Menstrual health is a fundamental determinant of overall well-being, influencing nearly half of the global population across different life stages. It encompasses the physical, mental, and social dimensions of health in relation to the menstrual cycle  [4]. Yet, enduring stigma and silence continue to restrict open communication, leading many individuals to conceal cycle-related symptoms and refrain from seeking support [3–5]. The consequences extend beyond personal well-being: menstrual cycle related symptoms (e.g., fatigue, severe menstrual cramps) contribute to significant absenteeism and presenteeism, with estimates suggesting up to 8.9 days of annual productivity loss per employee [8]. While over 70% of employees express a desire for menstrual health support, fewer than 5% report access to any such benefits at work [6,7]. Moreover, a recent systematic review confirms that menstrual health remains largely absent from organizational well-being initiatives [1]. Despite this clear gap, current discourse tends to frame menstrual health predominantly through a deficit lens – focusing on symptom burden and productivity loss – while overlooking potential cycle-related strengths such as phases of heightened focus. Digital interventions offer a scalable, low-threshold opportunity to address these gaps, yet their application in workplace settings remains largely unexplored [2,9].

The WorkFlow project investigates how low-threshold digital interventions can improve menstrual health awareness and literacy, reduce stigma, and foster open communication in organizational settings. Beyond understanding the current state of awareness and stigma, the project aims to identify what kinds of organizational measures can effectively address existing gaps – such as presenteeism, unmet support needs, and limited communication about menstrual health – and what concrete actions organizations can take to create more inclusive and health-supportive environments. The project takes a multi-perspective approach, engaging both menstruating and non-menstruating employees as well as organizational leaders, to build a comprehensive empirical foundation that makes organizations ready for the next step: scalable, evidence-based workplace health interventions.

Embedded in a large German organization with approximately 30,000 employees, WorkFlow comprises three interconnected studies:

First, a single-arm pre–post study examines whether a brief digital intervention – combining a reflective scenario that challenges implicit communication norms with a menstrual health knowledge quiz providing immediate feedback – can shift employees’ communication intentions and behaviors over a six-month period.

Second, qualitative research on leadership perspectives explores how managers – including those without personal menstruation experience – perceive and communicate about menstrual health, and what barriers and opportunities they identify for fostering more inclusive environments.

Third, the development of cycle–performance visualization prototypes integrate menstrual cycle data with self-reported work performance indicators, enabling individuals to recognize not only challenges but also personal strengths and positive patterns across their cycle – moving toward a more balanced and empowering understanding of menstrual health at work.

By establishing an empirical foundation across employee and leadership perspectives, WorkFlow aims to inform the design and evaluation of future randomized controlled trials (RCTs) testing digital interventions that address menstrual health – and related stigmatized health domains – in workplace settings. The insights generated will help organizations move from awareness to action, providing evidence-based recommendations for measures that can reduce presenteeism, enhance well-being, and foster inclusive workplace cultures. As the project progresses, the WorkFlow team aims to expand this research to further organizations across different industries and sectors. Organizations interested in collaborating on workplace menstrual health research and interventions are welcome to reach out.

Sou, D., Stebler, D., Principe, M., Kowatsch, T., Nißen, M., Please CyMe: Towards Enhancing Menstrual Health Awareness through Customization and Personalized Visualization in a Menstrual Health App, In Proc. of Mensch und Computer 2024 (MuC ’24). ACM, New York, NY, USA, 674–683, 10.1145/3670653.3677475

Sou, D., Kavassakali, V., Kowatsch, T., Nißen, M., From Stigma to Support: Fostering Menstrual Health Awareness and Literacy in the Workplace, Swiss Gender Medicine Symposium 2025, 20–21 October 2025, Bern, Switzerland, Abstract & Poster.

Sou, D., Principe, M., Kowatsch, T., Nißen, M., Designing Stigma-Mitigating Digital Health Interventions: The Case of Menstrual Health Literacy, International Conference on Information Systems (ICIS’25). TREO (Technology, Research, Education, and Opinion), 133, https://aisel.aisnet.org/treos_icis2025/133/

Sou, D., Kavassakali, V., Kowatsch, T., Nißen, M., Towards Stigma-Mitigating Information Systems: Menstrual and Menopausal Health in the Workplace as a Use Case, JAIS-AMCIS Paper Development Workshop, AMCIS 2025, Montréal, Canada.

1. Saeed Amirabdolahian, Guy Pare, and Stefan Tams. 2025. Digital Wellness Programs in the Workplace: Meta-Review. Journal of Medical Internet Research 27: e70982. https://doi.org/10.2196/70982
2. Oscar Castro, Alicia Salamanca-Sanabria, Aishah Alattas, Gisbert Wilhelm Teepe, Konstantin Leidenberger, Elgar Fleisch, Lorainne Tudor Car, Falk Muller-Riemenschneider, and Tobias Kowatsch. 2024. Top-funded companies offering digital health interventions for the prevention and treatment of depression: a systematic market analysis. Archives of Public Health = Archives Belges De Sante Publique 82, 1: 200. https://doi.org/10.1186/s13690-024-01424-z
3. Pauline De Corte, Moritz Klinghardt, Sophia von Stockum, and Klaas Heinemann. 2025. Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics—A Systematic Literature Review. Bjog 132, 2: 118–130. https://doi.org/10.1111/1471-0528.17973
4. Julie Hennegan, Inga T. Winkler, Chris Bobel, Danielle Keiser, Janie Hampton, Gerda Larsson, Venkatraman Chandra-Mouli, Marina Plesons, and Thérèse Mahon. 2021. Menstrual health: a definition for policy, practice, and research. Sexual and Reproductive Health Matters 29, 1: 31–38. https://doi.org/10.1080/26410397.2021.1911618
5. Mary M. Olson, Nay Alhelou, Purvaja S. Kavattur, Lillian Rountree, and Inga T. Winkler. 2022. The persistent power of stigma: A critical review of policy initiatives to break the menstrual silence and advance menstrual literacy. PLOS global public health 2, 7: e0000070. https://doi.org/10.1371/journal.pgph.0000070
6. Sonia Ponzo, Aidan Wickham, Ryan Bamford, Tara Radovic, Liudmila Zhaunova, Kimberly Peven, Anna Klepchukova, and Jennifer L. Payne. 2022. Menstrual cycle-associated symptoms and workplace productivity in US employees: A cross-sectional survey of users of the Flo mobile phone app. Digital Health 8: 20552076221145852. https://doi.org/10.1177/20552076221145852
7. Danielle M. Raves, Wynetta D. Herrera, Matthew E. Darnell, Tristan Rice, Craig Friedman, Stephanie C. Moratti, Stacy T. Sims, Wandasun B. Sihanath, Shannon N. Ehrhardt, and Amanda Phillips. 2025. A survey assessing the impact of symptoms related to the menstrual cycle and perceptions of workplace productivity: considerations for employer-sponsored menstrual health programs. BMC Women’s Health 25, 1: 418. https://doi.org/10.1186/s12905-025-03833-w
8. Mark E. Schoep, Eddy M. M. Adang, Jacques W. M. Maas, Bianca De Bie, Johanna W. M. Aarts, and Theodoor E. Nieboer. 2019. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ open 9, 6: e026186. https://doi.org/10.1136/bmjopen-2018-026186
9. Mi Seon Seo and Bok-Nam Seo. 2025. Effectiveness of digital healthcare in managing menstrual symptoms: a systematic review. Women’s Health Nursing (Seoul, Korea) 31, 2: 108–118. https://doi.org/10.4069/whn.2025.05.22

Davinny Sou – ETH Zurich, University of St.Gallen

Vassilka Kavassakali – EnBW Energie Baden-Württemberg AG, University of Applied Sciences Karlsruhe

Achim Reuther – EnBW Energie Baden-Württemberg AG

Saeed Amirabdolahian – HEC Montréal

Debra Soth – Berlin School of Economics and Law

Heike Wiesner – Berlin School of Economics and Law

Christy M.K. Cheung – Hong Kong Baptist University

Tobias Kowatsch – University of Zurich, University of St.Gallen, ETH Zurich

Marcia Nißen – Eastern Switzerland University of Applied Sciences, University of Zurich

January 2025 – today