SIST ISO 45010:2026

• Abstract:

  This document gives guidance to organizations on developing policies and practices that are supportive of workers’ menstrual and menopausal health and experiences 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.

• Status: Published
• Public Enquiry End Date: 02-Oct-2025
• Publication Date: 06-Oct-2026
• ICS: 03.100.30 - Management of human resources
• ICS: 13.100 - Occupational safety. Industrial hygiene
• Technical Committee: VZK - Quality management and quality assurance
• Current Stage: 6060 - National Implementation/Publication (Adopted Project)
• Start Date: 03-Aug-2026
• Due Date: 08-Oct-2026
• Completion Date: 07-Oct-2026
• Ref Project: ISO 45010:2026 - Occupational health and safety management — Menstruation and menopause in the workplace — Guidance

SIST ISO 45010:2026 is an International Standard from ISO that gives guidance on menstruation and menopause in the workplace. It helps organizations of any size or sector develop policies and practices that support workers’ menstrual and menopausal health and experiences at work. The document stays focused on the workplace - it excludes medical guidance outside work and does not apply to andropause.

What does SIST ISO 45010:2026 specify?

SIST ISO 45010:2026 specifies guidance for organizations on creating supportive workplace policies, practices and adjustments for menstruation and menopause. It is written so it can be adapted to different business needs, while remaining relevant to any organization regardless of size or sector.

The document is organized into a short front matter, Clause 1 to Clause 5, and Annexes A to G. Clause 2 names the normative reference, Clause 3 defines key terms, Clause 4 introduces menstruation and menopause at work, and Clause 5 gives practical actions. The annexes provide background, tools, examples and cross-references.

Annex	What it covers
Annex A	Background on menstrual cycle and symptoms, menopause and symptoms, intersectional factors, and misconceptions
Annex B	Manager toolkit, including confidential conversations, performance management, team management and workplace risk assessments
Annex C	Sample internal review checklist
Annex D	Recruitment considerations and ways to reduce barriers
Annex E	Initiatives for culture change, communications, training and community-building
Annex F	Workplace charter pro forma for supporting menstrual and menopausal health at work
Annex G	Cross-reference matrix showing how the document complements ISO 45001

What are the key requirements of SIST ISO 45010:2026?

SIST ISO 45010:2026 is guidance, so its practical value is in the workplace actions it recommends rather than in a compliance checklist. The main message is that menstruation and menopause should be treated as normal life-course experiences that can still affect work, and that organizations can reduce stigma and barriers through policy, design and management practice.

Workplace conditions and job design

Clause 5.2 and Clause 5.5 focus on the physical and work-design factors that affect workers day to day. The document points organizations toward the work setting, environment conditions, clothing, flexible working and task demands. In practice, this means looking at access to toilets, comfort, temperature, privacy, breaks, uniforms, PPE, shift patterns and whether the job allows enough control when symptoms change.

Policy and culture

Clause 5.3 and Clause 5.4 address policy guidance, supportive workplace cultures and management responsibilities. SIST ISO 45010:2026 links menopause and menstruation support to education, awareness, support systems and consistent policy implementation. For a reader, this means the subject should be built into existing workplace systems such as OH&S, wellbeing, equality, attendance and reasonable adjustment processes, rather than handled informally or ad hoc.

Disclosure, privacy and inclusivity

Clause 5.6 and Clause 5.7 focus on disclosure and privacy, then inclusivity in menstruation and menopause at work. The document says workers should be able to decide whether to disclose, and information should be handled with privacy and care. It also highlights inclusive design and intersectional considerations for women, transgender men and non-binary people, and for differences linked to age, race, ethnicity, religion, disability, neurodivergence, sexual orientation and gender identity. In practice, this means language, facilities, policies and support routes should work for a diverse workforce, not only for one assumed group.

Small and medium-sized enterprises, evaluation and review

Clause 5.8 gives considerations for small and medium-sized enterprises (SMEs), including using free resources, building communities of practice and building on existing practice. Clause 5.9 then turns to evaluation and metrics, so organizations can adapt existing measures or develop new tools to check whether changes are working. Annex C supports this with a sample internal review checklist. In practice, the document expects organizations to review progress, not just introduce one-off actions.

Recruitment and culture change

Annex D extends the guidance into recruitment, from job design and advertising through assessment, interviews and onboarding. Annex E supports culture change through awareness activities, communications, training plans and peer or community groups. Together these annexes show that the document covers the employment cycle, not only current employees, and helps organizations reduce barriers before someone starts work.

What terms does SIST ISO 45010:2026 define?

• Menstruation - the cyclical shedding of blood and tissue from the uterus and out through the vagina when fertilization has not occurred.
• Menopause - the time of life associated with the permanent cessation of the period; in this document it covers the whole menopause transition.
• Perimenopause - the phase before menopause when symptoms begin to occur.
• Postmenopause - the phase after menopause when symptoms can still be present.
• Menstrual and menopausal health - physical, mental and social well-being in relation to the menstrual cycle and menopause.
• Menstruation and menopause representative - an appropriately trained person who represents, coordinates and advocates for support and awareness.
• Intersectionality - the interconnected nature of a person’s combined social and political identities, which can affect their experience of work and health.
• Workplace adjustment passport - a document agreed between worker and employer that records adjustments and can follow the worker across roles or managers.

Who uses SIST ISO 45010:2026?

SIST ISO 45010:2026 is intended for employers and organizations in any sector, whether they are office-based, industrial, service-based or dispersed across multiple locations. The intro specifically names 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 construction or refurbishment.

It is also useful for workers who manage other people’s performance, workload, wellbeing or work environment. In practice, people use it to shape policy, design workspaces, train managers, review recruitment, run confidential conversations, assess risk and decide on workplace adjustments.

Which standards are used with SIST ISO 45010:2026?

The normative reference in SIST ISO 45010:2026 is ISO 45001:2018, which provides the occupational health and safety management system framework that this guidance complements.

Other standards named in the document help place the guidance in context:

• ISO 45003 - guidance on psychosocial risk management, used alongside the document’s focus on workplace stressors.
• ISO 53800 - guidance on gender equality and women’s empowerment, cited for gender inclusion in the workplace.
• ISO 25550 - guidance for an age-inclusive workforce, linked to inclusive working environments.
• ISO 25551 - guidance for carer-inclusive organizations, cited as another related inclusion resource.

What does the SIST ISO 45010:2026 document contain?

The document includes a structured introduction, definitions, practical workplace guidance, and annexes that expand the main clauses into usable tools. Figure 1 presents a considerations flowchart, and Figure 2 shows the framework for practical action, inclusivity and ongoing evaluation.

Annex A gives health-related background on menstrual and menopausal experiences, symptoms and common misconceptions. Annex B provides practical manager guidance for conversations, performance management and risk assessment. Annex C offers a checklist for internal review, while Annex D covers recruitment barriers and Annex E supports awareness, training and culture change. Annex F supplies a workplace charter pro forma, and Annex G maps the document to ISO 45001 so organizations can integrate the guidance into existing OH&S management systems.

SLOVENSKI STANDARD
01-november-2026
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 45010:2026
ICS:
03.100.30 Vodenje ljudi Management of human
resources
13.100 Varnost pri delu. Industrijska Occupational safety.
higiena Industrial hygiene
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

International
Standard
ISO 45010
First edition
Occupational health and safety
2026-09
management — Menstruation and
menopause in the workplace —
Guidance
Gestion de la santé et de la sécurité au travail — Menstruations
et ménopause au travail — Recommandations
Reference number
© ISO 2026
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: [phone]
Email: [e-mail]
Website: www.iso.org
Published in Switzerland
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 .26
Annex C (informative) Sample internal review checklist .36
Annex D (informative) Recruitment considerations and ideas to reduce barriers .40
Annex E (informative) Initiatives to facilitate culture change around menstruation and
menopause at work .43
Annex F (informative) Workplace charter pro forma for supporting menstrual and menopausal
health at work .48
Annex G (informative) Cross-reference matrix showing how this document complements
ISO 45001 .52
Bibliography .54

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
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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
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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, 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 menstruation or
menopause and their 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 menstrual and menopausal health 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?
[17]
By 2030, over 1,2 billion women worldwide will be menopausal or postmenopausal, and 1,8 billion women
[18]
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
closely 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 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 5.2
physically or psychologically demanding. What design changes should I consider that 5.3
support menstruation and menopause? 5.5
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
International Standard ISO 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
workers’ menstrual and menopausal health and experiences 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
[16] [16]
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 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
[14]
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 and menopausal health (3.5), 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
[19]
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 other available
sources. This may include HR or OH&S practitioners, a trained menstruation and menopause representative,
trade union or workers’ council representatives and/or 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 that
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 menstrual or menopausal 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 for 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 ensure 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 non-assigned 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, air quality 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 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 m
...

International
Standard
ISO 45010
First edition
Occupational health and safety
2026-09
management — Menstruation and
menopause in the workplace —
Guidance
Gestion de la santé et de la sécurité au travail — Menstruations
et ménopause au travail — Recommandations
Reference number
© ISO 2026
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: [phone]
Email: [e-mail]
Website: www.iso.org
Published in Switzerland
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 .26
Annex C (informative) Sample internal review checklist .36
Annex D (informative) Recruitment considerations and ideas to reduce barriers .40
Annex E (informative) Initiatives to facilitate culture change around menstruation and
menopause at work .43
Annex F (informative) Workplace charter pro forma for supporting menstrual and menopausal
health at work .48
Annex G (informative) Cross-reference matrix showing how this document complements
ISO 45001 .52
Bibliography .54

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
ISO technical committees. Each member body interested in a subject for which a technical committee
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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 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
www.iso.org/patents. ISO shall not be held responsible for identifying any or all such patent rights.
Any trade name used in this document is information given for the convenience of users and does not
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For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and expressions
related to conformity assessment, as well as information about ISO’s adherence to the World Trade
Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www.iso.org/iso/foreword.html.
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, 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 menstruation or
menopause and their 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 menstrual and menopausal health 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?
[17]
By 2030, over 1,2 billion women worldwide will be menopausal or postmenopausal, and 1,8 billion women
[18]
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
closely 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 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 5.2
physically or psychologically demanding. What design changes should I consider that 5.3
support menstruation and menopause? 5.5
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
International Standard ISO 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
workers’ menstrual and menopausal health and experiences 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
[16] [16]
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 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
[14]
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 and menopausal health (3.5), 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
[19]
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 other available
sources. This may include HR or OH&S practitioners, a trained menstruation and menopause representative,
trade union or workers’ council representatives and/or 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 that
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 menstrual or menopausal 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 for 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 ensure 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 non-assigned 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, air quality 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 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) The 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
“Further reading” in the Bibliography for references).
b) The organization should introduce menstruation and menopause representatives with suitable training
(see E.3.3), o
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