A regulation in Yunnan province that stipulates one to two days of menstrual pain leave for female employees has reignited discussions on the sometimes problematic implementation of such policies across the nation.

Yunnan introduced the regulation last month, allowing female workers who experience severe pain during their periods to take one to two days off after receiving medical diagnoses. The regulation took effect on Nov 1.

At least 20 provincial-level regions, including Beijing, Shanghai and the provinces of Shandong and Sichuan, have had menstrual pain leave in their local regulations since as early as the 1990s, but details vary.

For instance, Guangdong province's policy only applies to female employees who have to work on their feet for more than four consecutive hours.

Jiangxi province offers two to three days leave — longer than the usual one to two days leave provided in other regions.

And some regions do not specify the duration of the leave, only stating that appropriate rest should be arranged for those in need.

Most provincial-level areas require a doctor's note confirming symptoms before leave can be granted.

Shen Jianfeng, a law professor at the Central University of Finance and Economics in Beijing, said during an interview with media outlet ThePaper.cn that although rules on menstrual pain leave have been in place for a long time, it is difficult to ensure proper implementation, and many women have complained about difficulties in obtaining doctor's notes or consent from superiors, as well as workplace discrimination.

"Menstrual cramps are considered private affairs, making it more complicated for employees advocating for the leave," he said. "Some employees are required to present a medical certificate issued by a doctor, which undoubtedly adds to the burden."

A 26-year-old resident in Jiangsu province who only gave her surname, Zhang, said she has to take painkillers to curb period pain each month.

"During my period, my lower abdomen will throb with pain," she said. "I become listless, have no appetite and sometimes throw up."

In Jiangsu, a regulation that took effect in July 2018 states that for employees who are not able to work due to heavy or painful menstrual cycles, employers should arrange one to two days off for them if medical proof is provided.

"I have worked at my current institution for two years, and neither I nor any of my colleagues have taken days off due to our periods," Zhang said.

She added that her pain is so excruciating that she can barely sit up, let alone visit a hospital to get a certificate supporting her need for leave.

"I believe it is necessary to establish a paid leave system," she said.

Shen, the professor, said that local governments are suggesting clarifying prerequisites for being entitled to menstrual pain leave, such as whether taking days off would affect employees' income, as well as improving related regulations to address their difficulties in getting medical certificates.

Moreover, he said it is important to devote efforts to preventing gender discrimination at workplaces and researching approaches to manage costs incurred by the leave, so as to increase female employees' sense of security.