vivastreet mental health, menstruation and sex work

Over 95% of sex workers struggle to make ends meet due to “menstrual leave”

  • A quarter of UK women have experienced “period shaming” with millions of women missing work, school or exercise due to issues related to their menstruation
  • Over 50% of escorts choose not to work while menstruating and 43% have considered delaying or stopping their periods to be able to work
  • Almost 60% of sex workers say that being unable to work on their period affects their finances

While there has been much-needed discussion about period poverty in recent years, millions of women still lack access to sanitary products and support for period-related issues. Periods have been an embarrassing topic to many throughout history, despite the fact that nearly half of the world’s population will experience menstruation at some point in their lives, with many suffering from mental health implications.

Vivastreet conducted a survey of over 700 sex workers to learn more about how menstruation affects the mental health and lives of sex workers.


Sex work, like periods, is still a highly stigmatised topic. According to our findings, over 60% of sex workers said their periods affect them both mentally and physically.

One sex worker, in particular, admitted to suffering from anxiety, depression, and panic attacks, as well as feelings of injustice toward sex workers and their working conditions.

When Spain became the first European country to pass legislation granting paid medical leave to those suffering from severe period pains, it raised the question of whether a menstrual leave policy would work in the United Kingdom.

Charlie Thompson, partner and employment lawyer at Stewarts, told HR magazine, that fear of stigma may prevent menstruating Britons from taking time off. He also acknowledged that businesses are free to set their own policies regarding menstrual health rather than enacting a national law.

According to a survey of over 2,400 women conducted by period care company Yoppie, 26% believe period pains are not a legitimate reason to take time off from work, and 23% have previously lied about why they need time off when experiencing period pains. It also revealed that 84% of those polled would support making a menstrual leave policy a legal requirement.

But what about those who work for themselves, such as sex workers?

Periods don’t just affect the mental health of younger women and those new to menstruating. This bodily function can also affect the livelihood and mental health of sex workers.

Do sex workers still work on their period?

One of the most frequently asked questions about sex workers is “Can sex workers work during their period?”. 

The answer to this question is not straightforward. For some sex workers, their monthly period isn’t an issue, especially when their clients are okay with period sex. However, for some, period sex is frowned upon, and this means work has to stop for a few days to a full week. 


Over 50% of escorts choose not to work while menstruating, with 52% claiming that the side effects are both mentally and physically exhausting, making work unbearable.

It’s common for sex workers to inform clients that they are menstruating prior to their appointment, to avoid any last-minute surprises. Instead, oral sex or kink play might be the focus of the session. Of course, this is a matter of personal preference.

Some clients will still show up, but penetrative sex may be out of the question; however, one-fourth of surveyed sex workers stated that they do not work while menstruating because their clients dislike it.

Alternatively, certain tools can assist in accommodating penetration while a sex worker is menstruating. These tools are typically designed to either block menstrual blood or to create a barrier between the blood and the penetrating partner.

These tools can include:

  • Femidoms
  • Sponges
  • Menstrual cups and discs (that allow penetration)


Euphoria star, Chloe Cherry shared her sex work period hack when talking to the Going Mental podcast, suggesting folding and inserting a make-up sponge in your vagina. This is however far from a medically-approved method.

While the market for proper period sex tools is expanding, they remain scarce. For penetrative sex, 68% of sex workers who work while menstruating will use sponges, menstrual cups, or discs, while 16% prefer shower sex. Some sex workers also prefer to engage in anal sex or use dark bedding to make any possible stains less visible.

Katie, who works in the adult industry, uses menstrual sponges to work when she is menstruating. 

“I don’t feel shame about it as it is a natural part of being a woman,” she says. “And men have even asked for period play – not that I’ve done it as I’m a wimp about blood!”

Sex worker Amanda, prefers to take time off when she is menstruating but mentions she has previously used sponges. 

Around eight years ago one went a bit too high and got lost in my womb,” she says. “I had to have surgery to remove it and pretty intense antibiotics, so safe to say I was scared for life to ever do it again. So know the risks but it’s unlikely to happen, I’m just unlucky.”

Some sex workers would also focus on online content creation, phone sex or camming. However, camming platforms have strict rules about what content their users can broadcast, and sites like Chaturbate state in their Terms and Conditions that “Community Members may not broadcast, upload, or offer any content referencing or depicting menstruation, vomit, faeces or urine”. Meaning, if you are a sex worker looking for an alternative source of income while you are menstruating, you need to be extremely cautious of what you show on camera.

How do periods affect sex workers?

If a sex worker isn’t comfortable working while menstruating, they may have to take some time off. This can result in a loss of income, clients, and further stress or mental health challenges. 


Almost 60% of sex workers reported that being unable to work during their period impacts their finances, and 95% admitted they struggle to make ends meet.

A sex worker explained that “if we didn’t [work], it would be a 1-week unpaid vacation every month of which when you are running a business or you have a career or just any job that you are dedicated to, it’s not practical”, highlighting the issues many sex workers face when deciding whether to work on their period. 

Financial stability is one of the most important aspects of life. Unfortunately, in the adult industry, a simple bodily function can have an impact on income. Many sex workers can therefore suffer from depression due to a loss of income, especially if they do not have proper tools and methods in place. 

Sex worker Ruby shared that her periods affect her mentally due to being unable to earn money when she is menstruating, which she finds frustrating. Similarly to Amanda, she prefers not to use sponges as she has had a horrible experience in the past.

For sex workers that choose to work during their period, the job often becomes much more stressful due to the extra checks and steps. 

Common extra steps sex workers take during their period include:

  • Constant checks for leaks when using barrier methods
  • Choosing specific positions that limit the depth of penetration
  • Increasing foreplay time and avoiding penetration
  • Using dark-coloured bed sheets or red condoms



While many of these steps appear to be simple, the added stress of period sex can be taxing on the sex worker.

It does not come as a surprise that 43% of sex workers considered delaying or completely stopping their menstrual cycle in order to work. Because periods are frequently irregular, scheduling work around them can again add to the stress.

One Twitter user even went as far as having their uterus removed.

How is mental health linked to menstrual health?

The topic of menstrual and mental health is rarely discussed, contributing to the shame felt by menstruating women experiencing menstrual-related issues.

Carolyn Nicholas, a functional medicine certified health coach, and director of coaching at Able, stresses that everyone is different and so will be their experience. “Some women feel symptoms of PMT/PMS a week or two before they start their cycle, some as soon as they start and some don’t at all.”

She explains that depending on where we are in our cycle, our hormones fluctuate. This hormonal imbalance can also worsen any symptoms. 


Menstruation can have a variety of effects on mental health, but the two most common are period poverty and shame, and hormones.

Period poverty

Period poverty is one of the most significant links between mental health and menstruation.

Period poverty refers to portions of the population that can’t afford sanitary products. Plan UK found that 27% of girls in the UK admitted to overusing a sanitary product as they can’t afford a fresh one. Millions of women around the world use other methods during their cycle for a variety of reasons, including a lack of sanitary products.

This issue is frequently ignored, causing those with lower incomes to endure uncomfortable and humiliating situations. Lack of access to essential products can make them anxious and depressed, lowering their overall mental health.

With the cost of living crisis intensifying, one in eight Britons is expected to struggle to afford period products in the next year, according to a YouGov survey. The same survey found that 29% had never heard of the term “period poverty” nor knew what it meant. This figure increased to 42% in men who do not menstruate.

Period shame

Though modern medicine is advanced, we are still too shy to speak about common biological issues. Because discussing periods is often considered inappropriate, there’s no wonder 48% of UK girls feel embarrassed about their period. Menstruation is natural, but because of society’s taboo attitude, many women feel guilty about discussing their bodies.

Research by ActionAid also shows that one in 10 UK women has received negative comments about their period from a current or ex-partner.

Ruby however admitted she has never felt ashamed of her period or choice of career. “Most men don’t mind, they’ve seen it all before,” she says. “I have used sponges in the past and no one knew any different.”


Nicholas adds that “educating yourself on your periods is a good way to eradicate shame” as well as figuring out where the feeling of shame comes from.


Last but not least, hormones also play a prominent role in menstruation and mental health. 

Hormones are essential to the menstrual cycle to keep those who menstruate healthy. However, if these healthy hormones are out of balance, they can cause mood swings, depression, and anxiety.

A majority of sex workers said they feel moody, anxious, or depressed during their cycle.

Nicholas says the key is to keep the hormones in balance, which can be done by having good lifestyle habits such as getting quality sleep, having a healthy diet, getting enough exercise and “keeping an eye on your stress levels and implementing good stress management strategies”. 

Menstrual cycle hormones can also cause physical symptoms such as pain, irritable bowel movements, and headaches. These have a negative impact on mental health and can disrupt people’s lives. 49% of girls in the UK have missed a day of school because of their period, demonstrating how powerful these effects can be.

To relieve any physical and mental symptoms, Gigi Engle, a certified sex coach, sexologist and sex educator, swears by a “good self-love session”.

“Vitamin P – pleasure, is missing in too many women’s lives today, and the release of sexual pleasure is so healthy for mental and physical relaxation, flooding us with feel-good neurotransmitters and endorphins.


“After you masturbate and orgasm, the brain is flooded with oxytocin. This can make you very relaxed. If you get off right before sleep, it can ease you to bed like nothing else! In fact, many studies show that orgasm does indeed help you sleep better.”

If you feel that changing your habits did not help and still find it difficult to manage while menstruating, speak to your doctor to seek further advice.

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