am I comfortable sharing?
• Would medical or Occupational Health guidance help?
• Is this a temporary request, occasional support, or something ongoing?
• How might this affect my team or role?
• What alternatives could be explored?

 This keeps the conversation practical. It also helps reduce misunderstandings. The Chattervation position Menstrual health should be taken seriously at work. The luteal phase may be relevant for some people. Premenstrual syndrome, premenstrual dysphoric disorder, heavy menstrual bleeding, endometriosis, adenomyosis, polycystic ovary syndrome and other menstrual health issues can significantly affect people’s lives and work. But the answer is not to turn every social media conversation into a workplace demand. The answer is to have better conversations. The answer is to explore what is happening. The answer is to understand work impact. The answer is to use evidence and guidance where needed. The answer is to consider what is reasonably practicable from all angles. Compassion matters. So does realism. Support matters. So does evidence. The right question is not: “Should workplaces adjust to the menstrual cycle?” The better question is: “When menstrual health affects work, how do we have a respectful, practical and properly evidenced conversation about what support is needed, what is possible, and what is reasonably practicable?” That is where better workplace health begins. Better conversations. Better evidence. Better decisions.

References 

1. Chartered Institute of Personnel and Development (CIPD) — Menstruation and menstrual health in the workplace. This guidance highlights the impact of menstrual symptoms at work, disclosure concerns, and the importance of supportive workplace cultures.
   (CIPD)
2. Chartered Institute of Personnel and Development (CIPD) — More than two thirds of women say that menstruation symptoms have a negative impact on their work, new CIPD report finds. This reports findings from CIPD research, including negative work experiences, absence and non-disclosure related to menstruation symptoms.
   (CIPD)
3. National Health Service (NHS) — Premenstrual syndrome. This explains premenstrual syndrome and notes that a small number of women experience more severe symptoms known as premenstrual dysphoric disorder.
   (nhs.uk)
4. Royal College of Nursing (RCN) — PMDD: “I wasn’t being dramatic or oversensitive, I was unwell”. This describes premenstrual dysphoric disorder as a complex hormone-based mood disorder with symptoms that can start in the luteal phase.
   (The Royal College of Nursing)
5. National Institute for Health and Care Excellence (NICE) — Heavy menstrual bleeding: assessment and management. This guidance recognises heavy menstrual bleeding as something that can affect quality of life and should be assessed with the person’s priorities and preferences in mind.  (Nice)
6. Advisory, Conciliation and Arbitration Service (Acas) — Reasonable adjustments. This explains reasonable adjustments, including that what is reasonable depends on the situation and may include practicality, affordability, health and safety and whether the adjustment changes the basic nature of the job.
   (CIPD)
7. GOV.UK — Equality Act 2010: guidance on matters to be taken into account in determining questions relating to the definition of disability. This explains the legal definition of disability under the Equality Act 2010, including substantial and long-term adverse effect on normal day-to-day activities.
   (CIPD)

Explore This Further

At Chattervation, I help organisations develop more effective approaches to workplace health, Reasonable Adjustments and decision-making. Through practical workshops, tools and structured frameworks, I support managers and organisations to move beyond paperwork and towards better conversations, better evidence and better decisions. Because documentation is valuable. But only when it leads to action.