Spain Will Pay Sick Leave From Day Two for Severe Menopause Symptoms — But Only With a Public-System Diagnosis
Published on 11/03/2026 at 23:20 | Editorial boerse-global.de
Spanish employers will have to keep paying full wages for the first day a worker is off with debilitating menopause symptoms. From day two, the state takes over. That is the shape of a new legal decree that gives Spain its own sick-leave track for women whose secondary menopause disorder makes work temporarily impossible.
The Council of Ministers approved the measure on 20 October 2026 as Real Decreto-ley 31/2026, and the Boletín Oficial del Estado published it a day later, on 21 October 2026. It takes effect on 1 December 2026.
No diagnosis, no leave
Having menopause, or vague symptoms without a confirmed diagnosis, does not create any entitlement. Nothing is granted automatically. A doctor must formally diagnose a secondary menopause disorder, record the matching medical code, and state that the patient cannot temporarily carry out her job.
The decree also requires that both the diagnosis and any further treatment take place inside the public health system. Administration runs entirely electronically through the social security system, including direct digital transmission of the sick note to the employer.
Day one paid in full, then 60 % and 75 %
The payment structure departs sharply from Spain's ordinary sick-leave rules. For a normal illness, workers receive no statutory payment for the first three days, and the employer covers days four to 15.
Under the menopause scheme, financial cover begins on day two. On the first day of incapacity the employer continues the regular salary in full. From day two the social security system pays 60 % of the calculation base for the first 20 days, rising to 75 % from day 21.
On an illustrative calculation base of 1,500 euros a month, that works out to roughly 900 euros at 60 % and around 1,125 euros at 75 %.
Access hurdles are also waived. The minimum contribution period of 180 days within the last 5 years, normally required for sickness benefits, does not apply at all here.
A European first, still alone
The same decree covers sick leave for injuries resulting from gender-based violence. Minister Elma Saiz says more than 10.5 million women now contribute to the Spanish social security system. Spain already became the first European country to introduce dedicated sick leave for incapacitating menstrual pain in 2023.
Elsewhere in Europe the approach remains an outlier. According to reports, Germany, Italy, Greece, Portugal and Turkey still have no specific labour-law provisions for menopause symptoms. The European Trade Union Confederation, pointing to the patchwork across the bloc, is pressing for binding menopause protections in EU labour law.
