Picture a server at a packed restaurant, required to wear a form-fitting polyester uniform. When a hot flash hits mid-shift, the discomfort is immediate and visible. What she really needs is something as simple as a cotton T-shirt — but her employer's dress code leaves no room for that.
If she works in Philadelphia, that's about to change.
Starting January 1, 2027, Philadelphia will prohibit workplace discrimination on the basis of menstruation, perimenopause, and menopause, and will require employers to provide reasonable accommodations for employees affected by these conditions.
To be clear on the definitions: perimenopause is the transitional phase preceding menopause, characterized by fluctuating levels of estrogen and progesterone. Menopause itself marks the end of a person's reproductive years, clinically defined as twelve consecutive months without a menstrual period.
Both life stages have entered the broader cultural conversation in a significant way. Social media is saturated with influencers and wellness coaches promoting supplements promising relief from night sweats, brain fog, and reduced libido. Many also advocate for strength training, walking with weighted vests, hormone replacement therapy, and creatine supplementation for muscle preservation.
As a law professor at Villanova University who teaches and writes about employment law and gender discrimination — and someone who has personally taken up strength training, protein shakes, and needlepoint — I have a stake in how workplaces respond to the realities of women over 50.
In my view, Philadelphia's new ordinance is a meaningful template that other cities and states should follow: one that provides real relief to workers managing hormonal symptoms without placing unreasonable burdens on employers.
Following Rhode Island's lead
Women's health advocates have long flagged the inadequate training medical professionals receive on conditions related to menstruation, perimenopause, and menopause. A 2022 national survey of 145 OB-GYN residency program directors found that fewer than one in three programs included any menopause curriculum — a striking gap, given that every woman who lives long enough will experience it.
Progress in the medical field has been slow; in the workplace, it has been slower still. Workplace protections for menopause-related conditions have remained largely nonexistent — until recently.
In July 2025, Rhode Island became the first state to ban discrimination on the basis of menopause and mandate that employers provide reasonable accommodations for employees experiencing related symptoms. Philadelphia wasn't far behind.
In December 2025, the Philadelphia City Council amended the Philadelphia Code to prohibit discrimination on the basis of menstruation, perimenopause, and menopause. Under the new law, for instance, firing an employee because of heavy menstrual bleeding that resulted in visible leaking would constitute a violation.
The council also amended Section 9-1128 — which previously required employers to accommodate pregnancy, childbirth, and related medical conditions — to explicitly include "symptoms of menstruation, perimenopause or menopause." Accommodations apply when an employee requests them and do not impose an undue hardship on the employer.
Medical and public health experts who testified during the legislative process outlined the range of physical and emotional symptoms associated with these life stages: abdominal and pelvic cramping, fatigue, mood changes, headaches, irregular cycles, hot flashes, sleep disturbances, and cognitive changes. Notably, experts indicated that 23% of women experiencing perimenopause have symptoms severe enough to significantly disrupt their daily functioning.
Employers are not required to accommodate every symptom — only those that "substantially interfere with an employee's ability to perform one or more job functions." While the ordinance leaves "substantially interfere" undefined, the intent is clear: accommodations are triggered when a worker genuinely cannot perform part of her job. For example, period pain that prevents a retail worker from standing through a shift, or hot flashes that make working in a commercial kitchen untenable.
Clear and explicit protections
Given existing antidiscrimination law, why does a targeted ordinance like this matter?
Federal, state, and local laws already prohibit sex-based discrimination in the workplace. They also require employers with 15 or more workers to provide reasonable accommodations for pregnancy, childbirth, and related conditions. Separate federal, state, and local laws address disability discrimination and related accommodations.
The problem is that menopause and menstruation don't fit neatly into any of these frameworks. While a handful of employees across the country have successfully challenged terminations tied to menstruation-related conditions, others have lost their cases when courts ruled that menstruation falls outside the scope of the Pregnancy Discrimination Act or the Pregnant Workers Fairness Act.
Employees seeking protection under the Americans with Disabilities Act for conditions such as endometriosis — where tissue grows outside the uterus and can cause debilitating pain during menstrual cycles — face similarly steep legal hurdles. Philadelphia's ordinance sidesteps these complications by making protections explicit, rather than forcing workers to shoehorn their experiences into laws that weren't written with them in mind.
Reasonable accommodations
During legislative hearings, council member Nina Ahmad, who introduced the bill, emphasized that the accommodations envisioned are modest and largely low-cost. She and fellow council members pointed to practical examples: access to bathrooms and drinking water, brief flexible breaks, breathable uniforms, temperature controls or fans to manage hot flashes, the ability to layer clothing, stocked period products, and minor scheduling flexibility.
The accommodations required will naturally vary by industry. Many office workers already have latitude over what they wear, when they use the restroom, or whether to work remotely. But for employees in retail, food service, or other structured environments with strict break policies, something as basic as permission to step away for water or use the restroom on demand can make a meaningful difference.
Just as the nature of accommodations will vary by job, so too will the threshold for establishing undue hardship. Under the Philadelphia Code, undue hardship is an individualized assessment that weighs factors including the cost of the accommodation, the size of the workforce, and the employer's financial capacity.
The details will matter when implementation begins. But come January 2027, millions of Philadelphia workers will have new legal footing — and a clearer path to doing their jobs without having to suffer in silence.
Read more of our stories about Philadelphia and Pennsylvania, or sign up for our Philadelphia newsletter on Substack.
Ann Juliano does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
