Background <p>Menstrual-related symptoms such as menstrual pain and heavy bleeding impact individuals’ health, quality of life and can limit the ability to engage in daily life activities, including school. Menstrual-related symptoms thus risk reinforcing existing gender inequalities in health among young people, making it an issue of equal rights and public health concerns. No previous study has estimated the prevalence of menstrual-related symptoms and subsequent school absences in Sweden by using population-based data.</p> Methods <p>The study aimed to estimate the prevalence of menstrual-related symptoms and school absence among young people aged 16–29 in Sweden, and to examine associations between symptoms, absence, and sociodemographic factors. A sample (<i>n</i> = 5,483) of individuals aged 16–29 was drawn from a population-based cross-sectional study which used stratified random sampling. We used logistic regression to test sociodemographic factors associated with school absence due to menstrual-related symptoms.</p> Results <p>Menstrual-related symptoms were reported by most of the respondents (91.43%). Menstrual pain was reported by 76.59%, mood changes by 75.70%, ‘other’ menstrual complaints by half (57.88%) and heavy bleeding by 40.14%. Furthermore, 13.70% in total and 19.93% among those aged 16–19 reported that school absence because of menstrual symptoms occurred on every menstruation. Foreign-born individuals and Swedish-born individuals with two foreign-born parents had higher odds of reporting school absence due to menstrual-related symptoms, as did those with parents with short education and those with long-term health issues. ‘Other’ menstrual complaints (such as headache, tiredness and concentration difficulties) had the greatest impact on school absence.</p> Discussion <p>Menstrual-related symptoms are widespread among young people in Sweden. The subsequent absence from school is unevenly distributed according to the individual’s origin, parental education and long-term health issues and should be seen as an issue of gender equity and public health concern. Given the importance of schools for learning and development, student health services need to be equipped with screening methods and referral routines. Further studies should focus on socioeconomic inequities in menstrual health, with a particular focus on young migrants and second-generation immigrants.</p>