Menstrual health as an occupational equity issue in high-stress industries: A narrative review

This review examines menstrual health as a neglected dimension of women's health and occupational equity, with particular attention to high-stress and gendered occupational contexts. It asks how menstruation is addressed or silenced within workplace health frameworks, and how these dynamics are intensified in safety-critical, shift-based, and regulated occupations. A narrative review was conducted to synthesize literature from occupational health, feminist organizational scholarship, health policy, aviation studies, and workplace inclusion research. Aviation is used as a focal case, bringing together circadian disruption, fatigue exposure, public visibility, bodily discipline, and gendered occupational hierarchies. The review identifies four dynamics. First, rigid job design, workload intensity, circadian disruption, and recovery opportunities exacerbate menstrual health risks. Second, policy responses remain fragmented, uneven, and symbolic, offering recognition without accommodation or redistribution. Third, organizational cultures of silence and stigma frame menstruation as unprofessional, discouraging disclosure and reinforcing gendered norms of ideal workerhood. Fourth, inclusive and participatory leadership practices can create openings for psychological safety and employee voice, but their impact remains constrained without structural and policy reform. By reframing menstruation as an occupational health and equity issue rather than an individual concern, this review contributes to debates on embodied work, gendered organizations, and menstrual inclusion in high-pressure workplace contexts.