A woman walks past a shop selling women's clothing in Pristina. Picture by REUTERS/Hazir Reka.

Two Kosovo nonprofits join efforts to offer menstrual leave to employees, a concept that remains under debate worldwide.

“My stomach hurts, I have back pain, mood swings, and no energy.” This is how Vesa Lamaxhema describes the symptoms she suffers during her menstrual period.

Lamaxhema works at a well-known boutique in Kosovo’s capital, Pristina. She is on her feet most of the time, her work routine the same even on the most painful days. She takes medication for the menstrual pain and sometimes has to ask for sick leave for one or more days in a month, for which she needs a doctor’s note.

“It’s a bit problematic because as long as I am in pain, it’s difficult to be 100 percent fit for work,” she says.

Gynecologist Drita Kabashi, who works at American Clinic in Pristina, confirms that for some women, menstrual pain is debilitating.

“Unfortunately, there is a percentage of women, around 25–30 percent, who face severe pain during the menstrual cycle,” Kabashi says. “This is a large number of girls or women who need treatment or a sick day.”

Some of Kabashi’s patients are required by their employer to undergo a medical examination and obtain a doctor’s note to justify their absence from work.

Lamaxhema held six jobs during the last 10 years; none of her workplaces offered any kind of special leave for menstruation-related issues.

Some companies, and even some countries, do have menstrual leave policies or laws in place. Multinational giant Nike, for example, has been a pioneer in this area, with a menstrual leave policy since 2007; Zomato, a global restaurant aggregator/food delivery company in India with a workforce of 4,000+, instituted such a policy this summer.

The Power of Positive Discrimination

Two small nonprofits in Pristina have decided to do the same for their employees.

The Kosova Democratic Institute (KDI), affiliated with the local Transparency International office, monitors transparency of institutions, political parties, and political developments. KDI began offering menstrual leave in March 2015. According to Executive Director Ismet Kryeziu, female employees – nine in a staff of 15 – can take one day off a month during the menstrual cycle.

“This policy has been welcomed by all KDI staff, including men, and I think this is of particular importance,” Kryeziu says. “This policy has influenced the motivation of women to work, as it promotes a work environment of ‘positive discrimination.’”

The Center for Counseling, Social Services and Research (SIT) has offered menstrual leave since 2019. The center’s 10-person staff is split evenly between women and men.

Mirishahe Syla, SIT’s former gender adviser, says being able to take menstrual leave helps women feel more comfortable in the workplace.

Most workplaces tend to avoid discussing the needs or identities of employees from a gender perspective, Syla says.

Women at SIT can take off one day a month if they have pain during the menstrual cycle. “The goal is to create the proper working conditions for each employee and an environment where they can contribute to their full potential, without limiting or endangering themselves based on the specific needs they may have,” she adds.

At both NGOs, the day off is taken in good faith, and there is no need for a doctor’s note.

At other companies and institutions in Kosovo, issues related to menstruation continue to be taboo. Boutique employee Lamaxhema says many of her colleagues experience pain every month but are embarrassed to ask for time off.

Stigmatizing the Sufferers

“I’ve noticed there are many girls at work who are reluctant and refuse to tell their manager, more specifically men, that they suffer pain during their period,” she says. “Because of this mentality, they endure pain even when it’s unbearable.”

Sociologist Linda Gusia, an associate professor at the University of Pristina, confirms that the stigma surrounding the menstrual cycle and women’s bodies in general is still part of Kosovar society.

She believes it’s rather early for a meaningful, large-scale discussion about menstrual leave in Kosovo, precisely because of that stigma and the views within society about women and their bodies.

In this country, where relatively few women participate in the labor market, and just 4 percent of women inherit property, there are bigger problems to solve around women’s role in society before addressing more specific issues like menstrual leave, Gusia thinks.

There are few positive models in other countries for Kosovo to emulate.

Menstrual leave has been implemented, with varying success, in a handful of countries. In Japan, after labor unions pushed for it for two decades, a menstrual leave law was put on the books in 1947.

Asa Taguchi, anthropologist and researcher at Seijyo University in Tokyo, says although the law has been in place for more than 70 years, few women take advantage of it. According to her the number of women that take menstrual leave in Japan is going down each year.

Seirikyuuka (“physiological leave” in Japanese), has hardly been applied since the law’s passage because of the taboos related to menstruation.

“Women have found it difficult to insist on menstrual leave,” Taguchi says. “Earlier generations cited reasons such as ‘causes problems with colleagues,’ ‘the boss harasses them,’ and ‘male colleagues get angry.’ Those issues still exist, but now women have various medication options to avoid taking days off.”

Indonesia, Taiwan, South Korea, and Zambia also have menstrual leave policies in place. In Europe the issue remains under debate, and no national policies or laws exist. A law was proposed in Italy in 2016 but did not pass.

Italian feminist Matilde Cittadini recalls that reactions to the proposal were mixed.

“The draft law was not positively welcomed by all women parliamentarians,” she says. “True, many saw it as progressive and revolutionary, a way to empower women and break taboos on the menstrual cycle. On the other hand, many women MPs believed that if such a law got the green light, it would be a step back in the fight for equality.”

At Zomato, women and transgender people are granted up to 10 days off per year for their periods.

There shouldn’t be any shame or stigma attached to using menstrual leave, Zomato’s founder and CEO Deepinder Goyal said in announcing the policy in an August 2020 statement to employees: “You should feel free to tell people on internal groups or emails that you are on your period leave for the day.”

The decades-old debate whether women are entitled to time off because of menstrual pain is far from resolved. Proponents argue that this promotes gender equality by recognizing biological characteristics and differences between men and women, while others claim the opposite – that menstrual leave could widen gender inequality.

According to Kosovo’s Statistics Agency, only 13.7 percent of women in Kosovo are employed, in what’s far from a level playing field. Gusia says discussing menstrual leave in a country like Kosovo is not just premature, but if not well-researched could deepen the existing inequality.

Employed women have the right to 12 months of maternity leave. The employer pays 70 percent of their basic salary for six months; the government pays the following three months, at 50 percent of the basic salary. For the final three months, they are not paid. According to Gusia, some employers see little economic benefit in employing women, especially so if they are likely to take maternity leave, a situation that leads to discrimination against women in the labor market.

“I think that for a percentage of women, menstrual pain is severe, so they are forced to rest; and they should have the right to rest,” she says. “But the other side of the coin is when we talk about rights, and this is related to economic well-being. In the economic system in which we operate we have great discrimination, also [because of] the right to maternity leave or even access to the market, which is unfair in general.”

According to Gusia, there is something we can do regarding the menstrual cycle in Kosovo. She sees the need to eliminate the tax on menstrual pads, which now are taxed as luxury products.

“For me, in the context we are talking about, in addition to the need for a general reform of the economic system, something more achievable in the short term would be for girls and women to have access to sanitary napkins in schools and public. Also, it’s essential to remove the tax on pads because in this way they will be more accessible to most women and girls.”

To Syla, the reason for a menstrual leave policy is simple: “The idea was to create an environment and working conditions that enable each of us to work at full capacity, and at the same time to respect all the needs that we have.”

That seems simple indeed.

Donika Gashi has worked as a journalist, producer, and host at Klan Kosova, a major national television network in Kosovo. In January 2021 she will begin a fellowship at Radio Free Europe’s headquarters in Prague.