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Workplace relief is coming for employees with symptoms of menstruation, perimenopause and menopause in Philly

Accommodations might include brief, flexible breaks or temperature control to manage hot flashes. Disturbriana Media/E+ Collection via Getty Images

Imagine you’re a server at a busy restaurant that requires you to wear a form-fitting, polyester shirt as part of the uniform. When a hot flash hits, you are a sweaty mess. You really wish your employer would let you wear a cotton T-shirt instead.

If you live in Philadelphia, relief is on the way.

Beginning Jan. 1, 2027, the city of Philadelphia will prohibit discrimination on the basis of menstruation, perimenopause and menopause, and it will require employers to provide reasonable accommodations to employees for needs related to these conditions.

Perimenopause is the transitional period before menopause, marked by fluctuations in the hormones estrogen and progesterone. Menopause marks the end of the reproductive years, defined by not having a period for 12 consecutive months.

Both life stages are having a moment.

Social media is rife with influencers and life coaches selling supplements to relieve night sweats, clear brain fog and sustain libido. Many encourage strength training, walking with weighted vests, hormone replacement therapy and creatine, a compound that works to add muscle mass.

As a law professor at Villanova University, I teach and write about employment law and gender discrimination. I often focus on solutions to real-world problems for women and girls in the workplace.

Recently, I’ve taken up strength training, protein shakes and needlepoint. I’m clearly leaning into my identity as a woman over 50.

I believe the Philadelphia ordinance is a model for other cities and states to provide relief for workers suffering from symptoms of hormonal cycles and changes while balancing the needs of employers.

Woman lifts yellow shirt and reveals patch on stomach area
Low-dose estrogen patches have gained popularity as more people learn about the symptoms of perimenopause and menopause.
miodrag ignjatovic/E+ Collection via Getty Images

Following Rhode Island’s lead

Women’s health advocates have brought attention to the lack of training for medical professionals on the issues girls and women face resulting from menstruation, perimenopause and menopause.

In 2022, for example, a national survey of 145 OB-GYN residency program directors found that fewer than one-third of programs included curriculum on menopause. This is despite the fact that every single woman, if she lives long enough, will go through it.

While some progress has been made in the medical field, there has been even less when it comes to workplace protections.

To address this gap, in July 2025 Rhode Island became the first state to prohibit discrimination on the basis of menopause. Rhode Island also requires employers to provide reasonable accommodations to employees experiencing menopause-related symptoms.

The Philadelphia City Council said: “Hold my weighted vest.”

In December 2025, the council amended the Philadelphia Code to prohibit discrimination on the basis of menstruation, perimenopause and menopause. For example, if an employer fires an employee because of heavy menstrual bleeding resulting in leaking, that would violate the new law.

In addition, the City Council amended Section 9-1128, which requires employers to provide reasonable accommodations for needs related to pregnancy, childbirth or a related medical condition. That list now also includes “symptoms of menstruation, perimenopause or menopause” – provided the employee requests the accommodation and it does not cause an undue hardship for the employer.

Experts in medicine and public health and described the physical and emotional symptoms women and girls may face during these life stages. These symptoms include abdominal or pelvic cramping, fatigue, mood changes, headaches, irregular menstrual cycles, hot flashes, sleep disturbances and cognitive changes.

One expert noted that 23% of women who are experiencing perimenopause have symptoms severe enough to “.”

Employers will not have to accommodate every symptom, only those that “substantially interfere with an employee’s ability to perform one or more job functions.” Although the new ordinance does not define “susbtantially interfere,” the intent is to require accommodations when a worker cannot perform some part of her job – for instance, if period pain is so high that a retail worker cannot stand for their shift, or if hot flashes prevent a food service worker from staying in the kitchen.

Clear and explicit protections

In light of existing antidiscrimination laws, why is such a targeted law necessary?

Federal, state and local laws already prohibit employers in Philadelphia from discriminating because of sex. They also require employers with 15 or more employees to provide reasonable accommodations for pregnancy, childbirth and related medical conditions.

Federal, state and local laws also prohibit employers from discriminating against people with disabilities and require reasonable accommodations to allow them to perform the essential functions of the job.

But menopause and menstruation protections do not clearly fall within these protections.

There are a few cases across the country in which an employee successfully challenged their firing for a condition related to menstruation. But other employees have lost cases under federal law when courts ruled that menstruation is not covered by the Pregnancy Discrimination Act or Pregnant Workers Fairness Act.

Further, people seeking protection under the Americans with Disabilities Act for menstruation complications such as endometriosis, which occurs when tissue grows outside of the uterus and often causes severe pain during menstrual cycles, face an uphill battle. Instead of requiring employees who experience these sorts of symptoms to fit their cases into other statutes, Philadelphia’s new ordinance makes protection clear and explicit.

Reasonable accommodations

During a hearing on the proposed legislation, council member Nina Ahmad, who introduced the bill, noted that the accommodations envisioned are not costly. She and other council members gave : access to bathrooms and drinking water, brief flexible breaks, breathable uniforms, temperature control to manage hot flashes, fans or ventilation, ability to layer clothing, stocked period products and brief scheduling flexibility.

The type of accommodations necessary will change depending on the employee’s industry. Many women who experience symptoms already can decide what they wear to work, when they take a bathroom break and maybe even whether to work remotely. However, for workers in retail and service, or other workplaces with strict break policies, the ability to request a bathroom break or to drink water during a shift could significantly ease symptoms.

Just as the accommodations required will differ by job and industry, the employer’s ability to demonstrate undue hardship will also differ. Under the Philadelphia Code, undue hardship is an individualized assessment that considers such factors as the cost of the accommodations, the size of the workforce and the employer’s financial resources.

The devil is in the details, of course, but come January 2027, relief should be on the way for workers who are just trying to do their jobs while suffering from symptoms caused by menstruation, perimenopause and menopause.

Read more of our stories about Philadelphia and Pennsylvania, or sign up for our Philadelphia newsletter on Substack.

The Conversation

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.

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Newsom: We could lose the country in 2028

Newsom: We could lose the country in 2028

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2028 Dem hopefuls scramble for distance from AIPAC

Democrats eyeing White House runs in 2028 are preemptively breaking up with AIPAC.

Sen. Cory Booker, who received donations bundled by the American Israel Public Affairs Committee as late as December, told POLITICO that he’s sworn off the group’s funds (and other PAC money). California Gov. Gavin Newsom said he never has and “never will” take donations from the group. Sen. Ruben Gallego (D-Ariz.) vowed last week that he “wouldn’t take AIPAC money” anymore. A spokesperson for Pennsylvania Gov. Josh Shapiro said he has “never taken money or solicited support from AIPAC,” while a spokesperson for Kentucky Gov. Andy Beshear said “AIPAC has never contributed to Gov. Beshear and they’re never going to. Ever.”

Their retreat underscores how rapidly AIPAC has become a bogeyman for Democrats seeking to criticize the Israeli government, particularly with the Netanyahu administration’s involvement with President Donald Trump’s operation in Iran. Many former AIPAC-friendly Democrats see the historically bipartisan group as becoming more and more aligned with Netanyahu’s right-wing government in recent years. Its emergence as an early touchstone in the shadow 2028 presidential primary reflects a calculation among leading Democrats that liberal voters’ hard shift away from the longtime U.S. ally will stick.

“This is going to be a huge flashpoint in the primary throughout 2027 and into 2028,” said veteran Democratic strategist Mark Longabaugh, who advised Sen. Bernie Sanders’ 2016 presidential bid. “The constitution of the party just in the makeup of the voters has changed dramatically. The politics of Israel has changed dramatically.”

Recent AIPAC critics also include some Jewish Democrats who had previously supported the organization or received its backing.

After AIPAC poured $22 million into Illinois primaries last week to mixed results, Gov. JB Pritzker, a billionaire who does not accept outside funds, accused the group of becoming pro-Trump and said he wants no part of the group he once donated to. A spokesperson for Sen. Elissa Slotkin (D-Mich.) pointed to a podcast in which she said she swore off AIPAC’s support in 2022.

Former Chicago Mayor Rahm Emanuel told POLITICO he “need not worry about AIPAC’s support. It will not be forthcoming.”

Emanuel – a supporter of Israel whose father was Israeli – has also been a longtime critic of Israeli Prime Minister Benjamin Netanyahu. Emanuel contested past reporting that he held dual U.S.-Israelicitizenship when he was a child: “I never had Israeli citizenship. I’m 66, my whole life I’ve only had American citizenship and an American passport.”

Democrats cited a variety of reasons for rejecting AIPAC’s cash. Booker said it was part of a broader pledge he made at the start of the year to swear off all PAC money going forward. “I don’t believe we should be accepting any PAC money at all from anybody,” he told POLITICO on Friday.

Gallego likened taking the group’s backing to “endorsing what’s happening right now” in Iran and Gaza while appearing on POLITICO’s “The Conversation.”

And progressives like Reps. Ro Khanna (D-Calif.) and Alexandria Ocasio-Cortez (D-N.Y.), who have been highly critical of the Israeli government and have repeatedly sparred with AIPAC, have accused the group of targeting their campaigns and long rejected its financial aid. Sen. Chris Murphy (D-Conn.) bluntly told POLITICO: “I don’t take their money, they’re running ads against me.”

Other potential White House aspirants attempted to dodge the question. Sen. Raphael Warnock (D-Ga.), for instance, said he has “individuals who support me” when asked if he would reject AIPAC’s backing. Several more did not respond when reached through spokespeople, including former Vice President Kamala Harris, former Transportation Secretary Pete Buttigieg, Sens. Mark Kelly (D-Ariz.) and Jon Ossoff (D-Ga.), and Govs. Wes Moore of Maryland and Gretchen Whitmer of Michigan.

That so many Democrats declined to comment on the organization suggests that AIPAC still has some influence in Democratic politics. And the big-spending group can still help its preferred candidates to victory even as its name has become mud in Democratic primaries, as evidenced by its wins last week in two of the four Illinois House races where it spent big. But it’s also telling that no potential 2028 candidate openly embraced the group.

AIPAC and its allies hit back, accusing Democrats who are giving the group the cold shoulder of trying to silence pro-Israel voices within the party. They vowed to continue intervening in Democratic primaries to promote their interests. Deryn Sousa, a spokesperson for AIPAC, said “efforts to push pro-Israel Democrats out of the political process are alarming and fundamentally undemocratic.”

Patrick Dorton, a spokesperson for AIPAC’s super PAC, United Democracy Project, acknowledged the “difficult environment” the lobby is navigating after Gaza and with the war in Iran. But, he said, “we aren’t going to be deterred in ensuring that pro-Israel voices are heard in federal elections.”

“We are going to work with mainstream Democrats across the party to strengthen the U.S.-Israel relationship, and that includes presidential contenders,” Dorton said. “We’re going to remind everybody about the millions of pro-Israel Democratic voters who are part of the political process in federal elections.”

Top Democrats’ rush to rebuff AIPAC comes amid a party-wide grappling over how to handle Israel, after the Biden administration’s approach to the war in Gaza was found to have cost Harris votes in 2024 and as polls show Democratic voters continuing to sour on Israel as it aids the U.S. intervention in Iran. An NBC News poll this month showed 57 percent of Democrats view Israel negatively, a dramatic shift from when just 35 percent held a negative view of the country after Hamas attacked it on Oct. 7, 2023. A Quinnipiac University survey earlier this month showed 62 percent of Democrats felt America is too supportive of Israel.

Democrats eyeing 2028 have been publicly repositioning on Israel for months as Gaza reemerges as a flashpoint in midterm primaries. And their criticisms of Israel and its allies in the U.S. are growing sharper as the war in Iran escalates with no clear off-ramp from Trump.

Newsom earlier this month likened Israel to an “apartheid state” and said the U.S. should reconsider military support for Israel. Pritzker has long been a supporter of Israel and has advocated for a two-state solution, but recently told the New York Times that he’s “challenged” by current geopolitics because the U.S. is supporting Israeli policies “that I don’t think the majority of Americans believe in and I don’t think a majority even of Israelis believe in.”

Shapiro, who’s similarly been a longtime supporter of Israel and a two-state solution, has also criticized Netanyahu and Trump’s enabling of his agenda in recent podcast appearances. But he cautioned that denying Israel’s right to exist could lead to “permanent war.” A spokesperson for Shapiro said the Pennsylvania governor “has been clear that Donald Trump is failing to hold Netanyahu accountable” while also positing that “Israel has a right to exist in security as a Jewish state, and we must find a path to peace in the Middle East that includes a safe homeland for the Palestinian people.”

Leading progressives, including Ocasio-Cortez and Khanna, have gone further — accusing the Netanyahu administration of perpetuating genocide in Gaza and pushing to stop U.S. arms sales to the country.

But Democrats on both ends of the ideological spectrum have argued there are bigger issues around Israel than AIPAC. Shapiro, on a podcast last year, said putting Democrats on record over AIPAC was a “shortcut” for asking their views on Israel and a two-state solution. “Demanding answers on those questions is more important than ‘hey, what about this lobbying group or that lobbying group,’” he said.

Khanna, in a message to POLITICO on Monday, said, “What matters more is the clarity of calling what happened a genocide and stopping military sales to Israel used to kill civilians in Gaza and Lebanon.”

Still, progressive groups such as MoveOn and Justice Democrats are plotting how to make taking AIPAC money a red line for those vying to be the party’s next standard bearer.

“We’re going to be demanding that anyone who deserves to get the Democratic nomination not only doesn’t take AIPAC support or donations, but actively speaks out against this lobby,” said Justice Democrats spokesperson Usamah Andrabi.

In a sign of the volatile and complex politics surrounding Israel, some Democrats who are shutting the door to AIPAC donations are declining to call on their would-be rivals to do the same.

Pritzker, asked by POLITICO last week whether Democratic presidential candidates should accept AIPAC funding, criticized the flood of special-interest money in campaigns in general but cast taking PAC cash as “a matter of values” for each candidate. Murphy said “everybody will make their own decision about it.”

And Booker went so far as to call the AIPAC pile-on “problematic.”

“There are Iranian Americans that bundle money. There are Turkish Americans that bundle money. There are a lot of ethnic groups that bundle money, and often for things that I don’t agree with. But somehow AIPAC seems to be drawing a lot of attention, and that’s problematic to me,” Booker said. “[AIPAC] is not the problem in America. The problem in America is money in politics.”

CLARIFICATION: This article has been updated to include Emanuel’s statement that he has never held dual Israeli citizenship.

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