Braving work with monster cramps has plenty of people seeing red.

While most menstruators manage to eke through life when the red devil pays a visit, up to one in five women suffers from painful periods severe enough to disrupt daily activities, according to one 2012 study. Around 10% of women suffer from endometriosis, a disorder of the uterine tissue that can cause pelvic pain and a range of other unpleasant symptoms.

A number of countries offer paid menstrual leave to provide some relief: Japan, a pioneer in this area, extended seirikyuuka — or “physiological leave” — to painful period sufferers with its 1947 Labor Standards Law, the Atlantic reports. Indonesia, Taiwan, South Korea and some parts of China also began offering such a benefit in recent years, while Italy’s parliament mulled a menstrual leave bill last March. Private companies in India and the U.K. have endorsed the idea as well.

But despite the appeal of menstruators getting time to recuperate from physical pain, experts say there could be drawbacks. For starters, there’s pervasive period stigma: Women who dropped a tampon in a 2002 study, for example, were viewed by others as less competent and less likeable.

“The upside, of course, is that there are women for whom menstruation is an incredibly physically painful experience,” Naama Bloom, founder of the women’s health resource HelloFlo and author of “HelloFlo: The Guide, Period,” told Moneyish. “We do need to do something for them to accommodate them, because it is a monthly physical trauma experience.”

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But Bloom worries that paid menstrual leave could backfire, as “culturally, we assume that when women have their period they’re not capable of making good, rational decisions.” “The risk is that (for) those women who choose to take menstrual leave, all of their work from the days prior or the days during will be viewed with a different lens by their colleagues or bosses,” she said. “I don’t believe in that perception, but I know it exists.”

Emily Martin, general counsel and vice president for education and workplace justice at the National Women’s Law Center, agreed that paid leave specifically designated for menstrual pain — rather than leave for various physical conditions including menstruation — would likely cause “more harm than good.” And Chris Bobel, an associate professor of women’s, gender and sexuality studies at the University of Massachusetts Boston, suggested this could be “a good idea ahead of its time.” “As long as women are devalued as women, then menstrual leave runs the risk of being used against women,” she said in an email.

“This particular path, I think, is well-meaning but not the right one,” Martin told Moneyish. “It communicates, first of all, that women are particularly likely to miss work — it sort of pathologizes women’s bodies and suggests that by nature of being a woman, a woman is less able to be a dependable employee. I think that’s both inaccurate and harmful as a subsconscious message to send.” Menstruation is often weaponized, Bobel added, with detractors “relying on a deficit model or even a disease model, which misrepresents menstruation as pathology.”

It’s also possible that paid menstrual leave could make some employers more reluctant to hire women. “When we provide some sort of entitlement that only women can exercise in the workplace, it’s always a consideration to think about how to ensure that that doesn’t lead to discrimination (around hiring),” Martin said. “In the case of menstrual leave, it seems to me that it’s a risk without a lot of benefit.”

Then there are privacy considerations, Martin said, and the question of whether it’s really your employer’s business that you have your period. “There’s definitely something to be said for destigmatizing periods,” she said. “But I also think that it is reasonable for employees to not want to give employers all the physical details of whatever reason it is that they’re not coming in — whether it’s because they’re getting their period or they have diarrhea or they’re getting treated for a yeast infection.”

Also read: This bakery is selling $15 PMS brownies delivered for that time of the month

Menstrual leave could even widen the gender pay gap, which one common measure puts at 80 cents on a man’s dollar. “(I)f we insist that one group or another has an extra set of costs associated with their employment then we’ll end up seeing the wages of that group fall relative to groups that don’t have those associated costs,” Forbes contributor Tim Worstall wrote in 2014. He suggested that if all women were to take one day a month off from a 22- or 23-day working month, their wages would drop by 1/22 or 1/23 relative to non-menstruators, though he noted not all women were likely to partake.

An alternative might be expansion of vacation and/or sick days for all employees, Bobel said, as “there are menstruators that do not ID as women, such as some transmen who have periods or gender-queer people who do.” “It is absolutely important and necessary for working people to have the right to take paid time off when they have a physical need to,” Martin added, “whether that is stemming from menstruation or the stomach flu or the need to go to a prenatal appointment.”

Integrating menstruation-related conditions into leave policies for illness or physical incapacity could also help, Martin said, as well as “create new openness around the fact that a lot of people at work get periods.”

Bloom suggested creating more flex work opportunities, arguing that conscientious employees would complete their work on schedule. “Once people prove that they can be treated like grownups, we should just treat them like grownups,” she said. “If that means that you have an exceptionally painful period and you need to be at home and maybe take some medicine and have a two-hour nap during the day … then you should be able to do that — with the understanding that you’re still going to hit your deadline.”

Bobel sees an even bigger picture. “The key is to transform workplaces to be more inclusive of and sensitive to diverse workers and their varied needs — new parents, breastfeeding moms, people caring for ill parents, people going through chemo, etc.,” she said. “If we can be flexible in the way we structure work time, place and spaces (in the workplace), we can make room for more people.”

The menstrual leave proposition occupies a far broader conversation that includes a lack of reproductive education or access to clean menstrual materials in many countries; a so-called “pink tax,” or sales tax on menstrual products; and female prison inmates’ access to menstrual hygiene products, an effort pushed by progressive senators like Cory Booker (D-N.J.) and Elizabeth Warren (D-Mass.).

“While I think menstrual leave is not the way for employers to go,” Martin said, “I do think it’s a valuable thing that we’re having the conversation — that there is new cultural attention to issues of menstruation and equity. And that is really a significant sign of progress.”