Spain's menopause sick leave starts December 1; doctors seek common rules

Spain will pay a sick-leave benefit to women who cannot work because of a medically recognised condition linked to menopause, from 1 December 2026, under Royal Decree-law 31/2026, which the government approved on 20 October and published in the Official State Gazette on 21 October. In the week since, the rule has drawn debate among Spanish doctors: on 27 October, family doctors asked for common criteria on when to grant the leave, while gynaecologists said the change does not alter medical practice. Because it is a decree-law, the measure still has to be validated by the Spanish Congress within a month of publication, by about 21 November.

Menopause is a normal stage of life, but for some women a condition linked to it can make work very difficult. The new rule gives such cases their own category, recorded with a medical code, with no minimum contribution period. The government's point is that women should not lose income or protection because a menopause-related condition is treated as a private matter.

The debate among doctors shows where the hard part lies. Mariam de la Poza, who heads the Spanish Society of General and Family Physicians (SEMG) in Catalonia, welcomed the recognition but stressed that menopause itself is physiological, and that leave should follow from a specific condition that stops a woman working, not from being in menopause. Gynaecologists questioned whether a separate category is needed at all, since a disabling condition can already justify sick leave. Both positions point to the same practical question for the 1 December start: how doctors will decide, consistently, which cases qualify.

For women anywhere balancing careers with midlife health, Spain's move is part of a wider shift in how workplaces treat menopause. Several countries have debated menopause at work through guidance, employer policies or proposed laws; Spain is putting it into its social security system. How many women use the leave, and how doctors apply it, will be watched by other governments and employers.

Peepals calculation: From day 21 of leave, the reported benefit rises from 60% to 75% of the regulatory base, an increase of 25% in what the worker receives (75 / 60 = 1.25). For a regulatory base of 100 units a day, that is 60 units a day up to day 20 and 75 units from day 21. Our calculation from the reported figures.

Short-term: Spain's Congress must validate the decree-law by about 21 November; doctors and health services will need to agree how to certify qualifying cases before 1 December.

Long-term: If it works as intended, women with disabling menopause-related conditions in Spain can take leave without a contribution test, which could help more of them stay in work through midlife.

Who is affected: Working women in Spain with menopause-related conditions that stop them working; family doctors and gynaecologists who will certify the leave; employers, who pay the first day; and Spain's Social Security system.

What to watch next: The validation vote in Congress, due within a month of the decree's 21 October publication, and the start of the menopause leave on 1 December 2026.

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