Dr. Diksha R. Sarode
The debate around menstrual leave in India has gained significant visibility in recent years. From corporate policies to legislative proposals, the focus has largely been on whether workplaces should grant women paid leave during menstruation. While this is an important step toward acknowledging menstrual health, the conversation remains incomplete. It is shaped by a narrow lens — one that centres formal-sector, urban women while leaving out those at the margins.
At first glance, menstrual leave appears to be a progressive and necessary reform. It recognizes that menstruation can be physically and emotionally taxing, and that women should not be forced to work through discomfort or pain. However, this framing assumes something that is not universally true: that all women have the option to take leave.
For millions of women in India’s informal economy — domestic workers, sanitation workers, agricultural labourers, factory workers, etc. — the idea of “leave” is often non-existent. These workers operate outside formal contracts, without job security, social protection, or enforceable labour rights. Missing a day of work can mean losing wages or even employment. In such conditions, the question is not whether menstrual leave is available, but whether rest itself is possible.
This exclusion is reflected in broader labour trends as well. India’s female labour force participation remains significantly below the global average, with only 32.8% of women aged 15 and above participating in the workforce. At the same time, nearly 90% of working women are employed in the informal sector, where job security, paid leave, and basic labour protections are largely absent. For many, employment is already precarious; the absence of even basic protections like paid leave only deepens this vulnerability.
A stark illustration of this inequality can be seen in reports from Beed district (Maharashtra), where women working as sugarcane cutters have undergone large numbers of hysterectomy procedures. A hysterectomy — a serious and often irreversible surgery — has, in these cases, been linked to exploitative labour conditions, lack of access to accurate medical advice, and pressure to avoid missing work due to menstruation or pregnancy.
For many women in these conditions, the decision is shaped less by choice and more by survival. As one sugarcane worker from Beed district reportedly told The Indian Express, she opted for the surgery because “missing even a few days of work meant falling into debt.” Such accounts reflect a reality where the body itself becomes subject to economic pressure, and where the cost of menstruation is measured not in discomfort, but in lost livelihood.
Studies have found that as many as 36% of women in the region have undergone the procedure, compared to a national average of around 3%, with over 13,000 cases reported over the past decade. These numbers reflect not just a medical trend, but a structural crisis. Many women are misinformed or pressured into these surgeries as a way to avoid wage loss due to menstruation or pregnancy. Such procedures can also lead to long-term health complications, including early menopause, chronic pain, and reduced quality of life.
We demand menstrual leave in our workplaces, but how many of us extend the same consideration to the domestic workers in our homes? For many of them, taking even a single day off can mean losing wages or risking their job. Unlike formal workplaces, there are no policies, no safeguards, and often no room to even voice such needs. This contrast reveals a deeper contradiction: while we advocate for rights in structured spaces, we often overlook the inequalities we participate in within our everyday lives.
This reality reveals a disturbing contrast. While policy debates in urban workplaces revolve around granting a few days of leave, some of the most marginalized women are navigating conditions where their reproductive health is shaped by survival itself. Menstruation, in such contexts, is not accommodated — it is suppressed, managed, or effectively eliminated under structural pressure.
This is where the concept of intersectionality becomes essential. Introduced by Kimberlé Crenshaw, intersectionality helps us understand how systems of inequality interact to shape lived experiences. Applying this lens to menstrual leave reveals that not all women experience menstruation equally, nor do they have equal access to rest, healthcare, or workplace support.
In such a context, the demand for menstrual leave, when framed narrowly, risks becoming a class-specific reform. It addresses the needs of relatively privileged women while leaving behind those who may face harsher working conditions during menstruation. For instance, sanitation workers and factory workers often lack access to clean and safe toilets, while domestic workers may not have the autonomy to request time off without consequences.
Perhaps the limitation of the current debate lies not just in what it includes, but in what it leaves out. As pointed out by Dr. S. P. V. A. Sairam, while intersectionality helps map overlapping disadvantages, it does not fully account for the graded hierarchies that define Indian society. As Dr. B. R. Ambedkar described, this operates through an “ascending scale of reverence and descending scale of contempt.” To understand menstrual justice in India, it is essential to engage with Dr. Ambedkar’s framework on caste, gender, and labour.
A more inclusive approach requires expanding the conversation beyond leave policies alone. First, there is a need to strengthen labour protections and move toward the formal recognition of informal work, particularly in sectors like domestic labour and sanitation. Without this, rights cannot be meaningfully enforced. Second, wage protection mechanisms must be considered so that taking time off does not translate into economic loss. Third, improving access to clean and safe sanitation facilities is critical, especially for workers in public and labour-intensive roles. Finally, continued efforts toward awareness and destigmatization are necessary, as stigma often prevents women from articulating their needs or seeking care.
This is not an argument against menstrual leave. Rather, it is a call to rethink how the issue is framed. A policy that benefits only a segment of women cannot be considered a complete solution. Instead, menstrual leave should be understood as one part of a broader framework of menstrual justice — one that includes health, dignity, safety, and economic security for all women.
The question, therefore, is not simply whether menstrual leave should be implemented, but whether the movement advocating for it is willing to expand its scope. Until the realities of working-class women are brought to the centre of the conversation, the demand risks reinforcing the very inequalities it seeks to address.
A truly meaningful reform would ensure that no woman has to choose between her health and her livelihood — or worse, between her body and her survival.
References
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The Indian Express – Reports on hysterectomies among sugarcane workers in Maharashtra
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BBC News – Coverage on labour exploitation and medical practices
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Maharashtra State Commission for Women (2018) report on hysterectomy prevalence in Beed
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Government inquiry reports on sugarcane labour conditions in Maharashtra
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2025 White Paper on Menstrual Leave prepared by the Supreme Court of India (Centre for Research and Planning)
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Dr. Diksha R.S is a dentist and independent writer interested in anti-caste literature and philosophy.
