Menstruation, Menopause, and the Pregnant Workers Fairness Act

Abstract

Some workplaces are extraordinarily inhospitable to menstruators, especially those in low-wage jobs. Workers have been denied restroom breaks and then harassed or fired after menstrual blood leaked onto their clothes or their employer’s property. Employers routinely refuse to provide accommodations for menopause symptoms or time off for menstruation-related medical care. The failure to support menstruators is a significant barrier to ensuring workplace equality.

This Article explains how federal laws, including the landmark Pregnant Workers Fairness Act (PWFA), can—and should—be interpreted to help address these inequities. PWFA requires employers to provide “reasonable accommodations” for “pregnancy, childbirth, or related medical conditions.” Menstruation is a necessary precondition for pregnancy, menstrual disorders are a common cause of infertility, and menopause may be triggered by treatments for complications during pregnancy or childbirth.

In its 2024 regulations implementing PWFA, the Equal Employment Opportunity Commission (EEOC) confirms that menstruation can be within the ambit of the statutory language. This is the first federal regulation that explicitly requires accommodation of menstruation-related needs. In interpreting PWFA, and in separate guidance on harassment, the EEOC also clarifies that failure to support menstruators can violate general prohibitions on sex-based discrimination; recent guidance from the Departments of Education and Labor makes the same point.  

This Article provides practical advice on implementing PWFA to address menstruation-related needs, while minimizing the risk of backlash against menstruators. It also urges more effective enforcement of general workplace laws addressing employee health that could reduce the need for menstruators to ask for “special treatment”—and improve workplace conditions for all workers. However, existing legal protections leave some important gaps. Thus, this Article calls for research-informed policy changes to ensure that workers can manage menstruation and the transition to menopause with dignity.

An earlier draft of this Article was posted on SSRN under the title "Menstrual Justice and the Pregnant Workers Fairness Act."

Keywords: menstruation, perimenopause, menopause, pregnancy, workplace accommodations, discrimination, harassment, health, workplace safety, dignity, PWFA, Title VII, PDA, ADA, FMLA, Title IX, sex, gender, gender identity, age, disability, EEOC, DOL, DOE