Universities are still asking students to prove they have a body. It’s time to stop.

This blog was kindly authored by Ella Cockman, Final-year BASc Student at The London Interdisciplinary School.

A second-year student gets her period mid-exam. She sits through the entire paper in pain. No bag. No medication. No exit. She rushes to the toilet when it ends. This is not an unusual story. According to The Hidden Impact of Menstruation in Higher Education (HEPI Report 191), 70 per cent of students who menstruate say they sometimes cannot concentrate on their studies or assessments because of period pain. On average, ten study days are lost per academic year, rising to nineteen for those with a diagnosed condition.

But the most striking number in that report is this: of 117 higher education providers surveyed via Freedom of Information requests, only one, Anglia Ruskin University, explicitly names menstrual symptoms as valid grounds for assessment extensions or extenuating circumstances review. Just one.

The problem is not that universities have ignored this entirely. It is the dominant response – pointing students toward extenuating circumstances processes – that is structurally the wrong tool. The Good Practice Framework for Additional Consideration, published by the Office of the Independent Adjudicator for Higher Education, frames additional consideration as applying to circumstances that are ‘unexpected and beyond the student’s control’.’ Menstruation is not unexpected. It is a predictable, recurring biological event. Applying an emergency framework to a calendar event does not just fail students; it actively mis-frames the problem.

There is a further issue that extenuating circumstance cannot reach at all. Research from the Netherlands identifies what it calls presenteeism: being physically present but unable to perform. HEPI’s data confirm this is widespread. Of students who menstruate, 57 per cent report being unable to concentrate due to physical premenstrual syndrome (PMS) symptoms, and 48 per cent report the same due to mood or mental health symptoms even before menstruation begins. These students appear in no extenuating circumstance dataset. They showed up. They couldn’t do their best.

This invisibility has a longer history. A 2025 prospective cohort study using English school data found that heavy menstrual bleeding and period pain are associated with higher rates of persistent absence and lower odds of achieving five standard General Certificate of Secondary Education (GCSE) passes. The attainment gap starts at school and follows students into higher education. By the time they arrive at university, 85 per cent of providers have no menstruation policy of any kind, and where policies do exist, they cover staff only.

Other systems have made different choices. In 2018, Scotland became the first country in the world to legislate for free access to period products for all. In Denmark, Klassens Tid has embedded structured conversation about bodily experience into school life since 1993, normalising variation as routine rather than exception. These are not accommodations. They are anticipatory designs built on the assumption that students have bodies, not on the assumption that bodies are problems to be managed after the fact.

That distinction is the key one. Accommodation asks: how do we handle the exception? Anticipatory design asks: what do we already know about the people who will use this system, and how do we build for them accordingly? London South Bank University recently changed its policy to allow all students to submit assessments up to five days late with no penalty. Late submissions stayed flat, while extenuating circumstances claims fell by 154 per cent. Not designed with menstruation in mind, but a good example of what design that assumes human variability looks like.

What would a properly anticipatory approach look like at the sector level? Three things. 

First, Westminster and Wales should follow Scotland and Northern Ireland in legislating free access to period products in higher education, removing the most basic barrier – cost. 

Second, the Office of the Independent Adjudicator for Higher Education should revise its Good Practice Framework to explicitly include women’s health conditions, including severe symptoms in the absence of a formal diagnosis.

Third, and most fundamentally, universities should review how assessment schedules, tutorial structures, and pastoral support are designed not to accommodate menstruation as an exception, but to build in the flexibility that a student body with bodies requires.

The student who sat through that exam did not lack resilience. She lacked a university that had thought carefully enough about her. After a report as clear as HEPI’s, there is no excuse for that to continue.