Hormonal health
Tens of thousands demand menstrual leave to be written into UK law
More than 65,000 people have signed a petition for menstrual leave to be added to UK employment rights law.
The campaign needs 100,000 signatures for a parliamentary debate.
It was launched by Scots mum Michelle Dewar, who endured chronic pain for nine years before being diagnosed with endometriosis – a condition where tissue similar to the womb lining grows outside the womb.
Dewar wants the UK to follow Portugal, which recently introduced paid leave for people with similar conditions. She says protections must include no loss of pay, benefits or seniority.
Endometriosis UK has welcomed the petition but argues the government should go further and recognise menstrual health conditions such as endometriosis and adenomyosis as chronic diseases that deserve the same workplace support as illnesses such as diabetes or asthma.
Writing in the Scottish Sun, Emma Cox, chief executive of Endometriosis UK, said workplace discrimination remains widespread due to limited understanding.
“The taboo and embarrassment around ‘women’s issues’ makes the topic hard or impossible to discuss with managers,” she said.
Examples include fears about being made to wear light-coloured uniforms during heavy bleeding, fluctuating symptoms that lead to staff being unfairly labelled as “flaky”, and absence management policies that penalise people for their condition.
The charity says absenteeism caused by heavy and painful periods, endometriosis, fibroids and ovarian cysts costs the UK economy nearly £11bn each year.
Endometriosis UK is calling for the Employment Rights Bill to require menstrual health action plans in workplaces, giving staff clear guidance on support.
It also wants the NHS to cut diagnosis times, which average eight years and 10 months for endometriosis, and to extend that target to adenomyosis too, aiming for one year or less by 2030.
Cox warned that the term “menstrual leave” could be misleading.
She said: “We fear the term ‘menstrual leave’ could be misunderstood to imply it is for everyone who has periods and could lead to discrimination, or perpetuate the myth that it is ‘normal’ to have severe symptoms and that those who can’t cope are ‘weak’.”
The charity runs an Endometriosis Friendly Employer Scheme and workplace training to help organisations understand the impact of both endometriosis and adenomyosis.
Gail’s has unveiled a menopause action plan offering new workplace support to thousands of staff ahead of legal reforms due in 2027.
The high street bakery chain will offer new benefits including 24/7 digital GP access and a new employee assistance programme, according to The Times.
It will also explore new online training for staff, including specific training for management.
Gail’s people director Miranda Burgum told The Times: “All we’re trying to do is talk freely and for it not to be a forbidden subject. It’s helping our managers and teams understand that this isn’t a taboo.”
“We’re going to develop the education with our managers, so it will be threaded through all our policies
“It will look at induction training, it will look at the types of people we need to make sure that we make reasonable adjustments for.
“And if somebody needs some sort of risk assessment, we’re going to be looking at [that].”
The move comes ahead of reforms due to be introduced in spring 2027 under the Employment Rights Act.
UK employers with 250 or more employees will be legally required to publish and update official menopause action plans.
The plans are intended to support employers to take effective action to improve workplace gender equality and support employees experiencing menopause.
Hormone therapy started in peri- or early post-menopause was linked to a 22 per cent lower risk of cardiovascular events in women with vasomotor symptoms in a recent study.
The findings came from an observational analysis of 20 years of health data and do not show that hormone therapy caused the reduction in cardiovascular risk.
The association was strongest among Black women and women who started treatment within 10 years of menopause onset, although researchers cautioned that the findings should not guide clinical practice.
The study is the first of its kind in the US to assess the risk of future cardiovascular events among women with vasomotor symptoms who use hormone therapy during peri- and early postmenopause.
Samar R. El Khoudary, professor and chair of the Department of Epidemiology at the VCU School of Public Health and one of the study’s senior researchers, said: “The menopause transition represents a critical window for understanding how hormone therapy may relate to cardiovascular disease risk. Our findings suggest that timing of initiation may influence cardiovascular outcomes.”
The researchers stressed that the findings do not support using hormone therapy to prevent cardiovascular disease.
Potential benefits must also be weighed against risks, including the increased breast cancer risk observed with longer-term use.
The study was not a randomised controlled trial, the gold-standard method for testing biomedical treatments.
Rebecca C. Thurston, associate dean for Women’s Health Research at the University of Pittsburgh School of Medicine and one of the study’s senior researchers, said: “These findings point to women with vasomotor symptoms as those who may show cardiovascular benefit from hormone therapy initiated during the perimenopause and postmenopausal years.
“However, conclusions should be tempered by the observational nature of the study, and findings should not guide clinical practice.”
Vasomotor symptoms, meaning hot flushes and night sweats, affect up to 80 per cent of women during the menopause transition and last for an average of seven to ten years.
Their frequency and severity build through perimenopause and typically peak in early postmenopause.
Hormone therapy replaces oestrogen and progesterone that women’s bodies stop producing after menopause and is currently the most effective treatment for these symptoms.
Clinical trials led by the Women’s Health Initiative in the early 2000s raised concerns about hormone therapy’s impact on heart disease, stroke, breast cancer and other risks, leading to years of reluctance among patients and providers to use the treatment.
El Khoudary said: “Hot flashes and night sweats have a significant impact on a woman’s quality of life and ability to work productively.
“While hormone therapy is an effective treatment for these symptoms, questions have remained about its cardiovascular effects, particularly the importance of when treatment is initiated during the menopause transition.”
More recent research suggests the effects of hormone therapy on the heart and vascular system may vary by age and treatment timing, with women younger than 60 who start treatment closer to menopause onset having different levels of risk.
In 2026, the US Food and Drug Administration removed “black box” warnings from hormone therapy products, reflecting evolving evidence on the benefits and risks of treatment.
Researchers from Virginia Commonwealth University and the University of Pittsburgh analysed data from more than 2,700 women taking part in the Study of Women’s Health Across the Nation (SWAN).
The women reported vasomotor symptoms and had not previously experienced cardiovascular events.
Clinical data collected between 1997 and 2017 were used to examine whether women who started hormone therapy for vasomotor symptoms were more or less likely to experience stroke, congestive heart failure, heart attack or revascularisation procedures than women who did not start treatment.
El Khoudary said: “By using data from the SWAN study, we essentially were able to emulate a series of hypothetical clinical trials to gain a deeper understanding into how hormone therapy taken to mitigate vasomotor symptoms during peri- and early postmenopause influences cardiovascular risk over time.
“It allowed us to examine clinically meaningful cardiovascular disease events over long-term follow-up in a population and treatment window that has been challenging to study prospectively.”
Starting hormone therapy during peri- or early postmenopause was associated with an estimated 22 per cent lower risk of cardiovascular disease events.
Women who began hormone therapy within 10 years of menopause onset had an estimated 27 per cent lower risk compared with women who did not start treatment.
Among Black women, starting therapy during peri- or early postmenopause was associated with an estimated 49 per cent lower risk of cardiovascular disease events.
No clear reduction was seen among women who started therapy more than 10 years after menopause onset or among White women and other racial and ethnic groups.
El Khoudary said: “The differences in cardiovascular outcomes by race and ethnicity are notable, particularly because Black women are more likely to experience severe vasomotor symptoms.
“These findings highlight the need to better understand how hormone therapy timing may influence cardiovascular outcomes across diverse populations.”
It remains unclear why cardiovascular risk differed according to when hormone therapy was started, although researchers believe differences in blood vessel health with age may play a role.
Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.
The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.
Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.
The study was conducted by investigators at Cedars-Sinai Health Sciences University.
Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.
“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”
The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).
IBS is far more common in women than men.
Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.
“We must consider it as we move toward more personalised approaches to understanding and treating disease.”
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