By — Manushree Mahat
Abstract:
This article aims to examine the supposedly ‘complicated’ case of menstrual leaves in countries all around the globe, and the legislative blackhole associated with it. This article will look at the case of Karnataka in India in particular, to understand how policies of menstrual leave are taking place in India as a whole. By presenting the state as a patriarchal institution, this article will examine how the state will control women’s bodies as long as it is beneficial to them, and lack any assertive stance on issues that are actually crucial to women’s health. By intersecting two women’s issues, the menstrual leave agenda, and the endometriosis crisis, the article aims to look at how many states fail to address their patriarchy when it comes to women’s health issues, becoming complicit in the larger structures that diminishes women’s genuine health concerns.
Introduction: It only matters when ‘male’ partners are in the equation:
Endometriosis is a uterine condition characterized by severe pelvic pain, heavy bleeding during and between periods, and fatigue. The most significant marker of period pain is its first symptom–debilitating pelvic pain. Despite the painful nature of the condition, endometriosis remains one of the most underfunded medical conditions, like most women’s health issues. In 2020, 5% of global research was allocated to women’s health issues, of which only 1% was directed towards non-cancerous conditions like endometriosis. In 2020 itself, a study on adolescent girls in Karnataka revealed that 61.95% experienced menstrual pain.
Despite the fact that women with endometriosis have been suffering in silence for years, regarding their condition, no solid research, or cure has been discovered for the condition. However, research regarding the impact of endometriosis on male partners has found enough funding to be conducted. To think that a medical condition that has caused insurmountable pain to women for years without a clear cure, receiving funds for research centered on the sexual well-being of a man with a partner with endometriosis is ludicrous.
Women with endometriosis experience pelvic pain, fatigue, excessive bleeding, infertility, pain and bleeding during intercourse, but somehow the man’s well-being is in danger. Although the research is not implying that somehow men’s health issues are more important, the implication is hard to miss. In South India, and many parts of India largely, we can observe patriarchy in action when it comes to menstruation. The Sabarimala Temple in Kerala historically banned menstruating women of menstruating ages from its premises on grounds of purity. When women are treated like outsiders simply for menstruating, one can only imagine the lack of empathy a menstrual condition like endometriosis can be dealt with.
Menstrual leave: A debate on empowerment and normalization:
In November 2025, Karnataka became the first state in India to provide paid menstrual leave to all women working formal jobs. While the legislation itself seems like a step forward for many working women, it also entirely leaves behind many informal sector workers, and those working in unorganized labour. This is the reality for most cases where menstrual leaves are formalized, while it provides the facade of empowerment, it fails to address the deep-rooted patriarchy the state institutions are entrenched in to ever truly bring about change.
We can address this issue in the context of the ‘neoliberal neopatriarchal’ society that we live in, as argued by Beatrix Campbell. While women seem to have been given the inkling of an idea that the society that we’re living in has become far more progressive in the last few decades, this illusion is scarcely masked in its capitalist patriarchy. Campbell argues that the new world order does not tackle inequality on its face, but rather modernises it.
Corporate culture opens space for both men and women, without addressing the dual burden of economy and household dealt with by the women, neither does it address the pay gap. To discuss this argument in the context of menstrual leave while women are led to believe that they are ‘liberated’ to find entry within the workforce, their health concerns, their daily grievances that include menstruation are rarely, if ever, addressed. To think that bringing the menstrual leave policy to life would result in discrimination against women, is the demonstration of neglect of women’s health by the society, which is essentialized by the patriarchal state.
Menstruation and the normalization of period pains: Intersection of serious health concerns
A significant problem with endometriosis is that it is also a largely undiagnosed condition. Period pains are considered ‘normal’, even when they exceed that invisible threshold of what is considered ‘bearable’. This presents a startling duality that the state certainly cannot handle in its complexity. Instead of normalizing periods, while also addressing its difficult nature, the state chooses to be stagnant in its lack of funding and legislation.
A study in Bengaluru, Karnataka, revealed that while endometriosis is being diagnosed much earlier in school and college students, stigma around menstruation still delays treatment. This goes on to show that the patriarchy that has become commonplace with menstruation is big enough, that it has also hindered the treatment of a serious condition like endometriosis.
Going back to the discussion on menstrual leave, even when states try to legislate menstrual leave, it comes with the kind of loopholes that are scarcely addressed. Similarly, many workplaces simply don’t follow these rules even when they’re mandated, so the lack of punishable consequences is also glaringly obvious.
To give further context through events in other parts of India, in 2026, Former Union Minister for Women and Child Development Smriti Irani, stated that since menstruation is not a handicap, paid period leave is not necessary. This is an interesting statement to make as a woman herself–but certainly one that needs to be dissected for its complexity. Menstruation is a part of being a woman, but one certainly cannot diminish its physical and emotional strain on a woman’s health. To absolutely discredit menstrual leave is an ignorant move. But a certain thing she said does ring to a patriarchal reality we live in.
Let’s use the example of Smriti Irani to understand the government’s working paralysis when it comes to women’s health issues. The state chose not to address the stigma surrounding workplace discrimination that would be present if menstrual leave is mandated. Why are men so threatened by the idea of women not coming to work, due to a physically and psychologically strenuous time of their month? The government could’ve mandated menstrual leave, and normalized its necessity instead of hiding behind the patriarchal constraints. Instead, the state chose to actively engage with the patriarchy when it refused to address the concerns of discrimination following menstrual leave. Instead of mandating menstrual leave, it essentially mandated that women should be discriminated against if they apply menstrual leave.
Endometriosis directly comes into this complicated soup of acceptance/non-acceptance, because endometrial pelvic pain is entirely more torturous than period cramps. They are a serious health condition, and those with endometriosis deserve their rightful menstrual leave. Is it really equality, when the state scraps menstrual leave to ‘normalize’ menstruation, when normalization comes with an unbearable burden that women are expected to just deal with?
Conclusion
This menstrual leave not only addresses monthly periods, but also deeper menstrual health conditions like endometriosis, essentially accepting that women’s health conditions require further attention. It also accepts that there are certain conditions that put women at more disadvantage and risks, and therefore legislation must be put into place to really, and truly, create a more equal, and less patriarchal society, where men are not threatened by the idea of menstruation and menstrual leave.
About the Author:
Manushree Mahat is an amateur writer based in Kathmandu. She has experience in culture, lifestyle, and social journalism, and also dabbles in fictional storytelling once in a while.