It was hailed as a historic advance – one capable of tackling longstanding workplace taboos around period pain. A year after Spain became the first country in Europe to introduce paid menstrual leave, however, figures suggest that relatively few employees have made use of the policy.

In the 11 months since the law was introduced, menstrual leave was taken 1,559 times, according to data from Spain’s ministry of inclusion, social security and migration.

“As can be seen from the data, there has not been an avalanche of this type of temporary incapacity and its use has stabilised month by month since its implementation,” the ministry said.

From 1 June 2023, when the policy came into effect, to 24 April, the most recent date for which figures were available, the average leave taken spanned 3.03 days. An average of 4.75 people used the leave each day.

The data reflects how many times leave has been accessed, rather than how many employees have made use of it in Spain, a country of about 49 million people.

The policy has been divisive. Some see it as a step forward for women while others say it is riddled with failings.

“I don’t think it is working and I think it was to be expected,” said Irene Aterido, of RedCaps, a network of Spanish healthcare professionals who focus on gender and environmental research.

When it was passed last year, the legislation was touted as a means of allowing employees experiencing period pain to take as much leave as needed, as long as they had a doctor’s approval, with the state social security system picking up the tab.

It was another addition to menstrual leave offerings that span the globe, from Japan to Zambia, though the extent to which they have been used has been debated.

In Spain, the equality minister at the time, Irene Montero, billed the legislation as a means of addressing a long-overlooked issue. “It is a historic day for feminist progress,” she wrote on social media last year.

Months later, as the policy came into effect, she said: “No more making your period invisible, taking pills in order to work or dying in pain while pretending that nothing is wrong.”

Irene Montero, the equality minister when the law was passed, called it ‘a historic day for feminist progress’. Photograph: Violeta Santos Moura/Reuters

The wording of the legislation that was finally passed, however, limited menstrual leave to those with previously diagnosed conditions such as endometriosis, Aterido noted. “Menstrual leave is a misnomer because it is really leave due to intense secondary dysmenorrhea that has been diagnosed,” she said. “If you’re not diagnosed, your family doctor can’t sign off on menstrual leave.”

The paradox is that many of those who have conditions such as endometriosis are using contraceptives to manage it, Aterido said. “It’s almost like a bit of dark humour. Probably half or more are on hormone drugs, so they don’t get their period,” she said. “So this is an absurdity.”

Others are more positive. “The fear was that there was going to be this discrimination against women and there was going to be avalanche of leave requests because women were going to pretend to be in pain, but after a year there hasn’t been that many,” said Mónica Ciria, an adviser who deals with workplace problems.

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Her own experience of accessing menstrual leave had been straightforward, she said, describing it as a good alternative to sick days, the first three of which are not paid under most contracts. “For women with painful periods or who have problems with menstruation, it’s a relief because you’re not going to see your paycheck drop and you don’t have to force yourself to go to work when you’re not well.”

She acknowledged she was lucky to have an employer who she felt she could be open with. “For example, in my previous job I was afraid I would be stigmatised because you would hear comments like ‘now we’re going hire fewer women because they’re just giving away leave’.”

In a country where unemployment continues to hover around 12% – the highest in Europe – Aterido, who is also the founder of EndoMadrid, which seeks to protect the rights of those with conditions such as endometriosis, said women were right to worry.

“Every time a woman with endometriosis takes sick leave, she risks losing her job. That’s the reality,” she said. “It’s enormously naive to think that in the Spanish job market a woman with endometriosis is going to open up about her condition.”

In her case, the process of requesting leave had been onerous, hinting at another reason that take-up has remained limited. “It’s not automatic, you have see a doctor and ask for it,” Aterido said. “So when you’re sick and in a lot of pain, you have to drag yourself to the health centre.”

Her one attempt to request menstrual leave was successful, but only because she understood the legislation and how to go about processing the request. “My doctor didn’t know about it, so I had to explain it to him.”

Others had similar problems. One 31-year-old woman in northern Spain told the newspaper El País that the first time she asked about menstrual leave she was told it didn’t exist, and the second time staff at a different health centre told her they didn’t know how to put her request through the system.

Ciria remains enthusiastic. “For me, the most important thing has been the recognition that the pain is real,” she said. “It’s a huge step forward. Particularly when it comes to making this visible. It’s shown that women aren’t crazy … Hopefully other countries start to offer this kind of leave.”