ISO/FDIS 45010

Occupational health and safety management — Menstruation and menopause in the workplace — Guidance

This document is intended to provide guidance on developing policies and practices that are supportive of the menstruation, menstrual health and peri/menopause experiences of employees in the workplace.

Titre manque

Sistem vodenja varnosti in zdravja pri delu - Menstruacija, menstrualno zdravje in menopavza na delovnem mestu - Napotki

General Information

• Status: Not Published
• ICS: 03.100.30 - Management of human resources
• ICS: 13.100 - Occupational safety. Industrial hygiene
• Technical Committee: ISO/TC 283 - Occupational health and safety management
• Drafting Committee: ISO/TC 283 - Occupational health and safety management
• Current Stage: 5000 - FDIS registered for formal approval
• Start Date: 02-Apr-2026
• Completion Date: 15-Jan-2026
• Ref Project: kSIST ISO/FDIS 45010:2026 - Occupational health and safety management – Menstruation, menstrual health and menopause in the workplace – Guidance

Overview

ISO/FDIS 45010 is an International Standard developed by ISO/TC 283 that provides comprehensive guidance for organizations on creating policies and workplace practices supportive of menstruation, menstrual health, and menopause. By addressing these important health experiences, the standard aims to foster more inclusive, healthy, and supportive workplace environments for all employees. ISO/FDIS 45010 applies across all industries, sizes, and organizational types, making its practical recommendations universally relevant.

Menstruation and menopause are natural life course experiences rather than medical conditions. However, lack of understanding or support can lead to negative workplace outcomes such as increased absenteeism, reduced engagement, and higher employee turnover. Implementing supportive practices around menstrual and menopausal health not only benefits affected workers but also contributes to occupational health, safety, diversity, inclusion, and overall organizational performance.

Key Topics

• Workplace Policy Development: Guidance on establishing policies that consider the privacy, health, and practical needs related to menstruation and menopause.
• Physical Work Environment: Recommendations for improving facilities (toilets, hygiene, rest spaces) and workstations for comfort and accessibility.
• Supportive Culture: Strategies for establishing open communication, reducing stigma, and building awareness among managers and staff.
• Flexible Work Design: Insights into adjusting job roles, working hours, and environments to accommodate varying needs.
• Disclosure and Privacy: Balancing confidential support with the necessity for organizational awareness.
• Inclusivity: Considering the experiences of women, trans men, non-binary people, and the impacts of intersectionality related to age, ethnicity, and other social characteristics.
• Tailoring for SMEs: Specific cost-effective solutions for small and medium-sized enterprises.
• Evaluation and Continuous Improvement: Recommendations on assessing policy effectiveness and refining practices using defined metrics.
• Manager and HR Toolkits: Practical resources, such as checklists and charters, for internal assessments and implementation.

Applications

Adopting ISO/FDIS 45010 offers organizations practical steps to:

• Enhance Worker Wellbeing: Supporting menstrual and menopausal health can significantly boost job satisfaction, retention, and productivity.
• Reduce Absenteeism and Presenteeism: Proactive adjustments minimize time off and optimize worker engagement.
• Promote Diversity and Inclusion: Implementing gender-inclusive policies attracts a broader talent pool and supports organizational equality goals.
• Improve Employer Brand: Forward-thinking practices distinguish employers seeking to provide supportive, healthy work environments.
• Meet Occupational Health and Safety Expectations: The standard aligns with broader workplace wellbeing, safety, and hygiene objectives, helping organizations fulfill stakeholder and regulatory expectations.
• Support Managers and HR: By offering clear guidance, toolkits, and checklists, the standard makes it easier for those responsible for workplace health, diversity, or facilities to act confidently.
• Comply with National and International Best Practices: Adherence to ISO/FDIS 45010 signals a commitment to global standards and may support compliance with regulations or supplier requirements.

Related Standards

Organizations looking to adopt ISO/FDIS 45010 may also benefit from guidance in allied standards, such as:

• ISO 45001: Occupational health and safety management systems - Requirements with guidance for use
• ISO 53800: Guidelines on gender equality and inclusion in the workplace
• ISO 25550: Guidelines for generating an age-inclusive workplace
• ISO 25551: Guidelines for creating a carer-inclusive workplace
• BSI PAS 6463: Design for neurodiversity and sensory-friendly work environments

By integrating ISO/FDIS 45010 guidance within a broader occupational health and diversity policy framework, organizations can more effectively create workplaces that are inclusive, equitable, and attuned to the real-life experiences of all workers.

Keywords: ISO 45010, menstruation in workplace, menopause support, workplace policy, menstrual health, occupational health and safety, gender inclusion, workplace diversity, SME wellbeing, HR best practices, international standards, workplace inclusivity

Standards Content (Sample)

SLOVENSKI STANDARD
oSIST ISO/DIS 45010:2025
01-september-2025
Sistem vodenja varnosti in zdravja pri delu - Menstruacija, menstrualno zdravje in
menopavza na delovnem mestu - Napotki
Occupational health and safety management – Menstruation, menstrual health and
menopause in the workplace – Guidance
Titre manque
Ta slovenski standard je istoveten z: ISO/DIS 45010
ICS:
03.100.30 Vodenje ljudi Management of human
resources
13.100 Varnost pri delu. Industrijska Occupational safety.
higiena Industrial hygiene
oSIST ISO/DIS 45010:2025 en
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

oSIST ISO/DIS 45010:2025
oSIST ISO/DIS 45010:2025
DRAFT
International
Standard
ISO/DIS 45010
ISO/TC 283
Occupational health and safety
Secretariat: BSI
management – Menstruation,
Voting begins on:
menstrual health and menopause in
2025-08-04
the workplace – Guidance
Voting terminates on:
ICS: 13.100; 03.100.30
2025-10-27
THIS DOCUMENT IS A DRAFT CIRCULATED
FOR COMMENTS AND APPROVAL. IT
IS THEREFORE SUBJECT TO CHANGE
AND MAY NOT BE REFERRED TO AS AN
INTERNATIONAL STANDARD UNTIL
PUBLISHED AS SUCH.
IN ADDITION TO THEIR EVALUATION AS
BEING ACCEPTABLE FOR INDUSTRIAL,
TECHNOLOGICAL, COMMERCIAL AND
USER PURPOSES, DRAFT INTERNATIONAL
STANDARDS MAY ON OCCASION HAVE TO
This document is circulated as received from the committee secretariat.
BE CONSIDERED IN THE LIGHT OF THEIR
POTENTIAL TO BECOME STANDARDS TO
WHICH REFERENCE MAY BE MADE IN
NATIONAL REGULATIONS.
RECIPIENTS OF THIS DRAFT ARE INVITED
TO SUBMIT, WITH THEIR COMMENTS,
NOTIFICATION OF ANY RELEVANT PATENT
RIGHTS OF WHICH THEY ARE AWARE AND TO
PROVIDE SUPPORTING DOCUMENTATION.
Reference number
ISO/DIS 45010:2025(en)
oSIST ISO/DIS 45010:2025
DRAFT
ISO/DIS 45010:2025(en)
International
Standard
ISO/DIS 45010
ISO/TC 283
Occupational health and safety
Secretariat: BSI
management – Menstruation,
Voting begins on:
menstrual health and menopause in
the workplace – Guidance
Voting terminates on:
ICS: 13.100; 03.100.30
THIS DOCUMENT IS A DRAFT CIRCULATED
FOR COMMENTS AND APPROVAL. IT
IS THEREFORE SUBJECT TO CHANGE
AND MAY NOT BE REFERRED TO AS AN
INTERNATIONAL STANDARD UNTIL
PUBLISHED AS SUCH.
IN ADDITION TO THEIR EVALUATION AS
BEING ACCEPTABLE FOR INDUSTRIAL,
© ISO 2025
TECHNOLOGICAL, COMMERCIAL AND
USER PURPOSES, DRAFT INTERNATIONAL
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
STANDARDS MAY ON OCCASION HAVE TO
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on
This document is circulated as received from the committee secretariat. BE CONSIDERED IN THE LIGHT OF THEIR
the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below
POTENTIAL TO BECOME STANDARDS TO
WHICH REFERENCE MAY BE MADE IN
or ISO’s member body in the country of the requester.
NATIONAL REGULATIONS.
ISO copyright office
RECIPIENTS OF THIS DRAFT ARE INVITED
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Email: [e-mail]
Website: www.iso.org
Published in Switzerland Reference number
ISO/DIS 45010:2025(en)
ii
oSIST ISO/DIS 45010:2025
ISO/DIS 45010:2025(en)
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Introduction to menstruation, menstrual health and menopause at work . 3
5 Practical actions . 6
5.1 General .6
5.2 Physical aspects of work .7
5.2.1 General .7
5.2.2 Recommendations on physical aspects of work.7
5.3 Policy guidance and practice .8
5.3.1 General .8
5.3.2 Policy-related recommendations .8
5.4 Supportive workplace cultures .9
5.4.1 General .9
5.4.2 Supportive workplace culture recommendations .10
5.5 Work design .11
5.5.1 General .11
5.5.2 Work design recommendations .11
5.6 Disclosure and privacy relating to menstruation and menopause at work . 12
5.6.1 General . 12
5.6.2 Disclosure and privacy recommendations . 12
5.7 Inclusivity in menstrual health and menopause at work . 13
5.7.1 General . 13
5.7.2 Inclusivity recommendations . 13
5.8 Considerations for small and medium-sized enterprises (SMEs) .14
5.8.1 General .14
5.8.2 SMEs recommendations .14
5.9 Evaluation and metrics . 15
5.9.1 General . 15
5.9.2 Evaluation and metrics recommendations . 15
Annex A (informative) Further information on menstrual and menopausal health . 17
Annex B (informative) Manager toolkit .24
Annex C (informative) Sample internal review checklist based on recommendations from this
guide .31
Annex D (informative) Recruitment considerations and ideas to reduce barriers .34
Annex E (informative) Initiatives to facilitate culture change around menopause, menstruation
and menstrual health at work .36
Annex F (informative) Workplace Charter Proforma for Supporting Menopause, Menstruation
and Menstrual Health at Work .40
Bibliography .44

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Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
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with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types
of ISO documents should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent
rights in respect thereof. As of the date of publication of this document, ISO [had/had not] received notice of
(a) patent(s) which may be required to implement this document. However, implementers are cautioned that
this may not represent the latest information, which may be obtained from the patent database available at
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related to conformity assessment, as well as information about ISO's adherence to the World Trade
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This document was prepared by Technical Committee ISO/TC 283, Occupational Health and Safety
Management.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

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Introduction
0.1  General
This document can assist organizations in developing and embedding supportive structures, policies and
practices for menstruation, menstrual health, and menopause, and promote inclusive workplaces. The
practical workplace adjustments and activities recommended here complement good practice in workplace
wellbeing and occupational health and safety (ISO 45001) and gender inclusion in the workplace (ISO 53800).
Menstruation, menstrual health and menopause are not medical conditions but life course experiences (See
A.1 & A.2). For many workers, the experience of menstrual health and menopause is managed independently
and privately without the need for additional support by organizations. However, organizations can
introduce adjustments, supportive mechanisms and policies that reduce stigma and make a significant and
positive difference to workers.
Providing a supportive and inclusive workplace environment around menstruation and menopause can
have significant positive effects for worker engagement, job satisfaction and a more inclusive and culturally
safe workplace environment for all. A lack of knowledge, understanding or support for menstrual health
or menopause and associated symptoms can lead to challenges including presenteeism, absenteeism,
disengagement and additional or increased turnover costs.
Recommendations can assist employers and organizations, supervisors, human resources (HR), occupational
health and safety (OH&S) professionals, onsite healthcare professionals, wellbeing and diversity and
inclusion (D&I) practitioners, and architects and interior designers responsible for work space construction
and refurbishment. It can also support those workers who are responsible for managing individuals’
performances, workloads, wellbeing or work environments.
NOTE 1 In this document the term ‘menopause transition’ is used to refer to the experiences of pre- post- and
menopause transition. See 3.0.
NOTE 2 Further information on menstruation, menstrual health and menopause can be found in Annex A.
NOTE 3 See also ISO 25551 for guidance on generating a carer-inclusive workplace and ISO 25550 for guidance on
generating an age-inclusive work environment.
NOTE 4 While the document does not consider andropause in the workplace, many recommendations here can also
support workers experiencing andropause. Refer to Clause 3.1 for the definition.
0.2  Why start addressing this topic now?
By 2030, over 1.2 billion women worldwide will be menopausal or post-menopausal, meaning a significant
number of workers are or will experience menstruation and menopause while in the workplace. While
gender parity in labour force participation varies across different economies, it is often the case that women
are often expected to fit into modes of working and cultural expectations that were historically designed
at a time when women were not equally represented or prioritized as workers. Symptoms associated with
menstruation and menopause can also coincide with significant life challenges and responsibilities, and
research has shown that stress and symptoms associated with menopause are inextricably linked. For
example, symptoms associated with menstruation and menopause might occur when workers are also
dealing with stressors such as other health conditions; fertility issues; managing childcare and care for older
parents; children leaving home; financial constraints; relationship breakdown or other significant life events.
Promoting and supporting the health of workers brings multiple benefits to organizations, reducing
occupational risks and absences. It can increase reputation through attracting a workforce that want to work
in organizations that are inclusive, supportive of worker health and wellbeing, and free from deliberately or
accidentally discriminating against different groups.
There are other financial reasons for taking into account menstrual and menopausal health in the workplace.
There are direct financial costs associated with the recruitment and training of new staff to replace those
who have left. There are also indirect costs due to the loss of talent, knowledge and experience within the
organization.
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Workers can experience menstrual health or menopause symptoms which can impact their ability to
perform effectively at work, and can cause them to leave an unsupportive work environment. There is a
possibility that other workers choose to be underemployed or work fewer hours.
Implementing good practice around supporting menstruation, menstrual health and menopause in the
workforce benefits organizations by:
a) increasing worker engagement;
b) improving the health and wellbeing of workers and boosting their healthy working life expectancy
c) improving leadership cultures by generating more awareness amongst all managers; and
d) improving diversity and inclusion objectives by preventing high turnover in organizations due to
inadequate, unsupportive or inflexible working conditions.
e) attract a diverse workforce, increasing worker retention, and reducing the costs of attrition, recruitment
and training;
f) helping to comply with occupational health expectations from suppliers and buyers
0.3  Questions which this document can help to address
Table 1 identifies clauses which address key areas around menstruation, menstrual health and menopause.
Table 1 — Frequently Asked questions that this document addresses
Question Clause
I have a workforce who are located in different or high-risk physical environments. What 5.3
design changes should I consider to support menstruation and menopause? 5.5
B.3
I am recruiting new workers. How can I remove barriers in the recruitment process for Annex D
those who menstruate or are experiencing menopause?
I want to introduce or update a menstruation and menopause policy. What key factors 5.3
should I consider?
5.4
I run a small organization with limited resources. What cost-effective but impactful steps 5.8
can I take to support workers experiencing menstruation and menopause at work?
I am a supervisor. How can I support workers experiencing menstruation and menopause in 5.3
my workplace?
Annex B
My workforce is diverse. Do different minority ethnic or underrepresented groups experi- 5.7
ence menstruation and menopause at work differently? Annex A
I want my organization’s menstruation and menopause policies and practices to be gender 5.4
inclusive. How can my organization support trans and non-binary workers? 5.7

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DRAFT International Standard ISO/DIS 45010:2025(en)
Occupational health and safety management – Menstruation,
menstrual health and menopause in the workplace –
Guidance
1 Scope
This document gives guidance to organizations on developing policies and practices that are supportive of
the menstrual and menopausal health and menopausal experiences of workers in the workplace.
The document does not cover medical guidance or clinical options outside of the workplace. However, it does
include reference to qualified sources where such information is available.
The document is useful to managers, as well as human resources (HR), occupational health and safety
(OH&S), wellbeing and diversity and inclusion (D&I) practitioners, and architects and interior designers
undertaking work space construction or refurbishments. It is for those workers who are responsible for
managing individuals’ performances, workloads, wellbeing or work environments.
NOTE 1 The recommendations are applicable to all sectors, worker demographics, and small and large
organizations, and can be adapted to individual business needs.
NOTE 2 This document does not consider andropause.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1
andropause
health experience associated with decreasing levels of testosterone
Note 1 to entry: Andropause has different hormonal patterns, physiological change processes and cultural perceptions
to menopause.
3.2
menstruation
the cyclical shedding of blood and tissue from the uterus and out through the vagina when fertilization of
the egg has not occurred
Note 1 to entry: It usually takes 4-5 days for shedding to take place.

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3.3
menstrual cycle
hormonal cycle that prepares the uterus for pregnancy and triggers menstruation, beginning on the first
day of one period and ending when the next period starts
Note 1 to entry: Menstruation occurs approximately every 28/29 days, with variations in cycle length from 21 to 35
days considered ‘normal’.
3.4
period
commonly used term for the days of menstrual bleeding within each menstrual cycle
Note 1 to entry: The first period is called menarche and the last period occurs during menopause transition.
3.5
menstrual health
menstrual health is concerned with achieving physical, mental, and social well-being related to the
menstrual cycle
Note 1 to entry: Menstrual health can include adequate access to menstrual health education, menstrual products and
freedom from stigma and discrimination.
3.6
menopause
the time of life associated with the permanent cessation of the menses (period)
Note 1 to entry: Throughout this document the everyday use of the term “menopause” often refers to the entire
duration of menopause transition, unlike the medical definition, which differentiates between perimenopause (the
time before menopause when symptoms begin to occur), menopause (the moment in time traditionally marked by the
year anniversary of a person’s final period) and post-menopause (the time after menopause when symptoms can be
still present).
Note 2 to entry: Menopause usually happens between the ages of 45 and 55. Lifestyle, ethnicity and genetics have an
impact on the average age. While not common, menopause can occur earlier.
Note 3 to entry: Symptoms can vary in frequency and severity and often change over the course of the menopausal,
lasting anywhere for a few months or for several years.
Note 4 to entry: Medical menopause can occur earlier, for example due to surgery, chemotherapy or hormonal
1)
treatments. The WHO Fact Sheet can be reviewed for medical information.
3.7
perimenopause
time leading up to menopause during which noticeable changes are experienced
Note 1 to entry: A sub-stage of menopause in which hormones begin to fluctuate and symptoms (including irregular
menstruation, joint pain, changes in body temperatures, and sleep disturbances) can occur.
Note 2 to entry: This stage continues until menstruation has ceased for 12 consecutive months. Symptoms of
perimenopause can start several years before menopause. Symptoms can vary in frequency and severity and often
change over the course of menopause.
3.8
postmenopause
time after menopause
1) Available at https:// www .who .int/ news -room/ fact -sheets/ detail/ menopause #: ~: text = This %20means %20that
%20the %20ovaries ,55 %20years %20for %20women %20worldwide.

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3.9
menstruation or menopause advocate
an appropriately trained person appointed by an organization or worker representative group (such as a
trade union) who is trained to represent and support workers with menstrual and menopausal needs
Note 1 to entry: The terms “champion”, “ambassador” and “mentor” are also used to refer to this role.
3.10
intersectionality
interconnected nature of a person’s combined social and political identities
Note 1 to entry: Intersectionality recognizes that certain characteristics overlap to increase oppression, limit
opportunity and reinforce inequality. Examples of characteristics include age, sex, race, ethnicity, sexual orientation,
gender identity, religion, disability, neurodivergence, class, socio-economic background, and geographical location (in
terms of access to medical support). All of these aspects can have an impact on the experience of menstrual health and
menopause. Therefore, there is no one, singular experience.
3.11
non-binary
individuals who do not identify their gender as man or woman
3.12
symptoms
An indicator of a condition or illness
Note 1 to entry: This document uses the term “symptoms” to recognize that, even though menstruation and menopause
are not medical illnesses, some find that these changes or cyclical experiences have an impact on their quality of life.
It is important to recognize that some symptoms associated with menstruation and menopause can be caused by an
underlying medical condition (see Annex A).
3.13
transgender
person whose gender identity differs in some way from the sex they were assigned at birth
Note 1 to entry: Also referred to by shorthand trans, this umbrella term can include trans men, trans women, non-
binary people, gender questioning and gender-fluid people.
4 Introduction to menstruation, menstrual health and menopause at work
Menstruation and menopause are common and healthy biological processes; however, there is still a social
stigma around them, and the topics are frequently avoided and concealed within society. This can cause
some workers to struggle in silence. However, workplace cultures where menstrual health and menopause
are openly discussed enable workers and organizations to work collaboratively to identify appropriate
support or adjustments that enable workers to perform at their best.
Understandings of menstruation, menstrual health and menopause are often complex, culturally bound and
subject to stigma. This can result in workers feeling ashamed to discuss, or apprehensive about discussing, in
organizations. Menstruation and menopause are also subject to a number of misconceptions (see Annex F).
Menstruation and menopause are unique to each worker in terms of the experience of symptoms and their
frequency and severity, which can change over a worker’s life or journey through menopause, which can
happen over several years. Furthermore, diverse needs and experiences of menstruation and menopause
linked to ethnicity, religion, sexual orientation, gender identity and neurodivergence are often neglected
(see Appendix A.3).
References to menstruation, menstrual health and menopause in the workplace are uncommon. When
they do appear, they often take the form of discussions, conversations or policies that highlight severe and
negative physical, emotional and psychological symptoms. This focus can shape broader attitudes and
behaviours that reinforce the stigma that menstruation is always problematic and that menopause is a
negative, isolating experience.

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Menstruation, menstrual health and menopause and work can affect each other in positive and negative
ways. Symptoms can impact how workers experience work and under certain conditions can influence
worker engagement and turnover. In addition, workplace environments such as the type of the work, job
demands, and perceptions of managerial support can impact the experience of symptom frequency and
severity.
There are simple adjustments which can help workers to be more comfortable when experiencing discomfort
while working. Clause 5 gives guidance on potential adjustments, practical actions and support options.
Organizations might already have some support mechanisms in place that can be sensitized to include
references to menstrual health and menopause.
When workers need support at work, managers should be advised to seek guidance from their HR or OH&S
practitioner or a trained menstruation and menopause advocate as appropriate, and/or be provided with
resources from professional and reputable external providers. Annex B provides a toolkit to support HR and
managers.
In those cases where symptoms are severe enough to disrupt someone’s working life and are not alleviated
by self-help interventions, an underlying condition might be the cause. Workers with underlying or severe
ongoing symptoms are likely to require medical advice and the organization can be supportive in this
process. If a medical condition is causing severe symptoms, the worker should receive support in line
with other long-term medical conditions. It is important to understand that a period or menopause where
there is an underlying health condition should not be dismissed as “a bad period” or “a bad menopause”.
Additional support might prove necessary where a worker has a medical condition which is exacerbating
their menstrual or menopausal symptoms.
Aside from workers potentially concealing their discomfort, some might not realize their symptoms could
be helped by medical intervention and that they might be signs of an underlying condition.
NOTE 2 Some medical conditions involve a lack of menstruation, which might cause a worker to lack awareness
regarding their own menopause status. However, they might still be experiencing symptoms of menopause. Annex A
provides additional information on health-related aspects of menstruation and menopause.
The flowchart in Figure 1 can assist organizations to review what support is already available or can be
improved upon for workers who are experiencing symptoms.

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Figure 1 — Considerations flowchart
Organizations should also be aware that stressors in the workplace environment, often relating to
specific job roles and/or workplace cultures, can provoke or worsen symptoms. Possible stressors
include an accumulation of occupational psychosocial stress, experiencing gender, racial or other forms of
discrimination, being bullied, and pre-existing medical conditions such as a back or repetitive strain injury.
Workers can experience a combination of different stressors. Workers who are navigating new job roles,

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promotions and/or decision-making responsibilities might experience additional challenges. Being proactive
in identifying areas of risk and opportunity and introducing remedial actions that are worker-centric and
holistic are likely to result in better work environments for all.
It is important that organizations recognize that menopause can have an impact on workers in all roles and
levels of work. Organizations should avoid making assumptions about the experience and, in particular, the
age at which menopause might be experienced.
5 Practical actions
5.1 General
There are many ways in which an organization can implement changes to support its workers. This clause
provides ideas on potential workplace considerations, including considerations particularly relevant to
small and medium sized enterprises (SME’s) in 5.7.
Practical actions range from workplace environmental and physical factors to flexible work design and
creating a positive inclusive culture promotes awareness of menstrual health and then menopause.
Adjustments and actions should be embedded within existing systems and processes that attend to worker
health and wellbeing.
Guidance can be found in the following subclauses and Annexes:
— Examples of adjustments that can be implemented to support workers are included in 5.2 to 5.7. The
examples have been categorized for ease of reading; however, the adjustments might overlap for a range
of situations, and they are not an exhaustive list. All available adjustments should be easily accessible to
all workers (including women, trans men and non-binary people) without the need to disclose the reason.
— Annex C provides a checklist with several of the recommendations and adjustments mentioned in this
document. This can serve as a support tool when reviewing practices.
Figure 2 illustrates the framework, described throughout this standard, that suggests how organizations
can implement practical actions, while making inclusivity a core consideration, and using ongoing evaluation
and metrics to monitor progress in the organization.
Figure 2 — Areas to consider when supporting menstrual and menopausal health in the workplace

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5.2 Physical aspects of work
5.2.1 General
Workers who experience menstrual and menopausal symptoms work across diverse settings, and both on
fixed or variable work sites and remotely. Simple changes can be made to improve the symptom experience
for workers in these environments. Any changes made to the physical working environment are likely to
benefit all workers, creating a better workplace for all.
Adjustments made should account for existing risk management controls as well as individual needs,
particularly in complex or high-risk environments. To avoid any changes exposing workers to other
occupational risks, adjustments need to be implemented on a case-by-case basis and considered carefully in
light of the job role, risk and potential for harm.
5.2.2 Recommendations on physical aspects of work
Options that can be implemented to help workers manage symptoms include the following.
Physical work setting and layout
a) Allow unrestricted access to toilet or shower facilities, including considerations for mobile, remote
or shift workers. Where possible, self-contained toilet facilities should include washbasins inside the
cubicles and the provision of a shelf alongside the basin that can be used to place products on. Placing
the washbasin, soap dispenser and paper towels within reach of those seated on the toilet supports the
use of sustainable menstruation products such as the menstrual cup.
b) For sedentary jobs, provide ergonomic seating and opportunities to stand up, stretch or move around if
the job involves sitting for long periods of time to prevent aggravation of joint pain or cramps.
c) Where unallocated seating on a work site (often called hot desking) is used, it is helpful to provide desk
plans with as much information as possible. This can include details on lighting, windows, physical
proximity to washrooms or quiet rooms if available, and where to find warmer or cooler parts of the
building.
d) Assess the use of natural materials in the building or in workplace furnishings which can help with
thermal comfort. Choose furnishings and fabrics that are breathable and stay cooler but can be cleaned
easily when required.
e) Provide spaces for short-term recuperation, rest and management of episodic symptoms, such as
seating, privacy, or a calming environment.
f) Provide easy and complimentary access to menstrual products as well as safe storage to avoid damage
to menstrual products.
g) Provide safe/hygienic disposal for menstrual products in all toilet and changing facilities.
Work environment conditions
h) Provide easy access to cool drinking water, warm beverages and snacks (as some medication might
need to be taken with food). If a site is remote from facilities, consider selling or providing food and
refreshments on the premises.
i) Provide blinds or curtains to block out bright sunlight to avoid triggering headaches or photosensitivity.
j) Provide a quieter area or noise reduction options to support menopausal symptoms around hearing
sensitivity or headaches.
k) In humid conditions, where possible, provide de-humidifiers and ensure adequate ventilation to help
support changes in body temperature.
l) Where practicable, allow windows to be opened, and fans (desk or handheld) or a localised heat source
to be available.
oSIST ISO/DIS 45010:2025
ISO/DIS 45010:2025(en)
m) Assess lighting in tandem with health and wellbeing considerations and avoid centralised lighting
control where possible. Where heat-generation processes are part of the work, offset with lighting of a
cooler colour.
n) Identify areas in the building that are naturally warmer or cooler to support changes in body
temperature.
o) Where strong scents or odours (e.g. food facilities, chemicals), assess impact for olfactory (smell) due to
hypersensitivity associated with some menstrual or menopausal symptoms.
NOTE Guidance on sensory-friendly environments can be found in BSI PAS 6463.
p) Ensure menstrual health and menopause is supported through adequate hygiene management facilities
(including disposal options and running water) especially in sectors and regions with limited access.
Work clothing
q) Offer discreet places to change clothes and ability to store spare clothes.
r) Where uniforms are required, provide a comfortable size, ideally made from breathable natural fabric
(such as cotton or bamboo), and easy to launder. Where possible or feasible, allow options for darker
colours, additional items and fittings that allow for temporary fluctuations in size (elastic or adjustable
waistbands can be particularly helpful).
s) Check if personal protective equipment (PPE) and safety equipment can be made more comfortable
without compromising other health and safety requirements. This can include providing equipment
made of different materials or different sizes.
5.3 Policy guidance and practice
5.3.1 General
Providing clear and consistent policies that support menstrual health and menopause across the
organization supports managers, supervisors and workers to determine and apply actions to improve and
facilitate wellbeing of workers who have menstrual and menopausal need at work.
To facilitate a fair and consistent approach, relevant organizational policies should be regularly reviewed
and cross-referenced. In particular, the organization’s approach to menstrual and menopausal health should
fit with the organization’s overall wellbeing and health strategies, policies and procedures. This increases
the likelihood of any steps taken being effectively implemented and embedded into practice and culture.
Depending on the business needs, organization can introduce either a stand along policy or integrate
reference to menstruation, menstrual health and menopause into existing policies. However, both
approaches require cross-referencing or merging with current policy to provide consistent and supportive
protocol.
5.3.2 Policy-related recommendations
The following are policy-related recommendations:
Developing policy - considerations
a) Consult with a variety of workers who could be impacted. The consultation group should include
representation from a diverse range of workers in different roles. Privacy and confidentiality should be
protected to encourage participation and open discussion.
b) Reflect on which other policies are relevant and can be used by managers and workers to help support
menstrual and menopausal health (e.g. diversity and inclusion, performance management, sickness and
absence, flexible working), and review all relevant policies to create a consistent approach.

oSIST ISO/DIS 45010:2025
ISO/DIS 45010:2025(en)
c) Verify that absence or attendance management policy and processes allow for menstrual and
menopausal symptoms and experiences to be recorded.
d) Where applicable, engage with relevant regional or national policies and provision that support
menstruation and menopause.
Ensure menstrual health and menopausal are included as “worker factors” in risk assessments
Implementing policy - considerations
e) Effectively communicate policies to everyone in the organization (managers and HR should understand
the contents and implementation of these policies).
f) Review organizational procedures to support the implementation of the policies and actions.
g) Establish and embed a pathway for managers to achieve a good awareness and understanding about
the importance of supporting menstruation, menstrual health and menopause at work, including
compliance obligations regarding health and safety, and equality, diversity and inclusion.
h) Consider the introduction of “workplace support agreements”: a document individual to the worker
that follows the worker across different managers or roles. These are short documents which can help
workers and managers record agreed adjustments.
Ongoing policy - considerations
i) Given that menstrual and menopause symptoms and needs change over time, ensure policies include
requirement for periodic check-ins.
j) Review risk assessments to ensure they are gender-inclusive. This can include verifying that they
include a reproductive health and well-being component, a physical and mental health assessment, and
that they consider part-time and temporary workers. Assessments might be necessary to monitor the
impact of work on the worker and the worker’s ability to complete the allocated tasks.
k) Ensure recruitment, training and progression policies are inclusive of menstrual and menopausal
health (e.g. maintain access to training while adjustments are in place). See Annex D for examples of
recruitment considerations.
l) Embed consultation routes to discuss changes. Where relevant, the consultation group should include
representation from a range of workers in different roles, including representation of the demographics
of the organization and including worker representatives where they exist and safety representatives.
m) Ensure organizational strategies are inclusive of gender to avoid hidden bias in planning and design.
5.4 Supportive workplace cultures
5.4.1 General
Cultivating a healthy workplace culture is a critical part of making positive change and addressing any
potential stigma around menstruation
...

FINAL DRAFT
International
Standard
ISO/TC 283
Occupational health and safety
Secretariat: BSI
management — Menstruation and
Voting begins on:
menopause in the workplace —
2026-05-26
Guidance
Voting terminates on:
2026-07-21
RECIPIENTS OF THIS DRAFT ARE INVITED TO SUBMIT,
WITH THEIR COMMENTS, NOTIFICATION OF ANY
RELEVANT PATENT RIGHTS OF WHICH THEY ARE AWARE
AND TO PROVIDE SUPPOR TING DOCUMENTATION.
IN ADDITION TO THEIR EVALUATION AS
BEING ACCEPTABLE FOR INDUSTRIAL, TECHNO­
LOGICAL, COMMERCIAL AND USER PURPOSES, DRAFT
INTERNATIONAL STANDARDS MAY ON OCCASION HAVE
TO BE CONSIDERED IN THE LIGHT OF THEIR POTENTIAL
TO BECOME STAN DARDS TO WHICH REFERENCE MAY BE
MADE IN NATIONAL REGULATIONS.
Reference number
FINAL DRAFT
International
Standard
ISO/TC 283
Occupational health and safety
Secretariat: BSI
management — Menstruation and
Voting begins on:
menopause in the workplace —
Guidance
Voting terminates on:
RECIPIENTS OF THIS DRAFT ARE INVITED TO SUBMIT,
WITH THEIR COMMENTS, NOTIFICATION OF ANY
RELEVANT PATENT RIGHTS OF WHICH THEY ARE AWARE
AND TO PROVIDE SUPPOR TING DOCUMENTATION.
© ISO 2026
IN ADDITION TO THEIR EVALUATION AS
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
BEING ACCEPTABLE FOR INDUSTRIAL, TECHNO­
LOGICAL, COMMERCIAL AND USER PURPOSES, DRAFT
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on
INTERNATIONAL STANDARDS MAY ON OCCASION HAVE
the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below
TO BE CONSIDERED IN THE LIGHT OF THEIR POTENTIAL
or ISO’s member body in the country of the requester.
TO BECOME STAN DARDS TO WHICH REFERENCE MAY BE
MADE IN NATIONAL REGULATIONS.
ISO copyright office
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Published in Switzerland Reference number
ii
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Introduction to menstruation and menopause at work . 3
5 Practical actions . 5
5.1 General .5
5.2 Physical aspects of work .6
5.2.1 General .6
5.2.2 Recommendations on physical aspects of work.7
5.3 Policy guidance and practice .8
5.3.1 General .8
5.3.2 Policy-related recommendations .8
5.4 Supportive workplace cultures .9
5.4.1 General .9
5.4.2 Supportive workplace culture recommendations .10
5.5 Job design .11
5.5.1 General .11
5.5.2 Job design recommendations .11
5.6 Disclosure and privacy relating to menstruation and menopause at work . 12
5.6.1 General . 12
5.6.2 Disclosure and privacy recommendations . 12
5.7 Inclusivity in menstruation and menopause at work . 13
5.7.1 General . 13
5.7.2 Inclusivity recommendations . 13
5.8 Considerations for small and medium-sized enterprises . 15
5.8.1 General . 15
5.8.2 SMEs recommendations . 15
5.9 Evaluation and metrics .16
5.9.1 General .16
5.9.2 Evaluation and metrics recommendations .16
Annex A (informative) Further information on menstrual and menopausal health .18
Annex B (informative) Manager toolkit .25
Annex C (informative) Sample internal review checklist .35
Annex D (informative) Recruitment considerations and ideas to reduce barriers .39
Annex E (informative) Initiatives to facilitate culture change around menopause and
menstruation at work .42
Annex F (informative) Workplace charter pro forma for supporting menstrual and menopausal
health at work . 47
Annex G (informative) Cross-reference matrix showing how this document complements
ISO 45001 . 51
Bibliography .53

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
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The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types
of ISO document should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent
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This document was prepared by Technical Committee ISO/TC 283, Occupational health and safety
management.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

iv
Introduction
0.1  General
This document can assist organizations in developing and embedding supportive structures, policies
and practices for menstruation and menopause, and by extension, for menstrual and menopausal health.
The practical workplace adjustments and activities recommended in this document promote inclusive
workplaces and complement good practice in workplace well-being and occupational health and safety (see
ISO 45001) and gender inclusion in the workplace (see ISO 53800).
Menstruation and menopause are not medical conditions but life course experiences (see Clauses A.1
and A.2). For many workers, the experience of menstruation and menopause is managed independently and
privately without the need for additional support by organizations. However, organizations can introduce
workplace adjustments, supportive mechanisms and policies that reduce stigma and make a significant and
positive difference to workers.
Providing a supportive and inclusive workplace environment around menstruation and menopause can
have significant positive effects for worker engagement and job satisfaction, and a more inclusive and
culturally safe workplace environment for all. A lack of knowledge, understanding or support for menstrual
health or menopause and associated symptoms can lead to challenges including presenteeism, absenteeism,
disengagement and additional or increased turnover costs.
This document can assist employers and organizations, senior leaders, supervisors, human resource
professionals (HR), occupational health and safety (OH&S) professionals, onsite healthcare professionals,
well-being and diversity and inclusion (D&I) practitioners, and architects and interior designers responsible
for workspace construction and refurbishment. It can also support workers who are responsible for
managing individuals’ performances, workloads, well-being or work environments.
NOTE 1 Further information on menstruation, menstrual health and menopause can be found in Annex A.
NOTE 2 Further information on how this document complements ISO 45001 can be found in Annex G.
NOTE 3 See also ISO 25551 for guidance on generating a carer-inclusive workplace and ISO 25550 for guidance on
generating an age-inclusive work environment.
NOTE 4 While this document does not consider andropause in the workplace, many of its recommendations can
also support workers experiencing andropause.
0.2  Why start addressing this topic now?
[18]
By 2030, over 1,2 billion women worldwide will be menopausal or postmenopausal, and 1,8 billion women
[19]
menstruate every month, meaning a significant number of workers are or will experience menstruation
and menopause while in the workplace. While gender parity in labour force participation varies across
different economies, it is often the case that women are expected to fit into modes of working and cultural
expectations that were historically designed at a time when women were not equally represented or
prioritized as workers.
Symptoms associated with menstruation and menopause can also coincide with significant life challenges
and responsibilities, and research has shown that stress and symptoms associated with menopause are
inextricably linked. For example, symptoms associated with menstruation and menopause can occur when
workers are also dealing with stressors such as other health conditions, fertility issues, pregnancy loss,
deaths of significant others, managing childcare and care for older parents, children leaving home, financial
constraints, relationship breakdown or other significant life events.
Promoting and supporting the health of workers brings multiple benefits to organizations, such as reducing
occupational risks and absences. By fostering inclusivity, supporting worker well-being, and eliminating
discrimination, organizations can also enhance their reputation and attract a diverse workforce.
Workers can experience menstrual or menopausal symptoms which can impact their experience of work
and can cause them to leave an unsupportive work environment. Symptoms experienced in an unsupportive

v
environment can also contribute to underemployment or working fewer hours, which can impact their
career trajectories, promotional prospects and financial security in later life.
Implementing good practice around supporting menstruation and menopause in the workforce also benefits
organizations by:
a) increasing worker engagement;
b) improving the health and well-being of workers and boosting their healthy working life expectancy;
c) improving leadership cultures by generating more awareness amongst all managers;
d) improving diversity and inclusion objectives by preventing high turnover in organizations due to
inadequate, unsupportive or inflexible working conditions;
e) attracting a diverse workforce, increasing worker retention, and reducing the financial costs of attrition,
recruitment and training;
f) helping to comply with occupational health expectations from suppliers and buyers.
0.3  Questions this document can help to address
Table 1 identifies the elements of this document which address key areas around menstruation, menstrual
health and menopause.
Table 1 — Frequently asked questions that this document addresses
Question Clause/
subclause/annex
I have a workforce who are located across different environments, some of which are 5.3
physically or psychologically demanding. What design changes should I consider that 5.5
support menstruation and menopause? Clause B.3
I am recruiting new workers. How can I remove barriers in the recruitment process for those
Annex D
who menstruate or are experiencing menopause?
I want to introduce or update a menstruation and menopause policy. What key factors should 5.3
I consider?
5.4
I run a small organization with limited resources. What cost-effective but impactful steps can
5.8
I take to support workers experiencing menstruation and menopause at work?
I am a supervisor. How can I support workers experiencing menstruation and menopause in 5.3
my workplace?
Annex B
I have a diverse workforce. Do people from different racially and ethnically diverse 5.7
backgrounds experience menstruation and menopause at work differently? Annex A
My organization is gender inclusive. How can my organization’s menstruation and 5.4
menopause policies and practices support everyone? 5.7

vi
FINAL DRAFT International Standard ISO/FDIS 45010:2026(en)
Occupational health and safety management — Menstruation
and menopause in the workplace — Guidance
1 Scope
This document gives guidance to organizations on developing policies and practices that are supportive of
the menstrual and menopausal health and menopausal experiences of workers in the workplace.
This document is applicable to any organization regardless of size or sector and can be adapted to individual
business needs.
This document does not apply to medical guidance or clinical options outside of the workplace. However, it
does include reference to qualified sources where such information is available.
This document does not apply to andropause.
2 Normative references
The following documents are referred to in the text in such a way that some or all of their content constitutes
requirements of this document. For dated references, only the edition cited applies. For undated references,
the latest edition of the referenced document (including any amendments) applies.
ISO 45001:2018, Occupational health and safety management systems — Requirements with guidance for use
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO 45001:2018 and the following
apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1
andropause
health experience associated with decreasing levels of testosterone, typically in men
Note 1 to entry: Andropause has different hormonal patterns, physiological change processes and cultural perceptions
to menopause (3.6).
3.2
menstruation
cyclical shedding of blood and tissue from the uterus and out through the vagina when fertilization of the
egg has not occurred
Note 1 to entry: It usually takes 4 to 5 days for shedding (period (3.4)) to take place.

3.3
menstrual cycle
hormonal cycle that prepares the uterus for pregnancy and triggers menstruation (3.2), beginning on the
first day of one period (3.4) and ending when the next period starts
Note 1 to entry: Menstruation occurs approximately every 28/29 days, with variations in cycle length from 21 to 35
days considered as normal.
3.4
period
menses
days of menstrual bleeding within each menstrual cycle (3.3)
Note 1 to entry: The first period is called “menarche” and the last period occurs during menopause (3.6).
Note 2 to entry: This is a commonly used, colloquial term.
3.5
menstrual and menopausal health
state of physical, mental and social well-being and not merely the absence of disease or infirmity, in relation
[17] [17]
to the menstrual cycle (3.3)/menopause (3.6)
Note 1 to entry: Menstrual health can include adequate access to menstrual health education, menstrual products and
freedom from stigma and discrimination.
3.6
menopause
time of life associated with the permanent cessation of the period (3.4)
Note 1 to entry: In this document, the term “menopause” is used to refer to the entire duration of menopause transition,
unlike the medical definition, which differentiates between perimenopause (3.7), menopause (the moment in time
usually 12 months after a person’s final period) and postmenopause (3.8).
Note 2 to entry: Menopause usually happens between the ages of 45 and 55. Lifestyle, race, ethnicity and genetics have
an impact on the average age. While not common, menopause can occur earlier.
Note 3 to entry: Symptoms (3.12) that begin to occur in perimenopause can vary in frequency and severity and often
change over the course of the menopause, lasting anywhere from a few months to several years.
Note 4 to entry: Menopause can occur earlier (e.g. due to surgery, chemotherapy or hormonal treatments). The World
[15]
Health Organization (WHO) Fact Sheet can be reviewed for medical information.
3.7
perimenopause
phase before menopause (3.6) when symptoms (3.12) begin to occur
Note 1 to entry: In this document, “perimenopause” refers to a part of menopause in which hormones begin to fluctuate
and symptoms can occur.
Note 2 to entry: This phase continues until menstruation (3.2) has ceased for 12 consecutive months. Symptoms of
perimenopause can start several years before the cessation of the period (3.4). Symptoms can vary in frequency and
severity and often change over the course of menopause.
3.8
postmenopause
phase after menopause (3.6) when symptoms (3.12) can be still present
3.9
menstruation and menopause representative
appropriately trained person appointed by an organization or worker representative group (such as a trade
union or workers’ council) who represents, coordinates and advocates for support and to raise awareness
for workers with menstrual and menopausal needs

3.10
intersectionality
interconnected nature of a person’s combined social and political identities
Note 1 to entry: Intersectionality recognizes that certain characteristics overlap to increase oppression, limit
opportunity and reinforce inequality within social structures. Examples of characteristics include age, sex, race,
ethnicity, sexual orientation, gender identity, religion, disability, neurodivergence, class, socio-economic background
and geographical location (in terms of access to healthcare). All of these aspects can have an impact on the experience
of menstrual health (3.5) and menopause (3.6), thus creating new forms of stigma, inequality and exclusion.
3.11
non-binary
not identifying their gender as man or woman
3.12
symptom
indicator of a condition or illness
Note 1 to entry: This document uses the term “symptom” to recognize that, even though menstruation (3.2) and
menopause (3.6) are not medical illnesses, some find that these changes or cyclical experiences have an impact on
their quality of life. It is important to recognize that some symptoms associated with menstruation and menopause
can be caused by an underlying medical condition (see Annex A).
3.13
transgender
trans
differing gender identity in some way from the sex they were assigned at birth
Note 1 to entry: This term can include transgender men, transgender women, non-binary (3.11) people, gender
questioning, gender non-conforming and gender-fluid people.
3.14
workplace adjustment passport
document completed collaboratively between the worker and employer that follows the worker across
different managers or roles and can help workers and managers record agreed adjustments
4 Introduction to menstruation and menopause at work
Menstruation and menopause are part of healthy biological processes but there is still a social stigma around
them, and the topics are frequently avoided and concealed within society. This can cause some workers
to struggle in silence. Workplace cultures where menstrual and menopausal health are openly discussed
enable workers and organizations to work collaboratively to identify appropriate support or workplace
adjustments that enable workers to perform at their best.
Knowledge of menstruation and menopause is often culturally bound and subject to stigma. This can
result in workers feeling ashamed to discuss the subject, or apprehensive about discussing it, in their
organization. Menstruation and menopause are also subject to misconceptions (see Annex F). Menstruation
and menopause are unique to each worker in terms of the experience of symptoms and their frequency
and severity, which can change over a worker’s life or journey through menopause, which can happen
over several years. Furthermore, diverse needs and experiences of menstruation and menopause linked to
race, ethnicity, religion, sexual orientation, gender identity and neurodivergence are often neglected (see
Clause A.4).
References to menstruation and menopause in the workplace are uncommon. When they do appear,
they often take the form of discussions, conversations or policies that assume physical, emotional and
psychological symptoms are severe and negative. This focus can contribute to stigma and perpetuate taboos.
There is a two-way relationship between work and menstruation/menopause. Symptoms can impact how
workers experience work and at times can influence worker engagement and turnover. In addition, workplace
[20]
environments such as the type of the work, job demands and perceptions of managerial support can
impact the experience of symptom frequency and severity. Given that symptoms can change over time, this

can require considerations for working patterns, uniforms and equipment, and other workplace provisions.
Anticipating these changes can ensure workers remain comfortable, safe and able to perform their roles
effectively.
There are several simple workplace adjustments which can help workers to be more comfortable when
experiencing symptoms while working. Clause 5 gives guidance on potential workplace adjustments,
practical actions and support options. It is possible that organizations already have some support
mechanisms in place that can be sensitized to include references to menstruation and menopause.
When workers need support at work, managers should be advised to seek guidance from their HR or OH&S
practitioner, a trained menstruation and menopause representative, as appropriate, trade union or workers’
council representative and/or be provided with resources from professional and reputable external
providers. Annex B provides a toolkit to support HR and managers.
In those cases where symptoms are severe enough to significantly disrupt someone’s working life, it is
possible that there is an underlying condition. Existing medical conditions which can also be exacerbated
by menstrual or menopausal symptoms, requiring additional support in line with other long-term medical
conditions. Some workers potentially conceal or supress their discomfort. Others do not always realize
their symptoms can be helped by medical or healthcare support or are unaware of signs of an underlying
menstrual condition or menopause.
NOTE Some medical conditions involve a lack of menstruation, which can cause a worker to lack awareness
regarding their menopause status. However, it is possible that they can be experiencing symptoms of menopause.
Annex A provides additional information on health-related aspects of menstruation and menopause.
The flowchart in Figure 1 can assist organizations to review what existing support can be introduced,
adapted or improved for workers who are experiencing symptoms.

Figure 1 — Considerations flowchart
Organizations should be aware that stressors in the workplace environment related to specific job
roles and/or workplace cultures can worsen symptoms. Possible stressors include an accumulation of
occupational psychosocial stress, experiencing gender, racial or other forms of discrimination, being bullied,
and pre-existing medical conditions such as a back or repetitive strain injury. Workers can experience a
combination of different stressors. Workers who are navigating new job roles, promotions and/or decision-
making responsibilities can experience additional challenges. Being proactive in identifying areas of risk
and opportunity and introducing remedial actions that are worker-centric and holistic are likely to result in
better work environments for all.
It is important for organizations to recognize that menopause can have an impact on workers in all roles and
levels of work. Organizations should avoid making assumptions about the experience of menopause and the
age at which menopause can be experienced.
5 Practical actions
5.1 General
There are many ways in which an organization can implement changes to support its workers. This clause
provides ideas on potential workplace considerations, including considerations particularly relevant to
small and medium-sized enterprises (SMEs) in 5.8.

Practical actions range from workplace environmental and physical factors to flexible work design and
creating a positive inclusive culture promotes awareness of menstruation and menopause. They are relevant
to consider across a wide variety of workspaces including warehouses, depots, offices and off-site locations.
Workplace adjustments and actions should be embedded within existing systems and processes that attend
to worker health and well-being.
Guidance can be found in the following subclauses and annexes:
— Examples of workplace adjustments that can be implemented to support workers are included in 5.2
to 5.7. These examples are not exhaustive and have been categorized for ease of reading; however, the
workplace adjustments can overlap for a range of situations. Available workplace adjustments should be
easily accessible to all workers (including women, transgender men and non-binary people) and access
should consider the challenges of worker disclosure or menstruation or menopause (see 5.6).
— Annex C provides a checklist with several of the recommendations and workplace adjustments mentioned
in this document. This can serve as a support tool when reviewing practices.
Figure 2 illustrates the framework, described throughout this document, that suggests how organizations
can implement practical actions, while making inclusivity a core consideration, and using ongoing evaluation
and metrics to monitor progress in the organization.
Figure 2 — Areas to consider when supporting menstrual and menopausal health in the workplace
5.2 Physical aspects of work
5.2.1 General
Workers who experience menstrual and menopausal symptoms work across diverse settings, and on fixed
or variable work sites, including remotely. Simple changes can be made to improve the symptom experience
for workers in these environments. Any changes made to the physical working environment are likely to
benefit all workers, creating a better workplace for all.
Workplace adjustments made should account for existing risk management controls as well as individual
needs, particularly in complex or high-risk environments. To avoid any changes exposing workers to other
occupational risks, workplace adjustments should be implemented on a case-by-case basis and carefully
consider job role, risk and potential for harm.

5.2.2 Recommendations on physical aspects of work
5.2.2.1 Physical work setting and layout
The following recommendations should be implemented to help workers manage symptoms:
a) The organization should allow unrestricted access to private, hygienic toilet and wash facilities, including
considerations for mobile, remote or shift workers. Where possible, self-contained toilet facilities should
include washbasins inside the cubicles and the provision of a shelf alongside the basin that can be used
to place products on. Placing the washbasin, soap dispenser and paper towels within reach of those
seated on the toilet supports the use of sustainable menstruation products such as menstrual cups.
b) For sedentary jobs, the organization should provide ergonomic seating and opportunities to stand up,
stretch or move around if the job involves sitting for long periods of time to prevent aggravation of joint
pain or cramps.
c) Where unallocated seating on a work site (often called “hot desking”) is used, the organization should
provide desk plans with as much information as possible. This can include details on lighting, windows,
distance to washrooms or quiet rooms if available, and where to find warmer or cooler parts of the
building.
d) The organization should assess the use of natural materials in the building or in workplace furnishings
which can help with thermal comfort. Furnishings and fabrics should be chosen that are breathable and
stay cooler but can be cleaned easily when required.
e) The organization should provide spaces for short-term recuperation, rest and management of episodic
symptoms, such as seating, privacy or a quiet environment.
f) The organization should provide easy and complimentary access to menstrual products as well as safe
storage to avoid damage to menstrual products.
g) The organization should provide safe and hygienic disposal for menstrual products in all toilet and
changing facilities.
5.2.2.2 Work environment conditions
The following recommendations should be implemented to help workers manage symptoms:
a) The organization should provide easy access to cool drinking water, warm beverages and snacks (given
it is necessary to take some medication with food). If a site is remote from facilities, consider providing
food and refreshments on the premises.
b) The organization should provide blinds or curtains to block out bright sunlight to avoid triggering
symptoms related to headaches or photosensitivity.
c) The organization should provide a quieter area or noise reduction options to support menstrual or
menopausal symptoms that relate to hearing sensitivity or headaches.
d) The organization should manage temperature, humidity and air movement through adequate ventilation
and, where practicable, de-humidification, opening windows, fans or localized heat sources to support
changes in body temperature.
e) The organization should assess lighting in tandem with health and well-being considerations and avoid
centralized lighting control where possible. Where heat-generation processes are part of the work, these
should be offset with lighting of a cooler colour.
f) The organization should identify areas in the building that are naturally warmer or cooler to support
changes in body temperature.
g) Where strong scents or odours (e.g. food facilities, chemicals), the organization should assess impact for
olfactory (smell) due to hypersensitivity associated with some menstrual or menopausal symptoms.

NOTE Guidance on sensory-friendly environments can be found in BSI PAS 6463.
h) The organization should ensure menstrual and menopausal health is supported through adequate
hygiene management facilities (including disposal options and running water) especially in work
locations and regions with limited access.
5.2.2.3 Work clothing
The following recommendations should be implemented to help workers manage symptoms:
a) The organization should offer discreet places to change clothes and ability to store spare clothes.
b) Where uniforms are required, the organization should provide a comfortable size, ideally made from
breathable natural fabric (such as cotton or bamboo) and easy to launder. Where possible or feasible,
the organization should allow options for darker colours, additional items and fittings that allow for
temporary fluctuations in size (elastic or adjustable waistbands can be particularly helpful).
c) The organization should check if personal protective equipment (PPE) and safety equipment can be
made more comfortable and adapted without compromising other health and safety requirements. This
can include providing equipment made of different materials or different sizes.
5.3 Policy guidance and practice
5.3.1 General
Providing clear and consistent policies that support menstruation and menopause across the organization
empowers managers, supervisors and workers to determine and apply actions to improve and facilitate
well-being of workers who have menstrual and menopausal need at work.
To facilitate a fair and consistent approach, relevant organizational policies should be regularly reviewed
and cross-referenced. In particular, the organization’s approach to menstrual and menopausal health should
fit with the organization’s overall well-being and health strategies, policies and procedures. This increases
the likelihood of any steps taken being effectively implemented and embedded into practice and culture.
Depending on the business needs, organizations can introduce either a stand-alone policy or integrate
reference to menstruation and menopause into existing policies. However, both approaches require cross-
referencing or merging with current policy to provide consistent and supportive protocol.
5.3.2 Policy-related recommendations
5.3.2.1 Developing policy — Considerations
The following recommendations should be implemented when developing policy:
a) The organization should consult with a variety of workers who can be impacted. The consultation
group should include representation from a diverse range of workers in different roles from across
the organization, workers’ representatives where they exist and safety representatives. Privacy and
confidentiality should be protected to encourage participation, inclusion and open discussion.
b) The organization should reflect on which other organizational policies are relevant and can be used by
managers and workers to help support menstrual and menopausal health (e.g. diversity and inclusion,
performance management, sickness and absence, flexible working) and review all relevant policies to
create an embedded approach to menstruation and menopause support.
c) The organization should develop absence or attendance management policy and processes that allow
for workers to choose if they want to record menstrual and menopausal symptoms in a way that avoids
stigma or unfair penalization.
d) Where applicable, the organization should engage with relevant regional or national policies and
provision that support menstruation and menopause.

e) The organization should ensure menstruation and menopause are included as “worker factors” in risk
assessments
5.3.2.2 Implementing policy — Considerations
The following recommendations should be implemented when implementing policy:
a) The organization should effectively communicate policies to everyone in the organization, using
channels that are accessible and inclusive (managers and relevant functions should understand the
contents and implementation of these policies).
b) The organization should review organizational procedures to support the implementation of the policies
and actions.
c) The organization should establish and embed a pathway for managers to achieve a good awareness and
understanding about the importance of supporting menstruation and menopause at work, including
compliance obligations regarding health and safety, and equality, diversity and inclusion.
d) The organization should consider the introduction of workplace adjustment passports.
5.3.2.3 Ongoing policy — Considerations
The following recommendations should be implemented when maintaining policy:
a) Given that menstrual and menopause symptoms and needs change over time, the organization should
ensure policies include requirement for periodic check-ins with workers.
b) The organization should review risk assessments to ensure they are gender inclusive. This can include
verifying that they include a reproductive health and well-being component, a physical and mental health
assessment, and that they consider part-time and temporary workers. Assessments can be necessary to
monitor the impact of work on the worker and the worker’s ability to complete the allocated tasks.
c) The organization should ensure recruitment, training and progression policies are inclusive of
menstrual and menopausal health (e.g. maintain access to training while workplace adjustments are in
place). See Annex D for examples of recruitment considerations.
d) The organization should embed consultation routes to discuss changes. Where relevant, the consultation
group should include representation from a range of workers in different roles, including representation
of the demographics of the organization and including worker representatives where they exist and
safety representatives.
e) The organization should ensure organizational strategies are inclusive of gender to avoid hidden bias in
planning and design.
5.4 Supportive workplace cultures
5.4.1 General
Cultivating a healthy workplace culture is a critical part of making positive change and addressing any
potential stigma around menstruation and menopause. Creating an inclusive culture that supports positive
menstrual and menopausal health works not only celebrates diversity of experience, but also openly
challenges cultural prejudice and biases that are present and can negatively impact or undermine the value
and contribution of workers.
Good information relating to menstruation and menopause is key t
...

ISO/TC 283
Secretariat: BSI
Date: 2026-03-0905-12
Occupational health and safety management — Menstruation and
menopause in the workplace — Guidance
FDIS stage
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication
may be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying,
or posting on the internet or an intranet, without prior written permission. Permission can be requested from either ISO
at the address below or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: + 41 22 749 01 11
E-mail: [e-mail]
Website: www.iso.org
Published in Switzerland
ii
Contents
Foreword . iv
Introduction . v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Introduction to menstruation and menopause at work . 3
5 Practical actions . 5
5.1 General . 5
5.2 Physical aspects of work . 7
5.3 Policy guidance and practice . 9
5.4 Supportive workplace cultures . 11
5.5 Job design . 12
5.6 Disclosure and privacy relating to menstruation and menopause at work . 14
5.7 Inclusivity in menstruation and menopause at work . 15
5.8 Considerations for small and medium-sized enterprises . 16
5.9 Evaluation and metrics . 18
Annex A (informative) Further information on menstrual and menopausal health . 20
Annex B (informative) Manager toolkit . 28
Annex C (informative) Sample internal review checklist . 38
Annex D (informative) Recruitment considerations and ideas to reduce barriers . 42
Annex E (informative) Initiatives to facilitate culture change around menopause and
menstruation at work . 45
Annex F (informative) Workplace charter pro forma for supporting menstrual and menopausal
health at work . 50
Annex G (informative) Cross-reference matrix showing how this document complements
ISO 45001 . 55
Bibliography . 58

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
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The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types of
ISO document should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent rights
in respect thereof. As of the date of publication of this document, ISO had not received notice of (a) patent(s)
which may be required to implement this document. However, implementers are cautioned that this may not
represent the latest information, which may be obtained from the patent database available at
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Any trade name used in this document is information given for the convenience of users and does not
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This document was prepared by Technical Committee ISO/TC 283, Occupational health and safety
management.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.
iv
Introduction
0.1 General
This document can assist organizations in developing and embedding supportive structures, policies and
practices for menstruation and menopause, and by extension, for menstrual and menopausal health. The
practical workplace adjustments and activities recommended in this document promote inclusive workplaces
and complement good practice in workplace well-being and occupational health and safety (see ISO 45001)
and gender inclusion in the workplace (see ISO 53800).
Menstruation and menopause are not medical conditions but life course experiences (see Clauses A.1 and A.2).
For many workers, the experience of menstruation and menopause is managed independently and privately
without the need for additional support by organizations. However, organizations can introduce workplace
adjustments, supportive mechanisms and policies that reduce stigma and make a significant and positive
difference to workers.
Providing a supportive and inclusive workplace environment around menstruation and menopause can have
significant positive effects for worker engagement and job satisfaction, and a more inclusive and culturally
safe workplace environment for all. A lack of knowledge, understanding or support for menstrual health or
menopause and associated symptoms can lead to challenges including presenteeism, absenteeism,
disengagement and additional or increased turnover costs.
These recommendationsThis document can assist employers and organizations, senior leaders, supervisors,
human resource professionals (HR), occupational health and safety (OH&S) professionals, onsite healthcare
professionals, well-being and diversity and inclusion (D&I) practitioners, and architects and interior designers
responsible for work spaceworkspace construction and refurbishment. TheyIt can also support workers who
are responsible for managing individuals’ performances, workloads, well-being or work environments.
NOTE 1 Further information on menstruation, menstrual health and menopause can be found in Annex A.
NOTE 2 Further information on how this document complements ISO 45001 can be found in Annex G.
NOTE 3 See also ISO 25551 for guidance on generating a carer-inclusive workplace and ISO 25550 for guidance on
generating an age-inclusive work environment.
NOTE 4 While this document does not consider andropause in the workplace, many of its recommendations can also
support workers experiencing andropause.
0.2 Why start addressing this topic now?
[18]
By 2030, over 1.,2 billion women worldwide will be menopausal or postmenopausal, and 1.,8 billion women
[19]
menstruate every month, meaning a significant number of workers are or will experience menstruation and
menopause while in the workplace. While gender parity in labour force participation varies across different
economies, it is often the case that women are expected to fit into modes of working and cultural expectations
that were historically designed at a time when women were not equally represented or prioritized as workers.
Symptoms associated with menstruation and menopause can also coincide with significant life challenges and
responsibilities, and research has shown that stress and symptoms associated with menopause are
inextricably linked. For example, symptoms associated with menstruation and menopause can occur when
workers are also dealing with stressors such as other health conditions, fertility issues, pregnancy loss, deaths
of significant others, managing childcare and care for older parents, children leaving home, financial
constraints, relationship breakdown or other significant life events.
v
Promoting and supporting the health of workers brings multiple benefits to organizations, such as reducing
occupational risks and absences. By fostering inclusivity, supporting worker wellbeingwell-being, and
eliminating discrimination, organizations can also enhance their reputation and attract a diverse workforce.
Workers can experience menstrual or menopausal symptoms which can impact their experience of work and
can cause them to leave an unsupportive work environment. Symptoms experienced in an unsupportive
environment can also contribute to underemployment or working fewer hours, which can impact their career
trajectories, promotional prospects and financial security in later life.
Implementing good practice around supporting menstruation and menopause in the workforce also benefits
organizations by:
a) increasing worker engagement;
b) improving the health and well-being of workers and boosting their healthy working life expectancy;
c) improving leadership cultures by generating more awareness amongst all managers;
d) improving diversity and inclusion objectives by preventing high turnover in organizations due to
inadequate, unsupportive or inflexible working conditions;
e) attracting a diverse workforce, increasing worker retention, and reducing the financial costs of attrition,
recruitment and training;
f) helping to comply with occupational health expectations from suppliers and buyers.
0.3 Questions this document can help to address
Table 1 identifies the elements of this document which address key areas around menstruation, menstrual
health and menopause.
Table 1 — Frequently asked questions that this document addresses
Question ElementClause/
subclause/annex
I have a workforce who are located across different environments, some of which are 5.3
physically or psychologically demanding. What design changes should I consider that support 5.5
menstruation and menopause? Clause B.3
I am recruiting new workers. How can I remove barriers in the recruitment process for those
Annex D
who menstruate or are experiencing menopause?
I want to introduce or update a menstruation and menopause policy. What key factors should 5.3
I consider?
5.4
I run a small organization with limited resources. What cost-effective but impactful steps can
5.8
I take to support workers experiencing menstruation and menopause at work?
I am a supervisor. How can I support workers experiencing menstruation and menopause in 5.3
my workplace?
Annex B
I have a diverse workforce. Do people from different racially and ethnically diverse 5.7
backgrounds experience menstruation and menopause at work differently? Annex A
My organization is gender inclusive. How can my organization’s menstruation and 5.4
menopause policies and practices support everyone? 5.7
vi
Occupational health and safety management — Menstruation and
menopause in the workplace — Guidance
1 Scope
This document gives guidance to organizations on developing policies and practices that are supportive of the
menstrual and menopausal health and menopausal experiences of workers in the workplace.
This document is applicable to any organization regardless of size or sector and can be adapted to individual
business needs.
This document does not apply to medical guidance or clinical options outside of the workplace. However, it
does include reference to qualified sources where such information is available.
This document does not apply to andropause.
2 Normative references
The following documents are referred to in the text in such a way that some or all of their content constitutes
requirements of this document. For dated references, only the edition cited applies. For undated references,
the latest edition of the referenced document (including any amendments) applies.
ISO 45001:2018, Occupational health and safety management systems — Requirements with guidance for use
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO 45001:2018 and the following apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https://www.iso.org/obp
— IEC Electropedia: available at https://www.electropedia.org/
3.1
andropause
health experience associated with decreasing levels of testosterone, typically in men
Note 1 to entry: Andropause has different hormonal patterns, physiological change processes and cultural perceptions
to menopause (3.6).
3.2
menstruation
cyclical shedding of blood and tissue from the uterus and out through the vagina when fertilization of the egg
has not occurred
Note 1 to entry: It usually takes 4 to 5 days for shedding (period (3.4)) to take place.
3.3
menstrual cycle
hormonal cycle that prepares the uterus for pregnancy and triggers menstruation (3.2), beginning on the first
day of one period (3.4) and ending when the next period starts
Note 1 to entry: Menstruation occurs approximately every 28/29 days, with variations in cycle length from 21 to 35 days
considered as normal.
3.4
period (preferred term)
menses (admitted term)
days of menstrual bleeding within each menstrual cycle (3.3)
Note 1 to entry: The first period is called “menarche” and the last period occurs during menopause (3.6.).
Note 2 to entry: This is a commonly used, colloquial term.
3.5
menstrual/ and menopausal health
state of physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation
[17] [17]
to the menstrual cycle (3.3)/menopause (3.6)
Note 1 to entry: Menstrual health can include adequate access to menstrual health education, menstrual products and
freedom from stigma and discrimination.
3.6
menopause
time of life associated with the permanent cessation of the period (3.4(menses) (3.4))
Note 1 to entry: In this document, the term “menopause” is used to refer to the entire duration of menopause transition,
unlike the medical definition, which differentiates between perimenopause (3.7), menopause (the moment in time usually
12 months after a person’s final period) and postmenopause (3.8).
Note 2 to entry: Menopause usually happens between the ages of 45 and 55. Lifestyle, race, ethnicity and genetics have
an impact on the average age. While not common, menopause can occur earlier.
Note 3 to entry: Symptoms (3.12) that begin to occur in perimenopause (3.7) can vary in frequency and severity and often
change over the course of the menopause, lasting anywhere from a few months to several years.
Note 4 to entry: Menopause can occur earlier (e.g. due to surgery, chemotherapy or hormonal treatments). The World
[15]
Health Organization (WHO) Fact Sheet can be reviewed for medical information.
3.7
perimenopause
phase before menopause (3.6) when symptoms (3.12) begin to occur
Note 1 to entry: In this document, ‘perimenopause’“perimenopause” refers to a part of menopause (3.6) in which
hormones begin to fluctuate and symptoms (3.12) can occur.
Note 2 to entry: This phase continues until menstruation (3.2) has ceased for 12 consecutive months. Symptoms of
perimenopause can start several years before the cessation of the period (3.4). Symptoms can vary in frequency and
severity and often change over the course of menopause.
3.8
postmenopause
phase after menopause (3.6) when symptoms (3.12) can be still present
3.9
Menstruation/menstruation and menopause representative
appropriately trained person appointed by an organization or worker representative group (such as a trade
union or workers’ council) who represents, coordinates, and advocates for support and to raise awareness for
workers with menstrual and menopausal needs
3.10
intersectionality
interconnected nature of a person’s combined social and political identities
Note 1 to entry: Intersectionality recognizes that certain characteristics overlap to increase oppression, limit opportunity
and reinforce inequality within social structures. Examples of characteristics include age, sex, race, ethnicity, sexual
orientation, gender identity, religion, disability, neurodivergence, class, socio-economic background and geographical
location (in terms of access to healthcare). All of these aspects can have an impact on the experience of menstrual health
(3.5) and menopause (3.6), thus creating new forms of stigma, inequality and exclusion.
3.11
non-binary
not identifying their gender as man or woman
3.12
symptom
indicator of a condition or illness
Note 1 to entry: This document uses the term “symptom” to recognize that, even though menstruation (3.2) and
menopause (3.6) are not medical illnesses, some find that these changes or cyclical experiences have an impact on their
quality of life. It is important to recognize that some symptoms associated with menstruation and menopause can be
caused by an underlying medical condition (see Annex A).
3.13
transgender (preferred term)
trans (admitted term)
differing gender identity in some way from the sex they were assigned at birth
Note 1 to entry: This term can include transgender men, transgender women, non-binary (3.11) people, gender
questioning, gender non-conforming and gender-fluid people.
3.14
workplace adjustmentsadjustment passport
a document completed collaboratively withbetween the worker and employer, that follows the worker across
different managers or roles and can help workers and managers record agreed adjustments
4 Introduction to menstruation and menopause at work
This document is useful to managers, as well as human resource (HR) professionals, occupational health and
safety (OH&S) professionals, well-being and diversity and inclusion (D&I) practitioners, and architects and
interior designers undertaking work space construction or refurbishments. It is also useful to workers who
are responsible for managing individuals’ performances, workloads, wellbeing or work environments.
Menstruation and menopause are part of healthy biological processes but there is still a social stigma around
them, and the topics are frequently avoided and concealed within society. This can cause some workers to
struggle in silence. Workplace cultures where menstrual and menopausal health are openly discussed enable
workers and organizations to work collaboratively to identify appropriate support or workplace adjustments
that enable workers to perform at their best.
Knowledge of menstruation and menopause is often culturally bound and subject to stigma. This can result in
workers feeling ashamed to discuss the subject, or apprehensive about discussing it, in their organization.
Menstruation and menopause are also subject to misconceptions (see Annex F). Menstruation and menopause
are unique to each worker in terms of the experience of symptoms and their frequency and severity, which
can change over a worker’s life or journey through menopause, which can happen over several years.
Furthermore, diverse needs and experiences of menstruation and menopause linked to race, ethnicity,
religion, sexual orientation, gender identity and neurodivergence are often neglected (see Clause A.4).
References to menstruation and menopause in the workplace are uncommon. When they do appear, they often
take the form of discussions, conversations or policies that assume physical, emotional and psychological
symptoms are severe and negative. This focus maycan contribute to stigma and perpetuate taboos.
There is a two-way relationship between work and menstruation/menopause. Symptoms can impact how
workers experience work and at times can influence worker engagement and turnover. In addition, workplace
[20]
environments such as the type of the work, job demands and perceptions of managerial support can impact
the experience of symptom frequency and severity. Given that symptoms can change over time, this maycan
require considerations for working patterns, uniforms and equipment, and other workplace provisions.
Anticipating these changes can ensure workers remain comfortable, safe, and able to perform their roles
effectively.
There are several simple workplace adjustments which can help workers to be more comfortable when
experiencing symptoms while working. Clause 5 gives guidance on potential workplace adjustments, practical
actions and support options. It is possible that organizations already have some support mechanisms in place
that can be sensitized to include references to menstruation and menopause.
When workers need support at work, managers should be advised to seek guidance from their HR or OH&S
practitioner, a trained menstruation and menopause representative, as appropriate, trade union or workers’
council representative and/or be provided with resources from professional and reputable external
providers. Annex B provides a toolkit to support HR and managers.
In those cases where symptoms are severe enough to significantly disrupt someone’s working life, it is possible
that there may beis an underlying condition. Existing medical conditions which can also be exacerbated by
menstrual or menopausal symptoms, requiring additional support in line with other long-term medical
conditions. Some workers potentially conceal or supress their discomfort. Others do not always realize their
symptoms can be helped by medical or healthcare support or are unaware of signs of an underlying menstrual
condition or menopause.
NOTE Some medical conditions involve a lack of menstruation, which can cause a worker to lack awareness
regarding their menopause status. However, it is possible that they maycan be experiencing symptoms of menopause.
Annex A provides additional information on health-related aspects of menstruation and menopause.
The flowchart in Figure 1 can assist organizations to review what existing support can be introduced, adapted
or improved for workers who are experiencing symptoms. And seek support for menstruation and menopause
Figure 1 — Considerations flowchart
Organizations should be aware that stressors in the workplace environment related to specific job roles
and/or workplace cultures, can worsen symptoms. Possible stressors include an accumulation of occupational
psychosocial stress, experiencing gender, racial or other forms of discrimination, being bullied, and pre-
existing medical conditions such as a back or repetitive strain injury. Workers can experience a combination
of different stressors. Workers who are navigating new job roles, promotions and/or decision-making
responsibilities can experience additional challenges. Being proactive in identifying areas of risk and
opportunity and introducing remedial actions that are worker-centric and holistic are likely to result in better
work environments for all.
It is important for organizations to recognize that menopause can have an impact on workers in all roles and
levels of work. Organizations should avoid making assumptions about the experience of menopause and the
age at which menopause can be experienced.
5 Practical actions
5.1 General
There are many ways in which an organization can implement changes to support its workers. This clause
provides ideas on potential workplace considerations, including considerations particularly relevant to small
and medium-sized enterprises (SMEs) in 5.8.
Practical actions range from workplace environmental and physical factors to flexible work design and
creating a positive inclusive culture promotes awareness of menstruation and menopause. They are relevant
to consider across a wide variety of work spacesworkspaces including, warehouses, depots, offices, and off-
site locations. Workplace adjustments and actions should be embedded within existing systems and processes
that attend to worker health and well-being.
Guidance can be found in the following subclauses and annexes:
— Examples of workplace adjustments that can be implemented to support workers are included in 5.2 to
5.7. These examples aeare not exhaustive and have been categorized for ease of reading; however, the
workplace adjustments can overlap for a range of situations. Available workplace adjustments should be
easily accessible to all workers (including women, transgender men and non-binary people) and access
should consider the challenges of worker disclosure or menstruation or menopause (see 5.6).
— Annex C provides a checklist with several of the recommendations and workplace adjustments mentioned
in this document. This can serve as a support tool when reviewing practices.
Figure 2 illustrates the framework, described throughout this document, that suggests how organizations can
implement practical actions, while making inclusivity a core consideration, and using ongoing evaluation and
metrics to monitor progress in the organization.
Figure 2 — Areas to consider when supporting menstrual and menopausal health in the workplace
5.2 Physical aspects of work
5.2.1 General
Workers who experience menstrual and menopausal symptoms work across diverse settings, and on fixed or
variable work sites, including remotely. Simple changes can be made to improve the symptom experience for
workers in these environments. Any changes made to the physical working environment are likely to benefit
all workers, creating a better workplace for all.
Workplace adjustments made should account for existing risk management controls as well as individual
needs, particularly in complex or high-risk environments. To avoid any changes exposing workers to other
occupational risks, workplace adjustments should be implemented on a case-by-case basis and carefully
consider job role, risk and potential for harm.
5.2.2 Recommendations on physical aspects of work
The following recommendations should be implemented to help workers manage symptoms.
5.2.2.1 Physical work setting and layout
The following recommendations should be implemented to help workers manage symptoms:
a) The organization should allow unrestricted access to private, hygienic toilet and wash facilities, including
considerations for mobile, remote or shift workers. Where possible, self-contained toilet facilities should
include washbasins inside the cubicles and the provision of a shelf alongside the basin that can be used to
place products on. Placing the washbasin, soap dispenser and paper towels within reach of those seated
on the toilet supports the use of sustainable menstruation products such as menstrual cups.
b) For sedentary jobs, the organization should provide ergonomic seating and opportunities to stand up,
stretch or move around if the job involves sitting for long periods of time to prevent aggravation of joint
pain or cramps.
c) Where unallocated seating on a work site (often called “hot desking”) is used, the organization should
provide desk plans with as much information as possible. This can include details on lighting, windows,
distance to washrooms or quiet rooms if available, and where to find warmer or cooler parts of the
building.
d) The organization should assess the use of natural materials in the building or in workplace furnishings
which can help with thermal comfort. Furnishings and fabrics should be chosen that are breathable and
stay cooler but can be cleaned easily when required.
e) The organization should provide spaces for short-term recuperation, rest and management of episodic
symptoms, such as seating, privacy or a quiet environment.
f) The organization should provide easy and complimentary access to menstrual products as well as safe
storage to avoid damage to menstrual products.
g) The organization should provide safe and hygienic disposal for menstrual products in all toilet and
changing facilities.
5.2.2.2 Work environment conditions
The following recommendations should be implemented to help workers manage symptoms:
a) The organization should provide easy access to cool drinking water, warm beverages and snacks (given it
is necessary to take some medication with food). If a site is remote from facilities, consider providing food
and refreshments on the premises.
b) The organization should provide blinds or curtains to block out bright sunlight to avoid triggering
symptoms related to headaches or photosensitivity.
c) The organization should provide a quieter area or noise reduction options to support menstrual or
menopausal symptoms that relate to hearing sensitivity or headaches.
d) The organization should manage temperature, humidity and air movement through adequate ventilation
and, where practicable, de-humidification, opening windows, fans or localized heat sources to support
changes in body temperature.
e) f) The organization should assess lighting in tandem with health and well-being considerations
and avoid centralized lighting control where possible. Where heat-generation processes are part of the
work, these should be offset with lighting of a cooler colour.
f) g) The organization should identify areas in the building that are naturally warmer or cooler to
support changes in body temperature.
g) h) Where strong scents or odours (e.g. food facilities, chemicals), the organization should assess
impact for olfactory (smell) due to hypersensitivity associated with some menstrual or menopausal
symptoms.
NOTE Guidance on sensory-friendly environments can be found in BSI PAS 6463.
h) i) The organization should ensure menstrual and menopausal health is supported through
adequate hygiene management facilities (including disposal options and running water) especially in
work locations and regions with limited access.
5.2.2.3 Work clothing
The following recommendations should be implemented to help workers manage symptoms:
a) The organization should offer discreet places to change clothes and ability to store spare clothes.
b) Where uniforms are required, the organization should provide a comfortable size, ideally made from
breathable natural fabric (such as cotton or bamboo),) and easy to launder. Where possible or feasible,
the organization should allow options for darker colours, additional items and fittings that allow for
temporary fluctuations in size (elastic or adjustable waistbands can be particularly helpful).
c) The organization should check if personal protective equipment (PPE) and safety equipment can be made
more comfortable and adapted without compromising other health and safety requirements. This can
include providing equipment made of different materials or different sizes.
5.3 Policy guidance and practice
5.3.1 General
Providing clear and consistent policies that support menstruation and menopause across the organization
empowers managers, supervisors and workers to determine and apply actions to improve and facilitate well-
being of workers who have menstrual and menopausal need at work.
To facilitate a fair and consistent approach, relevant organizational policies should be regularly reviewed and
cross-referenced. In particular, the organization’s approach to menstrual and menopausal health should fit
with the organization’s overall well-being and health strategies, policies and procedures. This increases the
likelihood of any steps taken being effectively implemented and embedded into practice and culture.
Depending on the business needs, organizations can introduce either a stand-alone policy or integrate
reference to menstruation and menopause into existing policies. However, both approaches require cross-
referencing or merging with current policy to provide consistent and supportive protocol.
5.3.2 Policy-related recommendations
5.3.2.1 Developing policy — Considerations
The following recommendations should be implemented when developing, implementing and maintaining
policy.:
5.3.2.1 Developing policy - considerations
a) The organization should consult with a variety of workers who can be impacted. The consultation group
should include representation from a diverse range of workers in different roles from across the
organization, workers’ representatives where they exist, and safety representatives. Privacy and
confidentiality should be protected to encourage participation, inclusion and open discussion.
b) The organization should reflect on which other organizational policies are relevant and can be used by
managers and workers to help support menstrual and menopausal health (e.g. diversity and inclusion,
performance management, sickness and absence, flexible working) and review all relevant policies to
create an embedded approach to menstruation and menopause support.
c) The organization should develop absence or attendance management policy and processes that allow for
workers to choose if they want to record menstrual and menopausal symptoms in a way that avoids
stigma or unfair penalisationpenalization.
d) Where applicable, the organization should engage with relevant regional or national policies and
provision that support menstruation and menopause.
e) The organization should ensure menstruation and menopause are included as “worker factors” in risk
assessments
5.3.2.2 Implementing policy - considerations— Considerations
The following recommendations should be implemented when implementing policy:
a) The organization should effectively communicate policies to everyone in the organization, using channels
that are accessible and inclusive (managers and relevant functions should understand the contents and
implementation of these policies).
b) The organization should review organizational procedures to support the implementation of the policies
and actions.
c) The organization should establish and embed a pathway for managers to achieve a good awareness and
understanding about the importance of supporting menstruation and menopause at work, including
compliance obligations regarding health and safety, and equality, diversity and inclusion.
d) The organization should consider the introduction of “workplace adjustment passports”. .
5.3.2.3 Ongoing policy - considerations— Considerations
The following recommendations should be implemented when maintaining policy:
a) Given that menstrual and menopause symptoms and needs change over time, the organization should
ensure policies include requirement for periodic check-ins with workers.
b) The organization should review risk assessments to ensure they are gender -inclusive. This can include
verifying that they include a reproductive health and well-being component, a physical and mental health
assessment, and that they consider part-time and temporary workers. Assessments can be necessary to
monitor the impact of work on the worker and the worker’s ability to complete the allocated tasks.
c) The organization should ensure recruitment, training and progression policies are inclusive of menstrual
and menopausal health (e.g. maintain access to training while workplace adjustments are in place). See
Annex D for examples of recruitment considerations.
d) The organization should embed consultation routes to discuss changes. Where relevant, the consultation
group should include representation from a range of workers in different roles, including representation
of the demographics of the organization and including worker representatives where they exist and safety
representatives.
e) The organization should ensure organizational strategies are inclusive of gender to avoid hidden bias in
planning and design.
5.4 Supportive workplace cultures
5.4.1 General
Cultivating a healthy workplace culture is a critical part of making positive change and addressing any
potential stigma around menstruation and menopause. Creating an inclusive culture that supports positive
menstrual and menopausal health works not only celebrates diversity of experience, but also openly
challenges cultural prejudice and biases that are present and can negatively impact or undermine the value
and contribution of workers.
Good information relating to menstruation and menopause is key to building and managing organizations that
value diversity, equality and inclusivity. Any form of shaming, bullying, blaming, joking, dismissing,
problematizing, disbelieving or pathologizing experiences of menstruation or menopause should not be
tolerated in the workplace. Supportive cultures also allocate collective responsibility and accountability to
everyone for creating an inclusive environment, particularly managers and leaders.
NOTE For further guidance on diversity and inclusion, see ISO 30415.
NOTE 2 Annex E provides examples of initiatives to facilitate culture change around menopause and menstruation at
work.
5.4.2 Supportive workplace culture recommendations
5.4.2.1 Education and awareness
The following recommendations should be implemented to create a supportive workplace culture.:
a) Education and awarenessThe organization should provide workers and managers with access to
education on practical actions that they can adopt. This can include sign postings to external sources for
reliable information (see the “Further reading” in the Bibliography for references).
b) The organization should introduce menstruation and menopause representatives with suitable training
(see E.3.3), oversight and support. A representative should have reasonable capacity to undertake this
role alongside their existing role(s). The representative should understand how diversity, inclusion and
intersectional disadvantage impact on menstrual and menopausal experiences.
c) The organization should ensure adequate resources are given to ongoing education and awareness.
d) The organization should build awareness of how symptoms of menstruation or menopause (e.g. brain fog,
body pain) can temporarily affect a worker’s confidence and ability. This can help colleagues to be
supportive of each other and create a positive work environment.
e) The organization should improve awareness of potential health disparities thatexperienced by workers
from different racially and ethnically diverse backgrounds groups experience. Workers from different
backgrounds face different stressors, as shown in the following examples:
1) Within some communities, there is a higher prevalence of polycystic ovary syndrome (PCOS), which
[11]
can create infertility ; this can be both a physical and mental burden. Organizations can assess a
supplier’s commitment to diversity when arranging support services, such as access to counselling or
redirection to a doctor.
2) Women of some faiths are not permitted to use toilet or wash facilities that have been used by a man
outside their family. When providing workplace facilities, consider the worker demographics should
be considered to meet their needs.
5.4.2.2 Creating support systems
The following recommendations should be implemented to create a supportive workplace culture:
a) The organization should set up informal support or network groups to discuss concerns or plan well-
being activities (see Clause E.1E.1 for ideas).
b) The organization should make available regular confidential check-ins to any workers, or those who have
requested or discussed additional support needs, so they can raise any issues or concerns they have about
managing menstrual or menopausal symptoms in the workplace.
c) The organization should encourage a positive environment where workers feel able to self-manage
symptoms while working and where it is acceptable to take time off due to significant menstrual or
menopausal symptoms.
d) The organization should ensure privacy protections and voluntary worker participation if providing high-
quality digital health technology (e.g. symptom-tracking or well-being apps) that provide personal
support for menstruation and menopause.
e) Where relevant, the organizational should ensure that any existing insurance, employer assistance or
occupational health programmes include support for menstruation and menopause.
5.4.2.3 Management responsibilities
The following recommendations should be implemented to create a supportive workplace culture:
a) The organizational should clearly define how managers and supervi
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