(CNN) The real impact of menstruation on women and society is underestimated, researchers say, as a new study suggests period pain is linked to nearly nine days of lost productivity a year in workplaces and schools.

Researchers surveyed 32,748 Dutch women between the ages of 15 and 45 to evaluate lost productivity associated with menstrual symptoms. They measured both time off from work or school, as well as working or studying while feeling ill -- what the study termed "presenteeism."

The study , which was published Thursday, found that around 1 in 7, just under 14%, had taken time off from work or school during their period and 3.5% said that this happened during every, or nearly every, menstrual cycle.

Some 81% of the Dutch women said they had been less productive as a result of their menstrual symptoms. On average, the researchers calculated, women were absent from work or school 1.3 days per year because of their period and, on average, productivity loss was equivalent to 8.9 days per year.

"Women said that they weren't as productive as they could be while at work -- they needed to go to the toilet every hour or they had a headache and couldn't concentrate," said Theodoor Nieboer, an author of the report and a gynecologist at the Radboud University Medical Center in the Netherlands.

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