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Rakisha Kearns-White, YA Librarian, She/Her

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Rakisha Kearns-White, YA Librarian, She/Her

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I am Brooklyn Public Library’s favorite Kpop-loving, period equity, and young adult librarian. I am known throughout my library system as the Period Librarian because of my many years of offering shame-free puberty education and advocating for period equity for staff and patrons. I have been a young adult librarian at BPL for over 18 years, and my biggest advocacy has always been about making life better for children and teens.

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Feeling My Flos is a podcast about menstruation

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Feeling My Flos is a podcast about menstruation

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A podcast where menstruation is an event that happens to all types of bodies

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Me, Mom, and Our Friend

Kamilah and her mom, Sherene, remember the first few years of their periods - the good, the bad, and the ugly - and share lessons they've learned about menstruation. (And we record epic levels of mother-daughter sass.)

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Kamilah and her mom, Sherene, remember the first few years of their periods - the good, the bad, and the ugly - and share lessons they've learned about menstruation. (And we record epic levels of mother-daughter sass.)

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Alliance for Period Supplies - It's that time. *

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For many individuals, a period is a setback. It's something that dictates where they can go, what they can do, and how they're perceived. At the Alliance for Period Supplies, we're turning "that time of the month" into a time for change.

It's that time. To break the cycle of period poverty. To set every menstruating individual free from limitations. And to empower every person and organization to become part of the solution.

The Alliance for Period Supplies advocates
for change. Learn how.

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We work to end period poverty through advocacy, education, and community outreach

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Period Poverty means that 1 in 3 individuals miss work, school, and outings because of a lack of period supplies. We are working to end period poverty.

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Librarians help get the word—and the products—out

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Librarians help get the word—and the products—out

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That time of the month." "On the rag." "Shark week."

The euphemisms range from coy to absurd, but library workers and others want to make talking about menstruation-and accessing products related to it-as straightforward and shame-free as discussing hand-washing.

"The products are important, and normalizing the conversation is important," says Eiko La Boria, founder and CEO of The Flow Initiative, a New Jersey-based organization devoted to stamping out social, cultural, and economic inequities associated with "period poverty." She says libraries are a natural partner for her organization's outreach: "I wanted to implement greater access, and I thought, 'Libraries.'"

Accessibility, availability

Currently in the US, menstrual products are not covered by food stamps or federally funded health programs like WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) and SNAP (Supplemental Nutrition Assistance Program). Some states, however, are considering legislation to change that. In the meantime, many people struggle to afford the products, says Amanda Donovan, director of marketing and communications for the eight-location Spokane (Wash.) Public Library (SPL).

"Lack of access can lead to school or work absences and can cause stress and anxiety," Donovan says. When Washington Gov. Jay Inslee signed a 2021 law requiring schools, colleges, and universities to provide free period products in all women's and gender-neutral bathrooms, Donovan decided to build on that initiative. She thought: "We're like a school. They should be free here, just like soap or toilet paper."

Yet La Boria, whose organization works with the 10-location Jersey City (N.J.) Free Public Library (JCFPL) system, says that it's not just about addressing the needs of low-income populations. Affordability is one thing; sheer availability is another. "Menstrual equity has no regard for your socioeconomic status," she points out. "The richest woman on the planet has gone to the bathroom [on some occasion] and not had access to a period product."

Grants and donations can help cover the costs involved. Rachel Paulus, LGBTQ community outreach librarian for JCFPL, says La Boria's organization received a donation of 40,000 pads in June 2021 from U by Kotex via the Alliance for Period Supplies-which donates period products to women in need. These pads were subsequently distributed throughout JCFPL's branches. In addition, medical supply company Hospeco donated dispensers, installed them at cost, and provided an additional 1,200 products for free.

For libraries that need to start from scratch, Jillian Martinson, audience development manager for Elkhart (Ind.) Public Library (EPL), says Friends groups are a good resource when grants are unavailable. EPL's Friends group provided funding for the library system's five locations, allowing Martinson to buy everything she needed from menstrual supply company Aunt Flow.

"We use $200 dispensers that include tampons and pads, and there are 500 of each product in each [dispenser]," Martinson says. "For a year, for all five locations, it costs $2,400." She adds that for libraries without funding, Period.org -an organization created to provide menstrual products to communities in need-may be a possible resource.

SPL's Donovan, who also buys supplies from Aunt Flow, used her facilities budget to cover the expense of providing period supplies. "We prioritized and normalized this practice by including it in our budget, just as we would for toilet paper or soap," she says.

Information, please

One challenge, Donovan says, was her own discomfort with the subject. "It was a mental roadblock for me," she says. "I had to get up the courage to bring it up and to talk about periods to these male managers."

Paulus says some people also questioned the need for free period products. "You just have to educate people," she says. "It affects people everywhere. Seventy percent of teen girls say they miss class because of something period-related. I want to pass on this information so people can think about it."

The educational component is also about wording that removes stigma from periods, Paulus adds: "Male staff asked if we could [use other words], like 'sanitary products.' And I said no. Periods are periods. That's what it's called."

Martinson says it's also important to include period products in all restrooms-not just those designated for women, so that trans men and nonbinary people will also have access. "It's about providing dignity," she says. Pads and tampons at her library are clearly labeled menstrual products, not feminine hygiene products. "We also have signage that talks about moon cycles," she says, "so people can ask about this without calling attention to themselves."

Library guests may have different comfort levels when it comes to talking about and asking for period products. "No matter how progressive you are, [talking about them] may feel private," Donovan says, "so we hang a bag of products in the all-gender stalls, the wheelchair stall, the men's rooms, and the staff restrooms." She also placed discreet signage throughout the library, indicating products are available.

La Boria says for these programs to have wider success, the conversation needs to be opened to everyone. "You have to include men," she says. "The majority of elected officials are men, and these are the people you have to lobby to and speak with." She is creating a step-by-step toolkit that she hopes to make available via social media to help as many people as possible.

Ultimately, Donovan adds, the goal is to normalize the conversation about periods. "We're setting the example," she says. "We're hoping other libraries follow suit."

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Period. End of Story. | American Libraries Magazine

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Library workers want to make talking about periods-and accessing products related to menstruation-straightforward and shame-free.

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Rep. Meng's Plan to Improve Access to Menstrual Products

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Rep. Meng's Plan to Improve Access to Menstrual Products

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Meng Introduces Bold Plan to Improve Access to Menstrual Products

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WASHINGTON, D.C. – To help commemorate Menstrual Hygiene Day today, U.S. Rep.

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Summary+

Period poverty is the lack of access to menstrual products and inadequate education surrounding menstruation. Period poverty affects menstruators worldwide, including those in the United States. In a 2019 study, 64% of menstruators noted that they struggled to afford menstrual products within the last year. ¹ Stemming from the cost of products, stigmas, education, and the world pandemic, those who menstruate struggle to afford menstruation products and have adequate education on the subject. The effects of period poverty include effects on menstruators' physical and mental health as well as their productivity at work. Lawmakers are fighting to end period poverty with the Menstrual Equity Law. Reusable products are also becoming popular and affordable for menstruators to use, which is helping end period poverty in the United States.

Key Takeaways+

Period poverty, or the lack of information and education about menstruation as well as access to menstrual products, in the US affects all menstruators but especially those who are low-income, homeless, in college, imprisoned, or transgender. ¹⁰⁰

With the recent inflation problems, Bloomberg reported that prices for pads rose 8.3% and tampons prices rose 9.8% in 2021. ¹⁰¹

A study done by St. Louis University on period poverty found that 36% of those surveyed who were full-time or part-time employed had to miss one or more days of work a month because of a lack of menstrual products during their periods. ¹⁰²

Research done on the financial benefit of using menstrual cups estimates over 10 years found that a reusable cup would be 5% of the purchase of pads and 7% of the purchase cost of tampons. A reusable cup would also produce 0.4% of the plastic waste used for pads and 6% of the plastic waste used for tampons. ¹⁰³

Key Terms+

Bacterial Vaginosis (BV)-"Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or gray vaginal discharge that smells fishy." ²

Menstruator -Term used to describe those who menstruate.

Menstrual products -Products that are used during the menstrual cycle, such as pads and tampons.

Period poverty-"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities, and waste management." ³

Reusable menstrual cup-A small, flexible funnel-shaped cup made of rubber or silicone that you insert into your vagina to catch and collect period fluid. ⁴

Stigma-A set of negative and often unfair beliefs that a society or group of people have about something. ⁵

Tampon tax-"a charge on menstrual products meaning they have a value-added tax or sales tax." ⁶

Toxic Shock Syndrome (TSS)-A rare but potentially life-threatening condition caused by certain strains of bacteria that produce poisons (toxins). These toxins get into your bloodstream and can affect organs such as your heart, liver, or kidneys. ⁷

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities, and waste management." A: Periods occur when the female body prepares itself for pregnancy, and the egg is not fertilized, causing the lining of the uterus to shed through the vagina, resulting in blood flowing out of the vagina. ⁸ Many menstruators Term used to describe those who menstruate. experience cramps, lower back pain, bloating, and other symptoms during menstruation. ⁹ Most people start at the age of 12 but can start as early as 8 years old. ¹⁰ Periods usually come every 21 to 35 days and last from 2 to 7 days. However, everybody is different, and these numbers can vary. ¹⁰ Menstrual products Products that are used during the menstrual cycle, such as pads and tampons. include tampons, pads, and reusable cups, which are used to catch menstrual flow. Seventy percent of people who menstruate use tampons and will go through an average of 20 tampons per cycle. ¹² Reusable products are a recent development in the world of menstrual products and will be discussed later in the brief as a way to help decrease period poverty ³..

Q: What is Period Poverty?

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." A: Period poverty ³. is the lack of access to menstrual products Products that are used during the menstrual cycle, such as pads and tampons. (MP) and improper education about menstrual hygiene. It also includes a lack of access to washing facilities and waste management, but for this brief, we focus only on the lack of access to products and education. ¹³

Q: Who is affected by Period Poverty in the United States?

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." A: While everyone who menstruates is affected by the inequalities of high prices, lack of access, and education that come from menstruating, those that struggle the most from period poverty ³. in the US are women in low-income households, that are homeless, in college, who are imprisoned, and who are transgender or nonbinary. ¹⁴ In a 2019 study done on low-income women, two-thirds stated they had trouble affording products. Those who are homeless struggle to have resources due to the lack of donations from the public. ¹⁵ A study about period poverty and college students found that 14.2% of participants struggled within the last year to afford products. ¹⁶ A review of correctional facilities in New York found that 54% of women in the facility said that they did not have enough sanitary napkins (pads) each month. ¹⁷ A study surrounding Trans menstruators Term used to describe those who menstruate. found that 66% felt unsafe and 68% felt uncomfortable using the men's restroom while on their periods. ¹⁸ The lack of access and difficulty affording menstrual products Products that are used during the menstrual cycle, such as pads and tampons. at times leads to menstruators using other tools such as rags, cardboard, and paper towels. ¹⁹ The impact of not using proper menstrual products will be discussed later in this brief.

Q: How many women are affected by Period Poverty in the United States compared to other countries?

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." A: In a study surrounding menstrual products Products that are used during the menstrual cycle, such as pads and tampons. and women in the United States done by a tampon company, 42% of the participants said they had experienced struggles to afford menstrual products before. ²⁰ The study also included that those who are Black (35%) or Hispanic (36%) are more likely to struggle with period poverty ²¹ Taxes on menstrual products increase the prices causing menstruators ³. compared to those who are White (23%).Term used to describe those who menstruate. to not afford products. In the United States, states that heavily tax period products include Mississippi, Tennessee, and Indiana at 7%. Other states like Arkansas, Texas, Kansas, Idaho, Kentucky, West Virginia, and South Carolina tax products between 6-6.5%. ²² Around 16.9 million people who menstruate live in poverty in the United States. ²³ Among those women, two-thirds said they struggled with affording menstrual products in the last year, and 14% of college girls in a study surveyed said they struggled to afford period products. 24, 25 Period poverty can also be seen throughout the world. One study in the UK found that of the women interviewed, 50% reported that they struggled to afford period products in the last year. ²⁶ In Sub-Saharan Africa, on the other hand, 1 in 10 girls is likely to miss school monthly because of their period, leading to them missing 20% of the school year on period products. ²⁷ In China, a study showed that women spend around 1,040 yuan ($160.00) a year, including a 13% sales tax. ²⁸ In Mexico, 43% of girls surveyed do not like to go to school while on their periods. ²⁹

Q: When did period poverty become an issue?

A: In March 2019, stakeholders across sectors engaged in menstrual health met in Geneva to establish a global plan to fight menstruation health and hygiene. In this meeting, it was concluded that the lack of research done on this topic was something that needed to be changed which has influenced the increase in research being done and advocacy that is happening around the world surrounding menstruation. ³⁰

The high cost of menstrual products Products that are used during the menstrual cycle, such as pads and tampons. affects the ability of women to afford them and increases period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management."Tampon Tax "a charge on menstrual products meaning they have a value-added tax or sales tax." ³.. The ³¹ A study in 2019 on the menstrual product tax conducted by John Hopkins University found that 35 states tax menstrual products at 7.41% on average (between 4.70-9.90%). ³² While these percentages may not seem that large, the tax adds to the already high price of menstrual products. In the 40 years on average that a person menstruates, they will spend $13.25 a month and $6,000.00 total in those years on menstrual products before tax. ³³ As of September 20, 2022, 22 states still tax tampons, but there are still issues with cities and counties having their own sales tax. ⁶ contributes to this problem. While not an official tax, the Tampon Tax refers to the fact that many states across the country classify tampons and other period products as luxury items, which means sales tax applies to them. States that have a sales tax do not tax items like food and medical supplies because they are viewed as essential, while menstrual products are viewed as non-medical or non-essential items. ³⁴ With the recent inflation problems, Bloomberg reported that prices for pads rose 8.3% and tampons prices rose 9.8% in 2021. ³⁵ Thus, the cost of menstrual products Products that are used during the menstrual cycle, such as pads and tampons. is increasing to unaffordable prices.

Although menstrual products Products that are used during the menstrual cycle, such as pads and tampons. are a necessity, studies show that many women are unable to afford them, especially low-income women. In a 2019 study of low-income women in St Louis Missouri, researchers found that 64% of participants could not afford pads or tampons the previous year, 21% said they struggled monthly the previous year to purchase menstrual products, and 46% said they could not afford to pay for both food and menstrual products throughout the previous year. ³⁶ Around 38 million people in the US, or 12% of the population, benefit from food stamps, according to a study done in 2019. ³⁷ These help purchase groceries and other products. Because menstrual products are non-food items, they are not covered by food stamps. ³⁸ Most women who use food stamps do not have enough money to buy basic necessities. One woman, Eva Hernandez, shared her experience of selling her food stamps to have money to buy tampons because they are not covered by food stamps. ³⁹ She said, "If I need pads, we sell food stamps. Everybody does." ⁴⁰ Because low-income women are not able to afford period products, they may have to give up other resources to afford them.

The Stigma of Menstruation

The stigma A set of negative and often unfair beliefs that a society or group of people have about something."Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ⁵ surrounding menstruation also has a great effect on period poverty ⁴¹ Stigmas that come from menstruation include menstruation being gross and undiscussable and women being emotional, weak, mentally unstable, and hysterical when on their periods. ³. because it often leads to less knowledge and discussion of periods, an important part of period poverty that occurs here in the United States. It is important to note that there is limited research surrounding this topic, so anecdotal evidence will be used throughout this section. ⁴²

One study done by Thinx, a period product company, highlighted the stigma that is prevalent throughout the United States. When asking women across the country, 58% of the 1,500 women polled said they personally felt embarrassed, and 42% felt shame while on their periods. ⁴³ The feeling of shame and embarrassment women feel towards menstruation results in them not wanting to discuss other aspects of menstruation. ⁴⁴ Women then do not talk about the lack of access they may have, resulting in them not getting the resources needed to help with menstruation. ⁴⁵ The stigma surrounding menstruation leads to women not discussing menstruation and not receiving the resources necessary.

The stigma A set of negative and often unfair beliefs that a society or group of people have about something. ⁵ of menstruation affects the way menstruation is discussed among menstruators Term used to describe those who menstruate.. One stigma that occurs is the idea that menstruation is a private matter and should not be discussed with anyone. ⁴⁶ Since most people who menstruate learn from their mothers and peers about menstruation, this stigma causes little information to be shared and sometimes causes the little information that is shared not to be accurate. ⁴⁷ An example of stigma can be found in an article called "I thought I was dying," when an unnamed young woman shared her experience with menstruation. Both mother and daughter were unable to communicate about the daughter's knowledge of menstruation, leading to the girl spending months worrying about getting a period and being confused about what it was. ⁴⁸ Without good menstrual health education and discussion, situations like this have the possibility to continue, and menstruators do not have the information needed to educate their own children on menstruation. ⁴⁹

The lack of education surrounding menstruation contributes to period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management.""Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. here in the United States. The World Health Organization states that adequate menstruation knowledge includes timely, appropriate education at different ages, education for both boys and girls in school as well as having support from the teachers in helping the students understand menstruation. ⁵⁰ Research on education surrounding menstruation in school systems is limited but is included under sexual health education, which differs from state to state, and even from school to school. Many states follow the National Sexuality Education Standards, but these standards do not include all the information needed. The standards mention the physiological parts of menstruation but not specifically how to manage menstruation and personally care for it. ⁵¹ In a study done about all 50 states' health education standards for elementary and secondary schools, researchers found that only 3 states clearly cover what personal hygiene products are available with menstruation, and 3 other states have menstruation management, how to manage your physical, emotional, and mental well-being during menstruation, in their school health standards. ⁵² A study published in June 2022 noted the impact of the lack of education on adolescent girls' feelings toward menstruation. Though the exact number was not provided, of those interviewed, many reported that they felt they received inadequate education about menstruation before starting their periods. One girl noted, "I was in the bathroom doing my business and I saw blood and I was scared. I was crying because I didn't know if I was dying or not." ⁵³ Others expressed similar feelings toward starting their periods. Another article noted that 4 out of 5 teenagers felt they learned more about the biology of frogs than the female body, leaving them unprepared for menstruation. ⁵⁴ The absence of education in the United States on menstruation leads to menstruators Term used to describe those who menstruate. lacking knowledge, a key aspect of period poverty ³..

The recent COVID-19 pandemic affected the ability of menstruators Term used to describe those who menstruate. to access menstrual products Products that are used during the menstrual cycle, such as pads and tampons. and resources needed because of the impacts covid had on the supply and demand of menstrual products. It is important to note that this is a recent topic with few studies done to see the full effect. A study done on income loss globally found that 34% of US participants said they were earning less than before the pandemic, and 39% said they stopped working temporarily."Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ⁵⁵ In a study done on the effects of Covid on period poverty ⁵⁶ The study also found that income loss participants also had 3 times the likelihood of changing products less often or using makeshift menstrual products to manage and also 2 times the likelihood of feeling stressed when purchasing products. ⁵⁷ The recent supply chain problems and price increases of raw materials have also contributed to the decreasing number of menstrual products being produced. ⁵⁸ This problem has led to a 7% decrease in the production of menstrual products, with customers noting that their preferred products are not as available. ⁵⁹ However, as a result, companies like P&G, which produces around 60% of menstrual products in the United States, are working their plants twenty-four-seven to ensure their products are available. ³., research showed that those with income loss during the pandemic were 3.5 times as likely to experience period poverty as those with no income loss from March-October 2020. ⁶⁰ Though there has not been extensive research done on the effects COVID will have on period poverty in the future, the research that has been done shows that the shortage and its effect are current. Without enough menstrual products, those who menstruate have to use unsafe products or keep their products in for longer than recommended. ⁶¹

One of the main consequences of period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. in the United States is its effect on physical health. People experiencing period poverty find themselves without the financial resources to access suitable menstrual products Products that are used during the menstrual cycle, such as pads and tampons.. ⁶² This lack of resources forces menstruators Term used to describe those who menstruate. to use other options, such as rags, paper towels, or cardboard. ⁶³ Using these options can lead to infection, which menstruators struggle to care for. ⁶⁴ An article that discussed the impacts of period poverty stated that using unclean materials and not taking care of menstrual hygiene can cause urinary tract infections and vulvar contact dermatitis. ⁶⁵ These hygiene habits can lead to a lower quality of life because of the lack of hygienic care. ⁶⁶ Additionally, when women cannot access the proper amount of menstrual products, they leave the product in for over the recommended 8 hours, causing bacteria to build up in the vagina. This buildup puts women at risk of infection and other problems. ⁶⁷ By not having the right resources, women are putting their own health at risk monthly.

One infection that can occur from leaving menstrual products Products that are used during the menstrual cycle, such as pads and tampons. in the body for too long is Bacterial Vaginosis (BV "Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or gray vaginal discharge that smells fishy.""Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or gray vaginal discharge that smells fishy.""Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ⁶⁸ An estimated 1 in 3 American women will get BV. ⁶⁹ While there are other causes for BV, like being sexually active and pregnant, leaving a tampon in for an extended period of time increases the likelihood of BV. ²). ⁷⁰ There are not any serious effects from BV. One-third of BV cases clear up on their own, and the other two-thirds of cases require antibiotics to treat it. ⁷¹ However, it is important to remember that BV period poverty ⁷² ² is preventable by following the instructions for changing the tampon. Those who struggle with ³. are unable to follow those instructions at times because they do not have enough products to last their entire period. Using a tampon longer than the recommended time can lead to them having a higher possibility of bacteria building up and causing BV.

For some menstruators Term used to describe those who menstruate., having enough products to last their whole cycle is a challenge, causing them to use the same product for an extended amount of time.A rare but potentially life-threatening condition caused by certain strains of bacteria that produce poisons (toxins). These toxins get into your bloodstream and can affect organs such as your heart, liver, or kidneys. ⁷³ When using the same tampon for long hours, there is a higher chance that bacteria will build up, which can cause Toxic Shock Syndrome ⁷⁴ Tampons are not the only reason TSS occurs. Other causes are open wounds, surgery, and childbirth. ⁷⁵ In fact, half the time, TSS is caused by something other than tampons. ⁷ (TSS). For this reason, it is recommended to change the tampon every 4 hours. ⁷⁶ However, most people know TSS from tampon usage. ⁷⁷ While TSS is rare, 1 in 100,000 women get it, there is a 30-70% mortality rate for those who suffer from it because the bacteria buildup can cause toxins to enter and shut down a person's organs. 78,79 Though TSS is a medical condition that can be easily avoided with appropriate menstrual products, it continues to occur. To avoid TSS, doctors advise that people who menstruate change their tampons regularly, but many menstruators who do not have access to a suitable amount of products to last their whole cycle keep them in for longer. 80, 81

Those who are affected by period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. struggle with their mental health due to the stress they feel to afford products. In a study done by BMC Women about the struggles of Period Poverty among college-age women, it was discovered that young women who experienced period poverty within the last year were more likely to report having moderate to severe depression compared to those who have not experienced period poverty. ⁸² The study found that of the women surveyed who experienced period poverty monthly, 68.1% reported symptoms of moderate or severe depression, 61.2% of those who had experienced period poverty at any point experienced depression, and 43.4% who had never experienced period poverty experienced depression. ⁸³ While there may be other factors that contribute to the mental state of these college-age women, the study found enough evidence to show that Period Poverty does affect the mental health of women who struggle to afford menstrual products Products that are used during the menstrual cycle, such as pads and tampons. monthly.

There are also feelings of anxiety that come from period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³.. Menstruators Term used to describe those who menstruate. worry about whether they will be able to afford menstrual products Products that are used during the menstrual cycle, such as pads and tampons. that month and what other purchases to cut down to afford them. A recent study conducted by Always, a menstrual product brand, found that, especially with the economic problems that have occurred because of the pandemic, 1 in 3 parents is worried about the ongoing ability to afford menstrual products. ⁸⁴ Low-income families already have worries when it comes to their livelihood, so the added cost of menstrual products, an essential product in the lives of those who menstruate, is added stress.

Decreased Productivity at Work

Period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. also impacts menstruators Term used to describe those who menstruate. in the workplace due to not having enough menstruation products to complete a full day at work. Lack of access to menstrual products Products that are used during the menstrual cycle, such as pads and tampons. can impact the number of days women miss work monthly. A study done by St. Louis University on period poverty found that 36% of those surveyed who were full-time or part-time employed had to miss one or more days of work a month because of a lack of menstrual products during their periods. ⁸⁵ While there is limited information on workplace productivity in the United States, a study done in the UK found the impacts of period pains on menstruators in the workplace. The article noted that because of the lack of education and stigmas surrounding menstruation, people who menstruate do not understand their periods, including their symptoms. Because of the inadequate knowledge these women had surrounding menstruation, 14% of women took off days at least once because of their symptoms from menstruation, with 3.4% reporting absenteeism almost every period. It also reported that 80% of the participants felt less productive at work during their periods. ⁸⁶ The lack of access to menstrual products and the lack of knowledge surrounding menstruation have affected menstruators' ability to do work during their cycle.

On May 28, 2021, a federal bill called the Menstrual Equity For All Act of 2021 was introduced into the house. The purpose of this bill is to increase access and affordability for menstrual products Products that are used during the menstrual cycle, such as pads and tampons. for those who do not have proper access and other important aspects of menstruation. ⁸⁷

While the law is in the works currently, if the Menstrual Equity Law was passed, it would require schools, public government places, and correctional facilities to provide free menstrual products Products that are used during the menstrual cycle, such as pads and tampons.. The bill also would have companies with larger than 100 employees provide free menstrual products at work. This law would allow menstruators Term used to describe those who menstruate. easier access to products while using public facilities. The bill would also require Medicaid to cover menstrual products for its clients, so products such as pads and tampons would be paid for by Medicaid. ⁸⁸

In an article discussing the impacts of a bill being passed like the Menstrual Equity Law, the author makes the point that there would be budget increases needed to afford proper products to give for free."a charge on menstrual products meaning they have a value-added tax or sales tax." ⁸⁹ The government would have to partner with manufacturers in order to produce enough products for menstruation. Another gap in the law is that while products are being made available in public, menstruators Term used to describe those who menstruate. may struggle to obtain products for use at home. The Tampon Tax menstrual products Products that are used during the menstrual cycle, such as pads and tampons. to be high and, at times, not affordable for menstruators. ⁶ is also still in effect in states, causing prices of ⁹⁰ Without eliminating the tampon tax, many states will still suffer from high-priced menstrual products.

Reusable Menstrual Products

One way that the struggle of period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management."A small, flexible funnel-shaped cup made of rubber or silicone that you insert into your vagina to catch and collect period fluid. ³. can be reduced is through access to reusable menstrual products Products that are used during the menstrual cycle, such as pads and tampons.. Reusable menstrual products include pads made of cloth and cups that work similarly to tampons. Using these products means that menstruators Term used to describe those who menstruate. would not have to buy a product every month but just clean the product and be able to use it again, which would allow menstruators to not have to worry about being able to afford products. Companies like Ruby Cup, Diva Cup, and GladRags, all reusable menstrual cup ⁹¹ For example, whenever a cup is purchased at Ruby Cup, a cup is also given to someone who cannot afford one. ⁹² ⁴ companies, partner with menstrual organizations and donate to them whenever a menstrual cup is purchased.

While research is limited to the number of menstruators Term used to describe those who menstruate. who use this product and the impact of reusable menstrual products Products that are used during the menstrual cycle, such as pads and tampons., these products have the potential to change the way menstruators view their periods. Made from rubber or silicone, a cup can hold more blood, allowing some menstruators to wear it for up to 12 hours. ⁹³ Companies have also claimed that menstrual cups prevent fewer bacteria buildup and less likelihood of bacteria infections. However, there is not enough research done to back that claim. ⁹⁴ Menstrual products also allow menstruators to reuse the same product and can last, depending on the product, for 6 months to 10 years. ⁹⁵ Research done on the financial benefit of using menstrual cups estimates over 10 years found that a reusable cup would be 5% of the purchase of pads and 7% of the purchase cost of tampons. A reusable cup would also produce 0.4% of the plastic waste used for pads and 6% of the plastic waste used for tampons. ⁹⁶

With reusable period products being a recent development, a gap that can be found is the lack of research on product impact. In order for them to increase in credibility, researchers suggest more research be done. ⁹⁷ Another gap in reusable menstrual products Products that are used during the menstrual cycle, such as pads and tampons. is the price. For one reusable cup, the price is usually between $20.00-40.00. ⁹⁸ While reusable products will save menstruators Term used to describe those who menstruate. money in the long term, menstruators may not be able to spend that much money at once on a product. There is also a risk that the menstruator will not like the product or it will not be the correct size. ⁹⁹ However, some companies have size charts to help determine the correct size for each menstruator.

Preferred Citation: Krumperman, Katie. "Period Poverty in the United States." Ballard Brief. February 2023. www.ballardbrief.byu.edu.
Viewpoints published by Ballard Brief are not necessarily endorsed by BYU or The Church of Jesus Christ of Latter-day Saints

Katie is a public relations major with a minor in civic engagement leadership. She started being interested in period poverty at the age of 12 when she and other girls her age helped create reusable pads for girls in other countries. Her interest heightened when she lived in Salt Lake City, Utah for 18 months and was exposed to the effects of period poverty here in the United States. When not busy with school she loves being outdoors and being around her family and friends.

Summary+

Period poverty is the lack of access to menstrual products and inadequate education surrounding menstruation. Period poverty affects menstruators worldwide, including those in the United States. In a 2019 study, 64% of menstruators noted that they struggled to afford menstrual products within the last year. ¹ Stemming from the cost of products, stigmas, education, and the world pandemic, those who menstruate struggle to afford menstruation products and have adequate education on the subject. The effects of period poverty include effects on menstruators' physical and mental health as well as their productivity at work. Lawmakers are fighting to end period poverty with the Menstrual Equity Law. Reusable products are also becoming popular and affordable for menstruators to use, which is helping end period poverty in the United States.

Key Takeaways+

Period poverty, or the lack of information and education about menstruation as well as access to menstrual products, in the US affects all menstruators but especially those who are low-income, homeless, in college, imprisoned, or transgender. ¹⁰⁰

With the recent inflation problems, Bloomberg reported that prices for pads rose 8.3% and tampons prices rose 9.8% in 2021. ¹⁰¹

A study done by St. Louis University on period poverty found that 36% of those surveyed who were full-time or part-time employed had to miss one or more days of work a month because of a lack of menstrual products during their periods. ¹⁰²

Research done on the financial benefit of using menstrual cups estimates over 10 years found that a reusable cup would be 5% of the purchase of pads and 7% of the purchase cost of tampons. A reusable cup would also produce 0.4% of the plastic waste used for pads and 6% of the plastic waste used for tampons. ¹⁰³

Key Terms+

Bacterial Vaginosis (BV)-"Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or gray vaginal discharge that smells fishy." ²

Menstruator -Term used to describe those who menstruate.

Menstrual products -Products that are used during the menstrual cycle, such as pads and tampons.

Period poverty-"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities, and waste management." ³

Reusable menstrual cup-A small, flexible funnel-shaped cup made of rubber or silicone that you insert into your vagina to catch and collect period fluid. ⁴

Stigma-A set of negative and often unfair beliefs that a society or group of people have about something. ⁵

Tampon tax-"a charge on menstrual products meaning they have a value-added tax or sales tax." ⁶

Toxic Shock Syndrome (TSS)-A rare but potentially life-threatening condition caused by certain strains of bacteria that produce poisons (toxins). These toxins get into your bloodstream and can affect organs such as your heart, liver, or kidneys. ⁷

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities, and waste management." A: Periods occur when the female body prepares itself for pregnancy, and the egg is not fertilized, causing the lining of the uterus to shed through the vagina, resulting in blood flowing out of the vagina. ⁸ Many menstruators Term used to describe those who menstruate. experience cramps, lower back pain, bloating, and other symptoms during menstruation. ⁹ Most people start at the age of 12 but can start as early as 8 years old. ¹⁰ Periods usually come every 21 to 35 days and last from 2 to 7 days. However, everybody is different, and these numbers can vary. ¹⁰ Menstrual products Products that are used during the menstrual cycle, such as pads and tampons. include tampons, pads, and reusable cups, which are used to catch menstrual flow. Seventy percent of people who menstruate use tampons and will go through an average of 20 tampons per cycle. ¹² Reusable products are a recent development in the world of menstrual products and will be discussed later in the brief as a way to help decrease period poverty ³..

Q: What is Period Poverty?

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." A: Period poverty ³. is the lack of access to menstrual products Products that are used during the menstrual cycle, such as pads and tampons. (MP) and improper education about menstrual hygiene. It also includes a lack of access to washing facilities and waste management, but for this brief, we focus only on the lack of access to products and education. ¹³

Q: Who is affected by Period Poverty in the United States?

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." A: While everyone who menstruates is affected by the inequalities of high prices, lack of access, and education that come from menstruating, those that struggle the most from period poverty ³. in the US are women in low-income households, that are homeless, in college, who are imprisoned, and who are transgender or nonbinary. ¹⁴ In a 2019 study done on low-income women, two-thirds stated they had trouble affording products. Those who are homeless struggle to have resources due to the lack of donations from the public. ¹⁵ A study about period poverty and college students found that 14.2% of participants struggled within the last year to afford products. ¹⁶ A review of correctional facilities in New York found that 54% of women in the facility said that they did not have enough sanitary napkins (pads) each month. ¹⁷ A study surrounding Trans menstruators Term used to describe those who menstruate. found that 66% felt unsafe and 68% felt uncomfortable using the men's restroom while on their periods. ¹⁸ The lack of access and difficulty affording menstrual products Products that are used during the menstrual cycle, such as pads and tampons. at times leads to menstruators using other tools such as rags, cardboard, and paper towels. ¹⁹ The impact of not using proper menstrual products will be discussed later in this brief.

Q: How many women are affected by Period Poverty in the United States compared to other countries?

"Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." A: In a study surrounding menstrual products Products that are used during the menstrual cycle, such as pads and tampons. and women in the United States done by a tampon company, 42% of the participants said they had experienced struggles to afford menstrual products before. ²⁰ The study also included that those who are Black (35%) or Hispanic (36%) are more likely to struggle with period poverty ²¹ Taxes on menstrual products increase the prices causing menstruators ³. compared to those who are White (23%).Term used to describe those who menstruate. to not afford products. In the United States, states that heavily tax period products include Mississippi, Tennessee, and Indiana at 7%. Other states like Arkansas, Texas, Kansas, Idaho, Kentucky, West Virginia, and South Carolina tax products between 6-6.5%. ²² Around 16.9 million people who menstruate live in poverty in the United States. ²³ Among those women, two-thirds said they struggled with affording menstrual products in the last year, and 14% of college girls in a study surveyed said they struggled to afford period products. 24, 25 Period poverty can also be seen throughout the world. One study in the UK found that of the women interviewed, 50% reported that they struggled to afford period products in the last year. ²⁶ In Sub-Saharan Africa, on the other hand, 1 in 10 girls is likely to miss school monthly because of their period, leading to them missing 20% of the school year on period products. ²⁷ In China, a study showed that women spend around 1,040 yuan ($160.00) a year, including a 13% sales tax. ²⁸ In Mexico, 43% of girls surveyed do not like to go to school while on their periods. ²⁹

Q: When did period poverty become an issue?

A: In March 2019, stakeholders across sectors engaged in menstrual health met in Geneva to establish a global plan to fight menstruation health and hygiene. In this meeting, it was concluded that the lack of research done on this topic was something that needed to be changed which has influenced the increase in research being done and advocacy that is happening around the world surrounding menstruation. ³⁰

The high cost of menstrual products Products that are used during the menstrual cycle, such as pads and tampons. affects the ability of women to afford them and increases period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management."Tampon Tax "a charge on menstrual products meaning they have a value-added tax or sales tax." ³.. The ³¹ A study in 2019 on the menstrual product tax conducted by John Hopkins University found that 35 states tax menstrual products at 7.41% on average (between 4.70-9.90%). ³² While these percentages may not seem that large, the tax adds to the already high price of menstrual products. In the 40 years on average that a person menstruates, they will spend $13.25 a month and $6,000.00 total in those years on menstrual products before tax. ³³ As of September 20, 2022, 22 states still tax tampons, but there are still issues with cities and counties having their own sales tax. ⁶ contributes to this problem. While not an official tax, the Tampon Tax refers to the fact that many states across the country classify tampons and other period products as luxury items, which means sales tax applies to them. States that have a sales tax do not tax items like food and medical supplies because they are viewed as essential, while menstrual products are viewed as non-medical or non-essential items. ³⁴ With the recent inflation problems, Bloomberg reported that prices for pads rose 8.3% and tampons prices rose 9.8% in 2021. ³⁵ Thus, the cost of menstrual products Products that are used during the menstrual cycle, such as pads and tampons. is increasing to unaffordable prices.

Although menstrual products Products that are used during the menstrual cycle, such as pads and tampons. are a necessity, studies show that many women are unable to afford them, especially low-income women. In a 2019 study of low-income women in St Louis Missouri, researchers found that 64% of participants could not afford pads or tampons the previous year, 21% said they struggled monthly the previous year to purchase menstrual products, and 46% said they could not afford to pay for both food and menstrual products throughout the previous year. ³⁶ Around 38 million people in the US, or 12% of the population, benefit from food stamps, according to a study done in 2019. ³⁷ These help purchase groceries and other products. Because menstrual products are non-food items, they are not covered by food stamps. ³⁸ Most women who use food stamps do not have enough money to buy basic necessities. One woman, Eva Hernandez, shared her experience of selling her food stamps to have money to buy tampons because they are not covered by food stamps. ³⁹ She said, "If I need pads, we sell food stamps. Everybody does." ⁴⁰ Because low-income women are not able to afford period products, they may have to give up other resources to afford them.

The Stigma of Menstruation

The stigma A set of negative and often unfair beliefs that a society or group of people have about something."Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ⁵ surrounding menstruation also has a great effect on period poverty ⁴¹ Stigmas that come from menstruation include menstruation being gross and undiscussable and women being emotional, weak, mentally unstable, and hysterical when on their periods. ³. because it often leads to less knowledge and discussion of periods, an important part of period poverty that occurs here in the United States. It is important to note that there is limited research surrounding this topic, so anecdotal evidence will be used throughout this section. ⁴²

One study done by Thinx, a period product company, highlighted the stigma that is prevalent throughout the United States. When asking women across the country, 58% of the 1,500 women polled said they personally felt embarrassed, and 42% felt shame while on their periods. ⁴³ The feeling of shame and embarrassment women feel towards menstruation results in them not wanting to discuss other aspects of menstruation. ⁴⁴ Women then do not talk about the lack of access they may have, resulting in them not getting the resources needed to help with menstruation. ⁴⁵ The stigma surrounding menstruation leads to women not discussing menstruation and not receiving the resources necessary.

The stigma A set of negative and often unfair beliefs that a society or group of people have about something. ⁵ of menstruation affects the way menstruation is discussed among menstruators Term used to describe those who menstruate.. One stigma that occurs is the idea that menstruation is a private matter and should not be discussed with anyone. ⁴⁶ Since most people who menstruate learn from their mothers and peers about menstruation, this stigma causes little information to be shared and sometimes causes the little information that is shared not to be accurate. ⁴⁷ An example of stigma can be found in an article called "I thought I was dying," when an unnamed young woman shared her experience with menstruation. Both mother and daughter were unable to communicate about the daughter's knowledge of menstruation, leading to the girl spending months worrying about getting a period and being confused about what it was. ⁴⁸ Without good menstrual health education and discussion, situations like this have the possibility to continue, and menstruators do not have the information needed to educate their own children on menstruation. ⁴⁹

The lack of education surrounding menstruation contributes to period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management.""Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. here in the United States. The World Health Organization states that adequate menstruation knowledge includes timely, appropriate education at different ages, education for both boys and girls in school as well as having support from the teachers in helping the students understand menstruation. ⁵⁰ Research on education surrounding menstruation in school systems is limited but is included under sexual health education, which differs from state to state, and even from school to school. Many states follow the National Sexuality Education Standards, but these standards do not include all the information needed. The standards mention the physiological parts of menstruation but not specifically how to manage menstruation and personally care for it. ⁵¹ In a study done about all 50 states' health education standards for elementary and secondary schools, researchers found that only 3 states clearly cover what personal hygiene products are available with menstruation, and 3 other states have menstruation management, how to manage your physical, emotional, and mental well-being during menstruation, in their school health standards. ⁵² A study published in June 2022 noted the impact of the lack of education on adolescent girls' feelings toward menstruation. Though the exact number was not provided, of those interviewed, many reported that they felt they received inadequate education about menstruation before starting their periods. One girl noted, "I was in the bathroom doing my business and I saw blood and I was scared. I was crying because I didn't know if I was dying or not." ⁵³ Others expressed similar feelings toward starting their periods. Another article noted that 4 out of 5 teenagers felt they learned more about the biology of frogs than the female body, leaving them unprepared for menstruation. ⁵⁴ The absence of education in the United States on menstruation leads to menstruators Term used to describe those who menstruate. lacking knowledge, a key aspect of period poverty ³..

The recent COVID-19 pandemic affected the ability of menstruators Term used to describe those who menstruate. to access menstrual products Products that are used during the menstrual cycle, such as pads and tampons. and resources needed because of the impacts covid had on the supply and demand of menstrual products. It is important to note that this is a recent topic with few studies done to see the full effect. A study done on income loss globally found that 34% of US participants said they were earning less than before the pandemic, and 39% said they stopped working temporarily."Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ⁵⁵ In a study done on the effects of Covid on period poverty ⁵⁶ The study also found that income loss participants also had 3 times the likelihood of changing products less often or using makeshift menstrual products to manage and also 2 times the likelihood of feeling stressed when purchasing products. ⁵⁷ The recent supply chain problems and price increases of raw materials have also contributed to the decreasing number of menstrual products being produced. ⁵⁸ This problem has led to a 7% decrease in the production of menstrual products, with customers noting that their preferred products are not as available. ⁵⁹ However, as a result, companies like P&G, which produces around 60% of menstrual products in the United States, are working their plants twenty-four-seven to ensure their products are available. ³., research showed that those with income loss during the pandemic were 3.5 times as likely to experience period poverty as those with no income loss from March-October 2020. ⁶⁰ Though there has not been extensive research done on the effects COVID will have on period poverty in the future, the research that has been done shows that the shortage and its effect are current. Without enough menstrual products, those who menstruate have to use unsafe products or keep their products in for longer than recommended. ⁶¹

One of the main consequences of period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. in the United States is its effect on physical health. People experiencing period poverty find themselves without the financial resources to access suitable menstrual products Products that are used during the menstrual cycle, such as pads and tampons.. ⁶² This lack of resources forces menstruators Term used to describe those who menstruate. to use other options, such as rags, paper towels, or cardboard. ⁶³ Using these options can lead to infection, which menstruators struggle to care for. ⁶⁴ An article that discussed the impacts of period poverty stated that using unclean materials and not taking care of menstrual hygiene can cause urinary tract infections and vulvar contact dermatitis. ⁶⁵ These hygiene habits can lead to a lower quality of life because of the lack of hygienic care. ⁶⁶ Additionally, when women cannot access the proper amount of menstrual products, they leave the product in for over the recommended 8 hours, causing bacteria to build up in the vagina. This buildup puts women at risk of infection and other problems. ⁶⁷ By not having the right resources, women are putting their own health at risk monthly.

One infection that can occur from leaving menstrual products Products that are used during the menstrual cycle, such as pads and tampons. in the body for too long is Bacterial Vaginosis (BV "Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or gray vaginal discharge that smells fishy.""Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or gray vaginal discharge that smells fishy.""Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ⁶⁸ An estimated 1 in 3 American women will get BV. ⁶⁹ While there are other causes for BV, like being sexually active and pregnant, leaving a tampon in for an extended period of time increases the likelihood of BV. ²). ⁷⁰ There are not any serious effects from BV. One-third of BV cases clear up on their own, and the other two-thirds of cases require antibiotics to treat it. ⁷¹ However, it is important to remember that BV period poverty ⁷² ² is preventable by following the instructions for changing the tampon. Those who struggle with ³. are unable to follow those instructions at times because they do not have enough products to last their entire period. Using a tampon longer than the recommended time can lead to them having a higher possibility of bacteria building up and causing BV.

For some menstruators Term used to describe those who menstruate., having enough products to last their whole cycle is a challenge, causing them to use the same product for an extended amount of time.A rare but potentially life-threatening condition caused by certain strains of bacteria that produce poisons (toxins). These toxins get into your bloodstream and can affect organs such as your heart, liver, or kidneys. ⁷³ When using the same tampon for long hours, there is a higher chance that bacteria will build up, which can cause Toxic Shock Syndrome ⁷⁴ Tampons are not the only reason TSS occurs. Other causes are open wounds, surgery, and childbirth. ⁷⁵ In fact, half the time, TSS is caused by something other than tampons. ⁷ (TSS). For this reason, it is recommended to change the tampon every 4 hours. ⁷⁶ However, most people know TSS from tampon usage. ⁷⁷ While TSS is rare, 1 in 100,000 women get it, there is a 30-70% mortality rate for those who suffer from it because the bacteria buildup can cause toxins to enter and shut down a person's organs. 78,79 Though TSS is a medical condition that can be easily avoided with appropriate menstrual products, it continues to occur. To avoid TSS, doctors advise that people who menstruate change their tampons regularly, but many menstruators who do not have access to a suitable amount of products to last their whole cycle keep them in for longer. 80, 81

Those who are affected by period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. struggle with their mental health due to the stress they feel to afford products. In a study done by BMC Women about the struggles of Period Poverty among college-age women, it was discovered that young women who experienced period poverty within the last year were more likely to report having moderate to severe depression compared to those who have not experienced period poverty. ⁸² The study found that of the women surveyed who experienced period poverty monthly, 68.1% reported symptoms of moderate or severe depression, 61.2% of those who had experienced period poverty at any point experienced depression, and 43.4% who had never experienced period poverty experienced depression. ⁸³ While there may be other factors that contribute to the mental state of these college-age women, the study found enough evidence to show that Period Poverty does affect the mental health of women who struggle to afford menstrual products Products that are used during the menstrual cycle, such as pads and tampons. monthly.

There are also feelings of anxiety that come from period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³.. Menstruators Term used to describe those who menstruate. worry about whether they will be able to afford menstrual products Products that are used during the menstrual cycle, such as pads and tampons. that month and what other purchases to cut down to afford them. A recent study conducted by Always, a menstrual product brand, found that, especially with the economic problems that have occurred because of the pandemic, 1 in 3 parents is worried about the ongoing ability to afford menstrual products. ⁸⁴ Low-income families already have worries when it comes to their livelihood, so the added cost of menstrual products, an essential product in the lives of those who menstruate, is added stress.

Decreased Productivity at Work

Period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management." ³. also impacts menstruators Term used to describe those who menstruate. in the workplace due to not having enough menstruation products to complete a full day at work. Lack of access to menstrual products Products that are used during the menstrual cycle, such as pads and tampons. can impact the number of days women miss work monthly. A study done by St. Louis University on period poverty found that 36% of those surveyed who were full-time or part-time employed had to miss one or more days of work a month because of a lack of menstrual products during their periods. ⁸⁵ While there is limited information on workplace productivity in the United States, a study done in the UK found the impacts of period pains on menstruators in the workplace. The article noted that because of the lack of education and stigmas surrounding menstruation, people who menstruate do not understand their periods, including their symptoms. Because of the inadequate knowledge these women had surrounding menstruation, 14% of women took off days at least once because of their symptoms from menstruation, with 3.4% reporting absenteeism almost every period. It also reported that 80% of the participants felt less productive at work during their periods. ⁸⁶ The lack of access to menstrual products and the lack of knowledge surrounding menstruation have affected menstruators' ability to do work during their cycle.

On May 28, 2021, a federal bill called the Menstrual Equity For All Act of 2021 was introduced into the house. The purpose of this bill is to increase access and affordability for menstrual products Products that are used during the menstrual cycle, such as pads and tampons. for those who do not have proper access and other important aspects of menstruation. ⁸⁷

While the law is in the works currently, if the Menstrual Equity Law was passed, it would require schools, public government places, and correctional facilities to provide free menstrual products Products that are used during the menstrual cycle, such as pads and tampons.. The bill also would have companies with larger than 100 employees provide free menstrual products at work. This law would allow menstruators Term used to describe those who menstruate. easier access to products while using public facilities. The bill would also require Medicaid to cover menstrual products for its clients, so products such as pads and tampons would be paid for by Medicaid. ⁸⁸

In an article discussing the impacts of a bill being passed like the Menstrual Equity Law, the author makes the point that there would be budget increases needed to afford proper products to give for free."a charge on menstrual products meaning they have a value-added tax or sales tax." ⁸⁹ The government would have to partner with manufacturers in order to produce enough products for menstruation. Another gap in the law is that while products are being made available in public, menstruators Term used to describe those who menstruate. may struggle to obtain products for use at home. The Tampon Tax menstrual products Products that are used during the menstrual cycle, such as pads and tampons. to be high and, at times, not affordable for menstruators. ⁶ is also still in effect in states, causing prices of ⁹⁰ Without eliminating the tampon tax, many states will still suffer from high-priced menstrual products.

Reusable Menstrual Products

One way that the struggle of period poverty "Inadequate access to menstrual tools and education, including but not limited to sanitary products, washing facilities and waste management."A small, flexible funnel-shaped cup made of rubber or silicone that you insert into your vagina to catch and collect period fluid. ³. can be reduced is through access to reusable menstrual products Products that are used during the menstrual cycle, such as pads and tampons.. Reusable menstrual products include pads made of cloth and cups that work similarly to tampons. Using these products means that menstruators Term used to describe those who menstruate. would not have to buy a product every month but just clean the product and be able to use it again, which would allow menstruators to not have to worry about being able to afford products. Companies like Ruby Cup, Diva Cup, and GladRags, all reusable menstrual cup ⁹¹ For example, whenever a cup is purchased at Ruby Cup, a cup is also given to someone who cannot afford one. ⁹² ⁴ companies, partner with menstrual organizations and donate to them whenever a menstrual cup is purchased.

While research is limited to the number of menstruators Term used to describe those who menstruate. who use this product and the impact of reusable menstrual products Products that are used during the menstrual cycle, such as pads and tampons., these products have the potential to change the way menstruators view their periods. Made from rubber or silicone, a cup can hold more blood, allowing some menstruators to wear it for up to 12 hours. ⁹³ Companies have also claimed that menstrual cups prevent fewer bacteria buildup and less likelihood of bacteria infections. However, there is not enough research done to back that claim. ⁹⁴ Menstrual products also allow menstruators to reuse the same product and can last, depending on the product, for 6 months to 10 years. ⁹⁵ Research done on the financial benefit of using menstrual cups estimates over 10 years found that a reusable cup would be 5% of the purchase of pads and 7% of the purchase cost of tampons. A reusable cup would also produce 0.4% of the plastic waste used for pads and 6% of the plastic waste used for tampons. ⁹⁶

With reusable period products being a recent development, a gap that can be found is the lack of research on product impact. In order for them to increase in credibility, researchers suggest more research be done. ⁹⁷ Another gap in reusable menstrual products Products that are used during the menstrual cycle, such as pads and tampons. is the price. For one reusable cup, the price is usually between $20.00-40.00. ⁹⁸ While reusable products will save menstruators Term used to describe those who menstruate. money in the long term, menstruators may not be able to spend that much money at once on a product. There is also a risk that the menstruator will not like the product or it will not be the correct size. ⁹⁹ However, some companies have size charts to help determine the correct size for each menstruator.

Preferred Citation: Krumperman, Katie. "Period Poverty in the United States." Ballard Brief. February 2023. www.ballardbrief.byu.edu.
Viewpoints published by Ballard Brief are not necessarily endorsed by BYU or The Church of Jesus Christ of Latter-day Saints

Katie is a public relations major with a minor in civic engagement leadership. She started being interested in period poverty at the age of 12 when she and other girls her age helped create reusable pads for girls in other countries. Her interest heightened when she lived in Salt Lake City, Utah for 18 months and was exposed to the effects of period poverty here in the United States. When not busy with school she loves being outdoors and being around her family and friends.

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Period Poverty in the United States - Ballard Brief

# data[].attributes.attachment_link.description
Period poverty, or the lack of information and education about menstruation as well as access to menstrual products, in the US affects all menstruators but especially those who are low-income, homeless, in college, imprisoned, or transgender.

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What is menstruation? What is the menstrual cycle?
How is menstruation related to human rights?
What do people need to manage their menstruation?
What happens when menstruation cannot be managed properly?
What are symptoms or disorders related to menstruation?
What is PMS and when does it occur?
When does menstruation start? Is the onset of menstruation earlier today than it used to be? Exclusion from public life
Barriers to opportunities What are common myths and taboos about menstruation? How do they affect the status of women? Barriers to sanitation and health
What is period poverty? Heightened vulnerability
What are positive aspects of menstruation? Below is a list of universally agreed human rights that can be undermined by women's and girls' treatment during menstruation:
Does menstruation limit what people can do?
What is UNFPA doing on the issue of menstrual health?
Can a person get pregnant during menstruation?
Is menstruation bad for the environment?
Are menstrual products bad for your health?
How will the COVID-19 pandemic affect people's ability to manage their menstruation?
What is menstruation? What is the menstrual cycle?

Menstruation is the process in which the uterus sheds blood and tissue through the vagina. This is a natural and healthy process for girls and women of reproductive age. In Western communities, this is often called "the period." It typically lasts 2 to 5 days, but this varies by individual.

When a person begins to menstruate, this is called menarche. The age of menarche varies by individual.

Menstruation is part of the menstrual cycle - a cycle of biological changes that take place in a woman or girl's reproductive system to prepare her body for a potential pregnancy. The changes are triggered by hormones, which are natural chemicals in the body. This cycle begins when a girl reaches puberty and continues until she reaches the end of her fertility (also known as menopause, at which time menstrual cycles end).

The menstrual cycle is roughly 28 days long, but it can be shorter or longer. It begins with menstruation (considered day 1 of the cycle). Menstruation is the shedding of the lining of the uterus and the remnants of the unfertilized egg. It continues with an increase in the hormone estrogen, and the lining of the uterus becomes thick and spongy again (typically days 6-8). An egg is released from one of the ovaries, called "ovulation" (around day 14, but this can vary), then the egg moves through the fallopian tube towards the uterus (typically day 15-24). If the egg is not fertilized, it will not be implanted in the uterine wall but instead fall apart, and hormone levels such as estrogen and progesterone, will drop. This process is followed by the start of a new cycle.

While a person's menstrual cycles may be consistent - even predictable - they can also change or vary, particularly in the first few years after menarche. Some changes, such as absence of bleeding, signal a pregnancy. Other changes can be related to contraceptive use, stress, nutrition, physical activity or health concerns. Some cycle changes are just a natural part of ageing.

In Rajasthan, India, 15-year-old Priyanka Meena sleeps outside her home, in a space cordoned off by
a sari, when she has her periods. She wears the same clothes and uses the same utensils when she
menstruates; these are believed to be unclean and cannot be taken into the home, even after her period
is over. © UNFPA India

How is menstruation related to human rights?

Human rights are rights that every human being has by virtue of his or her human dignity. Menstruation is intrinsically related to human dignity - when people cannot access safe bathing facilities and safe and effective means of managing their menstrual hygiene, they are not able to manage their menstruation with dignity. Menstruation-related teasing, exclusion and shame also undermine the principle of human dignity.

Gender inequality, extreme poverty, humanitarian crises and harmful traditions can all turn menstruation into a time of deprivation and stigma, which can undermine their enjoyment of fundamental human rights. This is true for women and girls, as well as for transgender men and nonbinary persons who menstruate.

Over the lifetime of a person who menstruates, they could easily spend three to eight years menstruating, during which they might face menstruation-related exclusion, neglect or discrimination.

A variety of factors affect how people are treated during menstruation (and other times when they experience vaginal bleeding, such as during post-partum recovery).

One of these factors is the perception that menstruation is dirty or shameful. This view contributes to restrictions women and girls face during vaginal bleeding, which exist in many, if not most, countries. Some restrictions are cultural, such as prohibitions on handling food or entering religious spaces, or the requirement that women and girls isolate themselves. ( See examples of menstruation taboos and discrimination here.) Some restrictions are self-imposed; women or girls may fear participating in activities like school, athletics or social gatherings. Together, these practices can reinforce the idea that women and girls have less claim to public spaces, and that they are less able to participate in public life.

Another common misconception is that women and girls have diminished capacities, whether physical or emotional, due to their menstrual cycles. These ideas can create barriers to opportunities, reinforcing gender inequality. In truth, most women and girls do not have their abilities hindered in any way by menstruation.

Poverty and humanitarian crises can limit women's and girls' access to culturally appropriate, high quality menstrual supplies and safe, private washing facilities.

Vulnerable women and girls in middle- and high-income countries can also face poor access to safe bathing facilities and menstrual supplies - including those in impoverished school systems, prisons and homeless shelters.

The onset of menstruation, called menarche, can undermine girls' human rights. In many places around the world, menarche is believed to be an indication that girls are ready for marriage or sexual activity. This leaves girls vulnerable to a host of abuses, including child marriage and sexual violence.

Deeply impoverished girls have been known to engage in transactional sex to afford menstrual products.

The right to health - Women and girls may experience negative health consequences when they lack the supplies and facilities to manage their menstrual health. Stigma associated with menstruation can also prevent women and girls from seeking treatment for menstruation-related disorders or pain, adversely affecting their enjoyment of the highest attainable standard of health and well-being.

The right to education - Lack of a safe place or ability to manage menstrual hygiene as well as lack of medication to treat menstruation-related pain can all contribute to higher rates of school absenteeism and poor educational outcomes. Some studies have confirmed that when girls are unable to adequately manage menstruation in school, their school attendance and performance suffer.

The right to work - Poor access to safe means of managing menstrual hygiene and lack of medication to treat menstruation-related disorders or pain also limit job opportunities for women and girls. They may refrain from taking certain jobs, or they may be forced to forgo working hours and wages. Menstruation-related needs, such as bathroom breaks, may be penalized, leading to unequal working conditions. And women and girls may face workplace discrimination related to menstruation taboos.

The right to non-discrimination and gender equality - Stigmas and norms related to menstruation can reinforce discriminatory practices. Menstruation-related barriers to school, work, health services and public activities also perpetuate gender inequalities.

The right to water and sanitation - Water and sanitation facilities, such as bathing facilities, that are private, safe and culturally acceptable, along with a sufficient, safe and affordable water supply are basic prerequisites for managing menstrual health management.

What do people need to manage their menstruation?

Health issues particular to women's and girls' bodies - including not only menstruation but also pregnancy, childbirth, post-partum changes and menopause - have often been overlooked by decision-makers, policymakers, educators and even medical establishment. As a result, women and girls often know little about the changes they will experience as they advance through life. Many girls learn about menstruation only when they reach puberty, which can be a frightening and confusing experience.

People of different gender diversities, as well, such as transgender men and nonbinary people, often face additional barriers to information and supplies to safely manage menstruation, including possible threats to their safety and well-being.

In the last few years, however, menstrual health and hygiene management have become topics of conversation among girls' advocates, education experts, humanitarian professionals, human rights and global development specialists.

There is now wide agreement about what is required during menstruation:
- They must have safe access to clean material to absorb or collect menstrual blood, and these items must be acceptable to the individuals who need them.
- They must be able to change these materials in safety and privacy, and have a place to dispose of used menstrual supplies or to wash reusable supplies.
- Menstruating people must also be able to safely and privately wash with soap and water.
- They should have basic education about the menstrual cycle and how to manage menstruation without discomfort or fear.
- People who menstruate should also have access to health information and care, ensuring they are able to make informed choices about how to manage their menstruation, and enabling them to seek care if they experience menstruation-related disorders.

Menstrual products must also be safe, effective and acceptable to the people who use them. These products may include: Disposable menstrual pads (also commonly called sanitary napkins or sanitary towels), reusable menstrual pads, tampons, menstrual cups, and clean, absorbent fabrics such as cloths or period underwear.

UNFPA distributes menstrual products to women and girls in humanitarian crises. The choice of product is often determined by cultural and logistical needs. For example, in some communities, women are not comfortable with insertable products such as tampons or menstrual cups. In humid or rainy conditions, reusable menstrual pads may be difficult to thoroughly dry, possibly contributing to infection risks. In other conditions, lack of waste management systems might make reusable products more desirable than disposable ones.

"I end up using rags to absorb the blood flow," said 20-year-old
Nyanjuma Galoth, was living in a civilian protection camp in Juba,
South Sudan. © UNFPA South Sudan/Juma Delu

What happens when menstruation cannot be managed properly?

Lack of access to the right menstrual products may lead to greater risk of infection. For example, some studies show that, in locations with high humidity, reusable pads may not dry thoroughly, possibly contributing to infection risks. Other products, such as menstrual cups, require sterilization and tampons require frequent changing, both of which may present challenges in conditions like humanitarian crises.
Myth: Menstruation is dirty or dangerous
In some cases, women and girls do not have access to menstrual products at all. They may resort to rags, leaves, newspaper or other makeshift items to absorb or collect menstrual blood. They may also be prone to leaks, contributing to shame or embarrassment.

One study has suggested that there may be an increased risk of urogenital infections, such as yeast infection, vaginosis or urinary tract infections, when women and girls are not able to bathe and/or change or clean their menstrual supplies regularly. However, there is no clear causal relationship, and urogenital infections are more often caused by internal, than external bacteria.

Women and girls living in extreme poverty and in humanitarian crises may be more likely to face these challenges. In one Syrian refugee community, for example, health workers reported seeing high levels of such vaginal infections, perhaps a result of poor menstrual hygiene management. However, there is no strong evidence about the risks and prevalence of such infections.

Cultural expectations and beliefs can also play a role. Some traditions discourage menstruating people from touching or washing their genitals during menstruation, which might increase their vulnerability to infection and discomfort, and could affect their sense of dignity.

What are symptoms or disorders related to menstruation?

Menstruation is often different from person to person, and even one person can experience very different periods over their lifetime. This is often healthy and normal. But when menstruation prevents people from engaging in regular activities, medical attention is required. Unfortunately, lack of attention to, and education about, menstruation means that many women and girls suffer for years without receiving care. Below are some of the conditions and disorders related to menstruation.
Myth: Certain foods are off-limits to menstruating women and girls
One common menstruation-related complaint is dysmenorrhea, also known as menstrual cramps or painful periods. It often presents as pelvic, abdominal or back pain. In some cases, this pain can be debilitating. Studies show that dysmenorrhea is a major gynaecological issue among people around the world, contributing to absenteeism from school and work, as well as diminished quality of life.
Myth: Menstruation indicates readiness for marriage and sex
Sometimes, menstrual irregularities can indicate serious disorders. For example, some women and girls may experience abnormally heavy or prolonged bleeding, called menorrhagia, which could signal a hormonal imbalance or other concerns.
Myth: Menstruation limits women's abilities
Excruciating pain or excessive bleeding during menstruation can also indicate reproductive problems such as endometriosis (when the uterine lining grows outside of the uterus) or fibroids (lumpy growths in the uterus).
Myth: Real women menstruate
Irregular, infrequent or prolonged periods can indicate disorders such as polycystic ovary syndrome.

Extremely heavy periods can also increase the risk of iron-deficiency anaemia, which can cause extreme fatigue, weakness, dizziness and other symptoms. Severe or chronic iron-deficiency anaemia can cause dangerous complications during pregnancy as well as physiological problems.

The hormonal changes associated with the menstrual cycle can also cause physical and emotional symptoms, ranging from soreness, headaches and muscle pain to anxiety and depression. These symptoms are sometimes considered premenstrual syndrome (PMS), but when severe or disabling they are sometimes considered premenstrual dysphoric disorder.
Taboo: Menstruation should not be discussed publicly
There are also conditions that can exacerbate menstruation-related complaints. For example, studies show that female genital mutilation can cause longer and more painful periods.
Myth: All women are moody when they menstruate

On the last day of her period, Poonam, in India, burns her used pads to prevent animals from feeding
on them, which is considered inauspicious. © UNFPA India

Myth: Menstruation is a women's issue only
What is PMS and when does it occur?

Most people who menstruate experience some physical or emotional discomfort known as premenstrual syndrome (PMS) about a week before or during the first few days of their menstrual periods.

PMS manifests differently in different people and may vary between menstruation cycles. The most common symptoms during PMS include changes in appetite, backaches, acne, bloating, headaches, depression, feelings of sadness, tension or anxiety, irritability, sweating, tender breasts, water retention, constipation or diarrhea, trouble concentrating, insomnia and tiredness. For some, these symptoms can be so severe that they miss work or school, while others are not bothered.

On average, women in their 30s are most likely to have PMS. PMS may also increase as a person approaches menopause because of the fluctuations in hormone levels.

It is not really known why people experience PMS. Researchers believe it is because of the dramatic drop in estrogen and progesterone that takes place after ovulation when a woman is not pregnant. PMS symptoms often disappear when the hormone levels begin to rise again.

About half of women who need relief from PMS also have another health problem, such as depression or anxiety disorders, myalgic encephalomyelitis/chronic fatigue syndrome, irritable bowel syndrome, and bladder pain syndrome.

Stereotypes and stigma surrounding PMS can contribute to discrimination. For instance, people may assume that PMS affects all women, or that it undermines women's competence in the school or workplace.

When does menstruation start? Is the onset of menstruation earlier today than it used to be?

The onset of menstruation, called menarche, varies from person to person. It commonly starts between the ages of 10 and 16.

In rare cases, menarche can take place before a girl reaches age 7 or 8. Menarche can also be delayed or prevented due to malnutrition, excessive exercise or medical issues.

It is hard to know the global average age of menarche, because recent and comparable data are hard to find. One study from 1998 found that 14 is a typical age of menarche.

Some studies have found that menarche is occurring earlier among girls in certain places, often in high-income countries and communities. Research from countries such as South Africa suggest these changes are related to nutrition and socio-economic status, meaning that as nutrition and health improve, girls' bodies may mature slightly earlier. However, lack of systematically collected data from low-income countries means that broader or global conclusions cannot be made.

Similarly, it is difficult to determine the average age at which menstruation ends, known as menopause. Data from 1999 suggest an average age of around 50.

Zainab, from Yemen, said, "I always used cotton cloths, folded them and placed them in my
underwear. I came from an uneducated family so I did not know that there were menstrual pads used
for this purpose."

What are common myths and taboos about menstruation? How do they affect the status of women?

Menstrual taboos have existed, and still exist, in many or most cultures. Around the world and throughout history, misconceptions about menstruation have led to women's and girls' exclusion from all kinds of roles and settings - everything from leadership positions to space travel. Below is a non-exhaustive list of menstruation myths and taboos, as well as their impact on women and girls.

Menstrual blood is composed of regular blood and tissue, with no special or dangerous properties. Yet throughout history, many communities have thought the mere presence of menstruating women could cause harm to plants, food and livestock. In the 1930s, Western scientists hypothesized that menstruating women's bodies produced " menotoxins," a kind of poison.

People continue to hold similar beliefs today. Some communities believe women and girls can spread misfortune or impurity during menstruation (or other vaginal bleeding). As a result, they may face restrictions on their day-to-day behavior, including prohibitions on attending religious ceremonies, visiting religious spaces, handling food or sleeping in the home.

In western Nepal, the tradition of chhaupadi prohibits women and girls from cooking food and compels them to spend the night outside the home, often in a hut or livestock shed. Similar rules apply to women and girls in parts of India and other countries. (In one rural community in Ethiopia, the taboos about vaginal bleeding led not only to women and girls being exiled from the home during menstruation, but also during childbirth and postpartum bleeding.) Isolation and expulsion from the home are often dangerous for women and girls - and can even be fatal. For example, women and girls in Nepal have been exposed to extreme cold, animal attacks or even sexual violence.

(It is important to note that not all aspects of these traditions are negative. In some places, limitations on women's and girls' activities give them an opportunity to return their maternal home to relax. See more here.)

Menstrual stigmas also affect how women and girls are able to manage their health and hygiene. Some cultures prohibit women and girls from touching or washing their genitals during menstruation, possibly contributing to infections. In some parts of Afghanistan, it is even believed that washing the body during menstruation can lead to infertility. In other places, women and girls are fearful that their bodies could pollute water sources or toilets.

These beliefs also affect how women and girls dispose of menstrual products. In some places, women burn menstrual pads to avoid cursing animals or nature. In other places, burning menstrual products is believed to cause infertility. Some communities believe menstrual products should be buried to avoid attracting evil spirits. Others believe improper disposal of these products can cause a girl to menstruate continuously for life.

Many communities believe menstruating women and girls cannot eat certain foods, such as sour or cold foods, or those prone to spoilage. In fact, there are no medically recommended restrictions on the kinds of food menstruating people can or should eat, and dietary restrictions can actually put them at risk by limiting their nutrient intake.

In many places around the world, a girl's first period, called menarche, is believed to be a sign that she is ready for marriage, sexual activity and childbirth. This leaves girls vulnerable to a host of abuses, including child marriage, sexual violence or coercion, and early pregnancy. While menstruation is one indication of biological fertility, it does not mean girls have reached mental, emotional, psychological or physical maturity. In rare cases, menarche can take place before a girl reaches age 7 or 8, for example. And even older teens may not be mature enough to make informed choices about marriage, sexual activity or motherhood.

Menstruation is also commonly believed to limit women's physical or mental abilities. Nineteenth century physicians, for example, believed that periods "render it extremely doubtful how far they can be considered responsible beings." Similar ideas persist today. Women may face degrading comments about menstruation affecting their physical or emotional states. They may be excluded from certain roles or positions of leadership.

Women can also face stigma and mistreatment for not having periods. Those who do not menstruate may be disparaged as "not real women." Such perceptions contribute to some women's reluctance to use contraceptive methods that affect their menstrual cycles.

These beliefs can adversely affect women who do not experience regular monthly menstruation, such as women who have irregular cycles and transgender women.

These ideas are also harmful to transgender men who menstruate. These men can face discrimination, limited access to menstruation products and poor access to safe, private washing facilities.

Silence about menstruation can lead to ignorance and neglect, including at the policy level. This leaves women and girls vulnerable to things like period poverty and discrimination. It also adversely affects women and girls with heightened vulnerabilities. Those living with HIV can face stigma when seeking sanitation facilities, menstruation supplies and health care, for example. Those in prisons or other forms of detention may be deprived of menstruation supplies.

The menstrual cycle is driven by hormonal changes. These have different effects on different people. In some women, moodiness is a side-effect of these hormonal changes. Other women do not experience mood changes.

While it is true that menstruation is experienced in the bodies of women and girls - as well as other individuals such as non-binary and trans persons - menstrual health issues are human rights issues, and therefore of importance to society as a whole. This means that men and boys must be involved in conversations about gender equality and promoting positive masculinities aiming to eliminate menstruation-associated stigma and discrimination.

In Rajasthan, India, 15-year-old Priyanka Meena sleeps outside her home, in a space cordoned off by a
sari, when she has her periods. She wears the same clothes and uses the same utensils when she
menstruates; these are believed to be unclean and cannot be taken into the home, even after her period
is over. © UNFPA India

Period poverty describes the struggle many low-income women and girls face while trying to afford menstrual products. The term also refers to the increased economic vulnerability women and girls face due the financial burden posed by menstrual supplies. These include not only menstrual pads and tampons, but also related costs such as pain medication and underwear.

Period poverty does not only affect women and girls in developing countries; it also affects women in wealthy, industrialized countries.

Difficulty affording menstrual products can cause girls to stay home from school and work, with lasting consequences on their education and economic opportunities. It can also exacerbate existing vulnerabilities, pushing women and girls closer toward dangerous coping mechanisms. Studies in Kenya, for example, have shown that some schoolgirls have engaged in transactional sex to pay for menstrual products.

Period poverty is not only an economic issue, but a social and political one as well. For instance, some advocates have called for menstruation products to be taxation exempt. Such efforts in India have resulted in the elimination of tax on menstrual pads and tampons.

What are positive aspects of menstruation?

Regular menstruation can be an indication that a woman's reproductive health is on track.

It can help women understand and, in a general way, monitor their fertility. For instance, many women regard their monthly period as an indication that they are not pregnant. (This method is not foolproof, however, since even pregnant women can experience bleeding, such as implantation bleeding).

Some traditions offer menstruating women and girls a chance to bond with one another. In Rajasthan, India, where menstruation can restrict women's and girls' activities, recently married women may use it as an opportunity to visit their maternal families. Menstruation can also be an opportunity to take a break from regular responsibilities. One girl in Rajasthan, Poonam, told UNFPA that she is happy that she is not expected to help out with household chores when she is menstruating.

Girls in Rupantaran, Nepal, attend a learning session about their rights, bodies and health - including
menstruation. These sessions are part of the UNFPA-UNICEF Global Programme to Accelerate
Action to End Child Marriage. © UNFPA Nepal/Dhana Bahadur Lamsal

Does menstruation limit what people can do?

No. While menstruation has been used throughout history to exclude women and girls from all kinds of roles and settings, there is really nothing that menstruating people cannot do. Exercise, swimming, bathing, work and sex are all possible during menstruation.

In some cultures, there are restrictions on what people can do during menstruation, but these are customs, beliefs and traditions and have nothing to do with people's actual abilities. Menstruating women can - and have - competed in the Olympics, run marathons, traveled to space, held leadership roles, served as judges and held religious offices.

However, the management of menstruation does influence what people can do; women and girls may prefer to go swimming when they have access to menstrual cups or tampons, for instance. Menstrual symptoms can also affect what people feel like doing.

What is UNFPA doing on the issue of menstrual health?

UNFPA has four broad approaches to promoting and improving menstrual health around the world.

First, UNFPA reaches women and girls directly with menstrual supplies and safe sanitation facilities. In humanitarian emergencies, for example, UNFPA distributes dignity kits, which contain disposable and reusable menstrual pads, underwear, soap and related items. (In 2017, 484,000 dignity kits were distributed in 18 countries.) UNFPA also helps to improve the safety of toilets and bathing facilities in displacement camps by working with camp officials, distributing flashlights and installing solar lights.

UNFPA also promotes menstrual health information and skills-building. For example, some UNFPA programmes teach girls to make reusable menstrual pads. Others raise awareness about menstrual cups.

Second, UNFPA works to improve education and information about menstruation and related human rights concerns. Through its youth programmes and comprehensive sexuality education efforts, such as the Y-Peer programme, UNFPA helps both boys and girls understand that menstruation is healthy and normal. UNFPA also help raise awareness that the onset of menstruation (menarche) does not signify a physical or psychological readiness to be married or bear children. The UNFPA-UNICEF Global Programme to Accelerate Action to End Child Marriage, for instance, teaches girls and communities about reproductive health and the harms caused by child marriage. Programmes to end female genital mutilation, including the UNFPA-UNICEF Joint Programme to Eliminate FGM, raise awareness of the negative consequences the practice can have on menstrual health.

Third, UNFPA supports national health systems, which can promote menstrual health and provide treatment to girls and women suffering from menstrual disorders. This includes promoting adolescent- and youth-friendly health services, which can help girls and young women better understand and care for their bodies. UNFPA also supports the hiring and training of health workers, particularly midwives, who can provide care for, and information about, menstrual health complaints. UNFPA also procures reproductive health commodities that can be useful for treating menstruation-related disorders. For instance, hormonal contraceptive methods can be used to treat symptoms of endometriosis and reduce excess menstrual bleeding.

Last, UNFPA is helping to gather data and evidence about menstrual health and its connection to global development - a long overlooked topic of research. For instance, UNFPA-supported surveys provide critical insight into girls' and women's knowledge about their menstrual cycles, health and access to sanitation facilities. And a recent UNFPA publication provides a critical overview of the menstrual health needs of women and girls in the Eastern and Southern Africa region.

UNFPA distributes menstrual management supplies during humanitarian emergencies, often in
packages of supplies called dignity kits. © UNFPA Syria/Sufian Abdulmouty

Can a person get pregnant during menstruation?

Yes. It is widely believed that intercourse during menstruation cannot result in pregnancy. However, this is not true for women and girls with shorter or irregular menstrual cycles. Non-menstrual vaginal bleeding may also be mistaken for menstruation, which can convey a false sense of security against pregnancy. The only reliable way to prevent pregnancy is to use a modern form of contraception.

Is menstruation bad for the environment?

No, menstruation in itself is not bad for the environment. However, products used to manage menstruation can have a negative impact on the environment, depending on the product and the way it is disposed.

Menstrual products such as tampons and pads often contain plastics and chemicals that are bad for the environment. The time it takes for them to degrade in a landfill is centuries longer than the lifespan of a woman. Menstrual products can also be found in bodies of water and along shorelines. The manufacturing process to produce menstrual products also has environmental consequences.

More environmentally friendly options include reusable menstrual cups as well as reusable and/or biodegradable pads.

But in many places, alternative methods are not available or culturally acceptable. In all circumstances, the choice of menstrual product must be acceptable to the people using them. For example, some women are not comfortable with insertable products like menstrual cups. In humid environments, reusable menstrual pads may be difficult to thoroughly dry.

Given the potential environmental consequences of disposable menstrual products, it is important to expand the range of methods available to women, allowing them to make informed choices that fit their needs.

Are menstrual products bad for your health?

In general, no. However, there are possible health impacts to consider.

Use of highly absorbent tampons has been associated with toxic shock syndrome (TSS), a life-threatening condition, but these cases are rare. Frequently changing tampons greatly lowers the risk of TSS.

People with sensitive skin may have reactions to the materials used in menstrual products, such as the fragrances used in some pads.

In addition, many countries do not obligate manufacturers to disclose the ingredients or components of menstrual products, which could lead to women being exposed to unwanted materials. Some tampon brands, for instance, contain chemicals like dioxins. There has been little research to determine the health consequences, if any, caused by exposure to these chemicals.

How will the COVID-19 pandemic affect people's ability to manage their menstruation?

Communities around the world are feeling the numerous and overlapping effects of the COVID-19 pandemic. These may have significant impacts on some people's ability to manage their menstruation safely and with dignity:

Gaps in provision of water and sanitation services, such as lack of sewage maintenance or disruption of water supply, will have a direct impact on people's ability to manage their menstruation.

Stock-outs and supply chain disruptions mean that communities could lose access to menstrual pads, tampons and other menstrual materials.

People who may be quarantined because they have either contracted or come into contact with someone who has contracted COVID-19 may have limited access to menstrual products or running water.

Financial stress on families who may be underemployed due to the pandemic may lead to households prioritizing other basic needs like food or household bills over menstruation supplies.

Increased prices of menstrual health supplies due to increased demand, panic-buying or disrupted supply chains may leave some without supplies, or without the supplies of their choice.

Lack of knowledge of one's own menstruation and menarche may contribute to stress and anxiety. The pandemic may limit access to critical information related to menstrual health due to disruption of regular health services, school closures, limited access to technology and suspension of community-based programming.

In times of global crises, such as this pandemic, it is critical to ensure that menstruating people continue to have access to the facilities, products and information they need to protect their dignity, health and well-being. Decision-makers must assure these essential menstrual health items remain available.

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Menstruation and human rights - Frequently asked questions

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What is menstruation? What is the menstrual cycle

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Period Poverty: A Matter of Climate Justice

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Period Poverty: The Unspoken Health Crisis

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Editor's note: This is part of our Teen Health Week blog post series, which focuses on understanding and addressing the unique health needs of adolescents. We invite you to check back for new posts or to follow along for updates on Twitter at @PolicyLabCHOP.

Period poverty is defined as inadequate access to menstrual hygiene tools and education, including but not limited to sanitary products, washing facilities and waste management. While the term period poverty is relatively new in medical literature, menstrual hygiene management has been discussed for decades in the context of the gender gap in education for youth living in low- and middle-income countries.

As a group of adolescent health specialists and advocates with lived experience on this issue, we are breaking down how this affects youth globally and locally, offering our personal insights on the real-life impacts of period poverty on youth (indicated by italics) and sharing ways everyone working with adolescents can make a difference.

A global perspective on period poverty

According to a 2014 United Nations Educational, Scientific and Cultural Organization (UNESCO) report, 1 out of every 10 menstruating youth misses school during their menstrual cycle due to lack of access to menstrual products and resources. For example, menstruators in developing parts of the world, such as sub-Saharan Africa, are prone to using paper, old clothes, leaves, cotton, or wool pieces rather than more traditional menstrual products like disposable pads or tampons. Many schools in developing nations have insufficient toilets and inadequate privacy measures, as well as poor water, sanitation and hygiene infrastructure, making it difficult for students to safely manage their menstrual cycle.

Grace Clarke, an assistant researcher at Children's Hospital of Philadelphia (CHOP) and master's of public health student at La Salle University, grew up in Monrovia, Liberia and shares her experiences with this issue:

I personally had instances when the only means to manage my menstrual cycle was to use old clothes or tissue because my family couldn't afford to purchase menstrual products. As I gained more knowledge of period poverty in my community, I became more passionate about addressing this issue. In 2019, my younger sister, Lovetta Qualah, and I founded a nonprofit organization called Positive Action Driving Safety for Girls (PADS for Girls). We provide sanitary products to young, disadvantaged youth in rural parts of Liberia. By improving access and education about basic health needs, we are able to help youth at risk of poor health outcomes due to the undermining forces of poverty and stigma.

What do we know about period poverty in the United States?

The lived experiences around menstruation for people living in poverty in the U.S. are quite similar to those in low- and middle-income countries. Shelby Davies, a fellow in CHOP's Division of Adolescent Medicine, shares how this has impacted her patients in Philadelphia:

In spring 2020, as the COVID-19 pandemic began to shut down access to many services, I was approached by a colleague about a patient who badly needed menstrual products but could not afford them. Knowing my interest in the area, my colleague asked if I had any resources to share. The patient was in her late teens and had reached out in a moment of crisis in need of free menstrual pads. Her family did not have money for pads, and she often needed to use toilet paper as a replacement, which was both annoying and embarrassing. She had also become quite dependent on the pads she receives from her school, which was now closed due to the pandemic. I was saddened to learn that there were so few local organizations that could offer assistance.

Menstrual products are expensive in the U.S. In a national survey of 1,000 menstruating teens, 1 in 5 struggled to afford period products and 4 in 5 either missed or knew someone who missed class time because they did not have access to period products. Unfortunately, government benefits, such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), do not cover the cost of these necessary supplies. While the Coronavirus Aid, Relief, and Economic Security Act made period products medical expenses eligible for purchase with flexible spending accounts or health savings accounts, uninsured individuals cannot access this benefit.

Many students rely on menstrual products purchased and supplied by school districts and stored within a school clinic or school nurse's office. There are at least 14 states and local jurisdictions with proposed legislation to ensure that menstrual products are readily available in school bathrooms. However, many of these bills don't allocate corresponding funding, leaving it up to school districts to purchase these products. Despite local efforts, menstrual products provided by schools are now unavailable to many youth with school closures due to the pandemic.

What is CHOP doing to raise awareness about period poverty?

Recognizing that this could be an unmet need for our adolescent patients, a team within CHOP's Division of Adolescent Medicine is working on a quality improvement project to assess period poverty among youth seen in our adolescent specialty clinic. For youth who screen positive, we created a handout with resources for free or low-cost menstrual products in Philadelphia, and we hope to expand screening efforts into the CHOP Primary Care Network.

We have also started recruitment for a PolicyLab pilot grant research study that aims to use personal narratives to explore the lived experiences of adolescents who menstruate, understand the barriers and facilitators to adequate menstrual health and hygiene, and investigate the impact of shame and stigma on menstruating teens. In addition, we have expanded our efforts into the community through a spring 2020 CHOP Cares Grant to assess the need for menstrual products among youth experiencing housing instability in CHOP's Homeless Health Initiative shelters.

What can researchers, providers, policymakers and adolescent health experts do to help?

Based on what we have learned from our own work, we can offer a few insights and tips for those who want to make an impact here in our community and around the world.

1. Normalize conversations about periods. This is crucial to reducing shame and stigma and offering effective solutions.

2. Talk to teens about how they purchase menstrual products. This is as important to understanding their menstrual health as frequency or duration of periods.

3. Continue research to better understand the scope of the problem. We know this issue is impacting youth, but more research will be critical to further advocacy efforts.

4. Build a coalition of advocates within the medical community. Lack of access to period products can lead to poor health outcomes and should be seen as a medical issue. Children's hospitals should consider availability of menstrual products within their own institutions and how they can position themselves as a part of the solution.

5. Serve as advocates for key issues. There are several bills in Pennsylvania that could have an enormous impact on accessibility and affordability of menstrual products in the state, including bills that require Pennsylvania public schools and colleges and agencies that serve low-income, homeless and incarcerated populations to supply free pads and tampons. We encourage policymakers to support and invest in policies that not only improve widespread access to menstrual products but also help cover the cost when these products are distributed by school districts.

By addressing period poverty head on, one day, when a patient asks for help, we may be able to offer a concrete solution. And perhaps, one day, our patients may not even need to ask at all.

Shelby Davies, MD, is an affiliate trainee at PolicyLab and a medical fellow in Children's Hospital of Philadelphia's Division of Adolescent Medicine.

Grace Clarke is an MPH student at La Salle University.

Noreena Lewis, JD, is the community pediatrics and advocacy program coordinator for CHOP's Residency Program.

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Period Poverty: The Public Health Crisis We Don't Talk About

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Editor's note: This is part of our Teen Health Week blog post series, which focuses on understanding and addressing the unique health needs of adolescents. We invite you to check back for new posts or to follow along for updates on Twitter at @PolicyLabCHOP.

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Queens Public Library. Poverty Should Not Start with a Period

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Queens Public Library. Poverty Should Not Start with a Period

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Access to menstrual products is a dignity and equity issue, but every day people across the United States are unable to access the menstrual products they need. Local, state, and federal government

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Approximately half the population menstruates for a significant portion of their lives, but only in recent years have periods become part of the public policy conversation. Due to awareness-raising efforts at levels from the grassroots to the halls of the United States Congress, there is growing understanding of the many ways that menstruation affects everyday life. Law and policy are changing in response. For example, a little-noticed provision of the CARES pandemic relief bill now makes it possible for people with pre-tax Flexible Spending Accounts to use that money to purchase tampons and pads. Campaigns to end the unfair and unconstitutional tampon tax are under way in the 27 states that still impose sales tax on menstrual products. The overarching concern targeted by these campaigns and initiatives is period poverty.

While the phrase "period poverty" can mean many different things, it most commonly describes the inability to afford or access period supplies. For many people, period poverty became newly visible for the first time during the COVID-19 pandemic. Stories about consumers buying toilet paper in bulk ran on the nightly news. Similarly, many local and online retailers ran low or sold out of several major brands of tampons. With pandemic disruptions of businesses, many people lost their jobs. With closures of schools and community centers, many more lost access to their only regular source of food or menstrual products. For that reason, it is hardly surprising that in March 2020, I Support the Girls, a nonprofit that collects donations of bras and menstrual products for shelters and others in need, donated 900,000 menstrual products, compared to 200,000 in the same month the year before.

The pandemic may have made period poverty more salient for some, but it is not a new issue. For years, low income women and others have suffered in silence, "making do" with toilet paper, cut-up diapers, or rags when unable to afford tampons and pads.

The pandemic may have made period poverty more salient for some, but it is not a new issue. For years, low income women and others have suffered in silence, "making do" with toilet paper, cut-up diapers, or rags when unable to afford tampons and pads. One pre-pandemic study of low-income women in St. Louis found that 46% of those surveyed were not able to buy both food and menstrual products in the last year. Thirty-six percent of surveyed women who were employed reported missing work at least once a month because of their period s.

In a 2021 national survey of college students, researchers at George Mason University and the University of Pennsylvania found that 10% of all female college students are unable to afford menstrual products each month, leading to skipped classes and greater self-reported rates of moderate or severe depression. Period poverty impacts younger students, too. Over 52% of all public school students in America are eligible for free or reduced price lunch, which is a rough proxy for financial need. For the 2021-2022 academic year, children in a family of four are eligible for a reduced-cost lunch if annual household income is below $49,025, and a free lunch if annual household income is below $34,450. That means that a large number of public school families are likely facing the challenge of paying for period products. At one high school in St. Louis, up to two-thirds of girls reported that they do not have a reliable source of tampons or pads. One third of girls at the same school said that they stay home from class for that precisely that reason.

Menstrual Equity

In a small minority of states, schools are required to provide menstrual products for free to students. Other states should consider following the example of California, Illinois, New York, Oregon and Virginia, to name a few states. But merely making products available isn't enough. There must also be better menstruation-related education in schools. While this education could presumably be incorporated into sexual health education courses, such courses are not mandated in every state. Even in those states where this instruction is mandatory, there is no guarantee that the information will be scientifically accurate. Given the number of state legislatures that are considering anti-LGBTQ laws, ensuring uniform and gender-inclusive instruction in human biology is unlikely to be a short-term state legislative priority.

One powerful way that federal law can and should change to address period poverty is by making menstrual products eligible for purchase with Supplemental Nutrition Assistance (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits.

One powerful way that federal law can and should change to address period poverty is by making menstrual products eligible for purchase with Supplemental Nutrition Assistance (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits. Both programs are administered by the United States Department of Agriculture; states are not permitted to deviate from the federal program rules without a formal waiver. Earlier this year, the Illinois legislature passed a bill directing the Illinois Department of Human Services to apply for such a waiver, so that Illinois residents could purchase menstrual products with their federal benefits. In 2021, the New York State Assembly considered similar legislation, but it stalled in committee. Given the widespread nature of period poverty, advocates should continue working for change at the national level. Representative Grace Meng (D-NY) has repeatedly proposed a comprehensive Menstrual Equity for All Act, most recently in 2021. That bill would require employers with 100 or more employees to provide free menstrual products at work and make menstrual products available for free in all federal buildings.

A society where menstrual products are available for free to all who need them is not just a pipe dream. Scotland has shown the rest of the world that it is achievable. In 2020, during the ongoing pandemic, the Scottish Parliament unanimously passed the Period Products (Free Provision) (Scotland) Bill. That law requires schools, colleges and universities to make menstrual products available for free, requires local authorities to make free period products available in their communities, and provides funds for that purpose. In the United States, some cities have taken similar steps. In 2019, Brookline, Massachusetts became the first municipality to require free menstrual products in town-owned restrooms. In 2022, Los Angeles began a pilot program that makes tampons and pads available at six city libraries.

An estimated 61% of all people in the United States live paycheck-to-paycheck or struggle to make ends meet. Approximately half the population will continue to menstruate for large portions of their lives. It is time to harness awareness of period poverty into momentum for ending it.

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Period Poverty in the United States: What the Law Should Do - Gender Policy Report

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For too many low-income people, menstrual products are inaccessible and unaffordable. Federal and state governments should take action to fix period poverty.

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"Period Poverty and Mental Health of Menstruators During COVID-19 Pandemic

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"Period Poverty and Mental Health of Menstruators During COVID-19 Pandemic

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Abstract

Menstruation is a naturally occurring phenomenon; however, millions of adolescent girls and women, as well as nonbinary persons who bleed every month, are deprived of menstruating safely and respectfully. Those belonging to marginalized sections face the brunt of lack of access to water, sanitation, and hygiene facilities; affordable menstrual supplies; and inequitable distribution of menstrual health education and are victims of period poverty. Their preexisting suffering was further exacerbated by the COVID-19 pandemic, which negatively affected the mental health of those menstruating. Adolescent girls and women in communities found it persistently challenging to access and afford menstrual products while deprived of menstrual hygiene education. These put them under immense stress and elevated financial liability, predisposing them to period poverty. Interventions addressing period poverty rely on mustering collective community voices and deploying adequate policy tools. All the efforts and solutions must provide social and financial protection nets and psychological aid through mental health support groups. It is core to drive menstrual health equity for all menstruators, irrespective of who they are, what they do, and where they live.

Keywords: period poverty, menstruators, COVID-19, mental health, menstrual hygiene

Introduction

Around 1.8 billion people menstruate every month worldwide, meaning at a given point each day, 800 million women and girls menstruate, comprising 26% of the global population. Most menstruators experience their first period between ages 10 and 16, lasting up to about 50 years of age, accounting for more than 50% of their average life span ( 1).

Periods are a difficult time for women because it has an impact on both their physical and mental health every month. Hormonal fluctuations during the premenstrual period activate several neural mechanisms that cause physical (e.g., pain and swelling) and psychological (e.g., negative affect and mood) symptoms ( 2). Blood loss is accompanied by muscle stiffness, cramps, painful breasts, food cravings, mood swings, irritability, fatigue, headache, and swelling.

Menstruation continues to be a normal physiological phenomenon for all menstruators, but safety, accessibility, dignity, and equity during menstruation remain elusive. This frequently causes them to suffer from what is now known as period poverty. Women and adolescent girls are exposed to precarious situations/adverse situations when they bleed, adding to their woes of experiencing excruciating pain and discomfort on a regular basis.

For a healthy and safe period, menstruators need access to clean water, sanitation, and essential menstrual products that are affordable and safe. More than 35% of the world's population lacks these necessities. Poor hygiene measures during menstruation can pose serious health risks, such as reproductive and urinary tract infections, thrush, and others. Menstruators require access to sanitary facilities, clean water, and affordable, safe menstrual products in order to have a healthy and secure period.

Menstrual health needs can also be unmet due to traditional gender roles, cultural taboos, and poor living situations. Young adolescents, nonbinary people, and transgender men are unable to manage their periods in a dignified or safe manner ( 3). Menstruation-related orthodox beliefs, coupled with a lack of menstrual health supplies, menstrual hygiene education, handwashing stations, restrooms, and waste management, deter girls and women from enrolling and attending school or maintaining their employment, jeopardizing their future educational opportunities and livelihood prospects ( 4).

Period poverty also includes the economic vulnerability that menstruators encounter due to the financial burden of buying menstrual pads, cups, or tampons and having to bear related costs of pain medication and underwear ( 5). With people who identify as gender nonbinary and people with disabilities frequently being ostracized in the society, these problems exacerbate existing vulnerabilities, pushing those who menstruate to use unhealthy coping mechanisms. A study in Kenya, for example, reported that a few schoolgirls involved themselves in transactional sex to procure menstrual products in dire situations ( 6).

Period poverty and COVID-19

COVID-19 exacerbated period poverty in many ways, negatively affecting menstruators' physical and mental health. During the COVID-19 lockdowns, supply chains broke down around the world, and many microenterprises in the private sector ceased trading, distribution, and delivery of nonessential goods, particularly in hard-to-reach areas. Retail stores were shut down during the lockdown, and restrictions on movement were mandated. This made procuring menstrual hygiene goods difficult, which turned to become a scarce resource ( 7).

The erratic availability of menstrual supplies forced many belonging to underprivileged communities to use unsafe materials during periods. In remote regions, families facing immense economic difficulties were not able to spend money on buying pads for the women of their families. Consequently, menstruators were compelled to resort to unclean and hazardous homemade alternatives such as rags, dry leaves, ashes, linings, cotton, and mud, which were less effective and dangerous. Using such alternatives lead to reproductive tract infections and illnesses that can be life-threatening ( 8). For example, in India, according to data reported by the Ministry of Health and Family Welfare, only 12% of women and girls had access to sanitary napkins. At the same time, many depend on conventional unhygienic methods during menstruation ( 9). For women residing in slums and crowded areas and dependent on community toilets for sanitation, the social distancing restrictions of COVID-19 made menstrual health and hygiene management an arduous task ( 10).

The interrupting global supply chains caused the cost of menstrual products to rise at an unprecedented rate. Most young girls who bleed are school and college adolescents with financial dependency on their parents. On average, women make up 46% of the labor force around the world, and most of them are homemakers dependent on their male counterparts for their financial needs ( 11).

Other menstruators, including nonbinary persons, are at the highest risk in the hierarchy of financial security. These adverse circumstances in the pandemic, while disrupting livelihoods and straining household incomes, predisposed menstruators to severe financial risk as most could not afford safe menstrual products. During the pandemic and the incumbent lockdown in India, many female migrant workers who were part of the mass exodus to their villages had almost negligible access to toilets or money for food, let alone sanitary napkins ( 8).

During the peak of COVID-19, critical social services and community initiatives that women and girls relied on for support were paused. Similarly, caregivers who were sick and in isolation could not provide washing and toileting assistance, specifically to dependents like people with disabilities, despite these facilities being essential to good menstrual hygiene management ( 12).

In a survey by Plan International concerning menstrual hygiene management, water, sanitation, and hygiene (WASH) professionals from 24 countries reported that COVID-19 had aggravated the situation for menstruators. About 73% of the respondents agreed that the pandemic restricted access to menstrual supplies due to acute shortages in production and dismantled supply chains; 68% said that access to WASH facilities that facilitate privacy for cleaning and disposal of sanitary products was impaired; 58% agreed that prices of menstrual products sky-rocketed, and about 54% felt that there almost was nil menstrual health literacy. About 51% of respondents said there was reduced availability of clean water needed during periods; around 47% felt that the environment for disposal of menstrual products was unavailable, while 24% said that there was emotional distress, stigma, shame, and harmful practices linked with menstruation ( 13).

With the lockdown, millions of students had to stay home as most of the schools and colleges were shut down; the proximity that adolescent girls had with their teachers, family members, and peer networks was absent, which resulted in them having unverified and limited information on their menarche and its management, especially with curriculums and programs around menstrual hygiene not being incorporated into study modules of educational institutions. This challenge heightened in those locations where young people were limited by poor internet connectivity and limited access to virtually available resources ( 13).

Period poverty and mental health

Period poverty has also disempowered women, disrupting their mental health and wellbeing. The lack of means for hygienic management of menstruation can cause discomfort and psychological stress and can add to the shame and sometimes depression that women and girls experience because of menstruation-related taboos and stigma ( 14). Another instance of discriminatory practice during periods is from Egypt, where a study found many schoolgirls reporting that they do not bathe during their menstruation because it is considered a social taboo to come in contact with water during the menstrual cycle ( 15).

A study in Nepal found that many girls were forced to stay in a hut or sleep in the fields during their period even though the government had decreed this practice illegal ( 16). Such malpractices are rampant across the globe as well in India. They have severe psychological outcomes on women and impair their mental health as they become victims of prejudiced societal norms.

COVID-19 triggered a massive 25% rise in common mental health problems of anxiety and depression worldwide ( 18). During the first lockdown in France, 9.6% of 890 women aged 18-50 years had difficulty accessing period protection. About 49.4% of women experiencing period poverty had depressive symptoms, compared to 28.6% of women who had not experienced menstrual poverty, and 40% had anxious symptoms (vs. 24.1%). The links between period poverty and depression were significant. It appeared worthwhile to look beyond the initial symptoms of depression and anxiety in women and inquire about the access to menstrual health products as probable causes ( 18).

The pandemic saw a substantial mental health crisis, wherein the most vulnerable sections felt the brunt of lack of adequate care. Most menstruators facing period poverty reported moderate to severe depression, given their agony of grappling with periods amid an unprecedented health emergency like the pandemic. Young girls felt isolated and lonely as their avenues of seeking menstrual hygiene education, like schools, colleges, and peer groups, were restricted. The associated societal stigma deeply rooted in cultures resulted in overwhelming anxiety with suicidal tendencies and suicides reported in extreme situations of period poverty ( 18).

Periods amid the pandemic prevented young women from going to school and participating in sports and social activities, which affected their physical and mental health. They also found having conversations about the stigma around periods and expressing their feelings difficult, especially with their parents, leaving them with a sense of isolation. Many menstruators from lower socioeconomic classes were compelled to forego food and necessities in favor of menstrual supplies risking their physical health. This led to financial burdens as well as emotional stress and anxiety. The government and civil society's efforts toward distributing menstrual hygiene products and ensuring menstrual equity were also denuded in the wake of COVID-19 lockdowns, and a lack of menstrual health education led to increasingly poor mental health outcomes ( 12).

Menstruators living in urban areas, especially working women, were also presented with significant challenges. As the burden of domestic responsibilities increased, the boundaries separating personal life and jobs diminished due to working remotely from home. They suffered from an additional strain of dealing with menses during a lockdown, probably while suffering from COVID-19, which disproportionately impacted their mental health ( 8).

Since the stress levels were at an all-time high during the pandemic, the menstrual cycles of a large number of women became erratic. Studies claimed that stress-related irregular menstruation cycles were typical, which is problematic since it is associated with infertility and severe mental health issues, among others. One of the research also revealed that the newly introduced COVID-19 vaccine also caused menstrual irregularities for many people, though for a short duration ( 18, 19).

Another study sought to investigate the mental health status and menstrual changes of hospitalized female COVID-19 patients in the isolation ward of an Indonesian national referral hospital between January and August 2021, with follow-up for 3 months after discharge. Among the 158 female patients, there was an increase in patients with a cycle length of more than 32 or 24 days, as well as significant increases in menstrual irregularity and heavy menstrual bleeding. Following COVID-19 infection, 37.3% of patients reported a change in menstrual pattern. Neurotic symptoms were reported by 32.3% of the women, psychotic symptoms by 12.7%, and posttraumatic stress disorder symptoms by 38.0%. Patients suffering from mental health issues were twice as likely to report a menstrual change. This demonstrates that menstrual changes and increased symptoms of mental health disorders during COVID-19 are linked to each other ( 20).

Discussion

The pandemic has not just been a public health crisis. COVID-19 in the past 2 years has highlighted the lingering challenges associated with menstrual health. It ranged from inadequate water and sanitation facilities to a lack of menstrual health education to incompetence in addressing cultural stigma ( 21). It has proven to be a "syndemic" with a looming mental health crisis and ostracization of those already vulnerable, including menstruators facing period poverty. This deleterious event is a stark reminder of our frail social protection net, which crumbled under an unprecedented health emergency. Though the COVID-19 pandemic is dwindling and the world seems to return to a new normal, it has left an indelible impact on our lives. Therefore, in a world constantly reclaiming the losses due to the pandemic, it becomes imperative to deliberate on actions that address period poverty.

There needs to be a global call to build community responses that encapsulate the essence of inclusivity. This is imperative to ensure those who have faced the devastating impact of the pandemic and sit at the bottom of the social and economic pyramid are reached, and their health needs are met. Menstrual hygiene management should be a part of the government's health response during any emergency. This includes disseminating menstrual health and hygiene information as part of more extensive health campaigns. There needs to be coordination between Health and Education departments so that protection against period poverty is built into all recovery responses. As part of a remote online learning curriculum, integrating menstrual education should be a prerogative for all educational institutions. It should also be realized that menstrual hygiene education is not only for adolescent girls; boys also can reap its benefits. Imparting adequate education to all girls and boys on menstruation at an early age at home and on school premises promotes early initiation of safe menstrual health practices and challenges the persistent stigma around a naturally occurring biological process ( 7).

Policy efforts at the union and federal levels should push to bring down the cost of sanitary products and improve their access, specifically among those who are vulnerable and in need of community support. Encouraging local medium and microenterprises to meet the demands of menstrual supplies and eventually decline the reliance on global supply chains can help address the issue of shortages in emergencies like the pandemic ( 7). Other policy instruments include distributing menstrual products free of cost or at subsidized prices for those who belong to low-income groups and in public avenues like schools and shelter homes. The provision of subsidies is also an effective mechanism to incentivize local entrepreneurs, specifically self-help groups and women cooperatives, to manufacture their menstrual hygiene products and be the torchbearer of disseminating menstrual health literacy in their communities. Social enterprises and nonprofits can play a crucial role in driving the menstrual health education movement at the grassroots ( 21).

To steer financial inclusion, direct conditional cash transfers can also be one of the many tools which can be administered that consumers can use to buy menstrual products. This can enable poor communities to buy affordable products and shift the orthodox perceptions that prevail on the utility and value of such menstrual supplies ( 21).

Tax exemptions on all sanitary products should be a mandate. Public advocacy for tax reforms for menstrual products is one lever, when deployed, can help address the affordability of sanitary products for one and all. It can lay the foundation for a far-reaching information, education and communication (IEC) campaign and raise awareness about menstrual health and hygiene around the globe. An all-inclusive response to address period poverty should be adopted with a gender equality construct prioritizing the menstrual equity policy ( 21).

About 1.7 billion people globally do not have access to necessary sanitation services. In countries tagged as developing nations, around 75% of people lack basic handwashing facilities at home ( 22). Therefore, in addressing period poverty, all the proposed interventions must tackle infrastructural impediments like better water access and address archaic societal norms, stigma, and discrimination in male-dominated household settings ( 7). Drawing investments in essential public health infrastructure, including water and sanitation systems, is a proven strategy to address the lack of access to menstrual products in resource-constrained settings. Proper waste management practices and WASH facilities must be provided to curtail COVID-19 spread and ensure that respectful menstruation is maintained during any emergency response and in the future, as countries focus on building back better ( 13, 21).

Other than being a physiological phenomenon, periods or menstruation is affected by social determinants involving the requirement of better health services, education, inclusive workplaces, the emancipation of women, and in a larger sense achieving gender equality. Therefore, there cannot be a denial that menstruation, education, public health, and poverty link together ( 6). Despite concurrent efforts to include menstruation in these domains, period stigma, shame, and taboos are prevalent in all households, health centers, institutions, and public spaces. Period poverty inadvertently poses physical, mental, and emotional challenges for people who menstruate. Menstrual health and hygiene management is an impetus to achieving universal health coverage. Alleviating period poverty remains a social justice and human rights issue that needs to be endorsed and promoted by the governments, civil society, and, most importantly, the citizens.

Data availability statement

The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author.

Ethics statement

Ethical review and approval was not required for this Perspective in accordance with the local legislation and institutional requirements.

Author contributions

SD and AR conceptualized the paper together. SD provided intellectual input for details of the paper. AR wrote the first draft. SD edited the paper. All authors contributed to the article and approved the submitted version.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor AP declared a past co-authorship with the author SD.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

References

14. McCammon E, Bansal S, Hebert LE, Yan S, Menendez A, Gilliam M. Exploring young women's menstruation-related challenges in Uttar Pradesh, India, using the socio-ecological framework. Sex Reprod Health Matters. (2020) 28(1):1749342. 10.1080/26410397.2020.1749342 [[ PubMed] [ CrossRef] PMC free article] [ Google Scholar]

15. El-Gilany AH, Badawi K, El-Fedawy S. Menstrual hygiene among adolescent schoolgirls in Mansoura, Egypt. Reprod Health Matters. (2005) 13(26):147-52. 10.1016/S0968-8080(05)26191-8 [[ PubMed] [ CrossRef] Google Scholar]

16. Thomson J, Amery F, Channon M, Puri M. What's missing in MHM? Moving beyond hygiene in menstrual hygiene management. Sex Reprod Health Matters. (2019) 27(1):12-5. 10.1080/26410397.2019.1684231 [[ PubMed] [ CrossRef] PMC free article] [ Google Scholar]

20. Muharam R, Agiananda F, Budiman YF, Harahap JS, Prabowo KA, Azyati M, et al. Menstrual cycle changes and mental health states of women hospitalized due to COVID-19. PLoS One. (2022) 17(6):e0270658. 10.1371/journal.pone.0270658 [[ PubMed] [ CrossRef] PMC free article] [ Google Scholar]

Articles from Frontiers in Global Women's Health are provided here courtesy of Frontiers Media SA

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Period poverty and mental health of menstruators during COVID-19 pandemic: Lessons and implications for the future

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Menstruation is a naturally occurring phenomenon; however, millions of adolescent girls and women, as well as nonbinary persons who bleed every month, are deprived of menstruating safely and respectfully. Those belonging to marginalized sections face ...

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How Does Period Poverty Have a Negative Effect on Teenage Girls

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How Does Period Poverty Have a Negative Effect on Teenage Girls

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Janet Michel, Annette Mettler, Silvia Schönenberger, Daniela Gunz

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Period poverty: why it should be everybody’s business | Published in Journal of Global Health Reports

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By Janet Michel, Annette Mettler & 2 more. Period poverty, defined as a lack of access to menstrual products, hygiene facilities, waste management, and education, affects many women causing physical, mental, and emotional challenges…

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NYC City Council Tackles Bill to Boost Menstrual Product Access

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NYC City Council Tackles Bill to Boost Menstrual Product Access

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A City Council committee scrutinized five bills Monday aimed at increasing access to menstrual products for both students and individuals in the criminal justice system.

The legislative package, which also includes increasing education about feminine hygiene items, was the focus of the Sept. 18 meeting of the City Council's Women and Gender Equity Committee, chaired by Queens City Council Member Tiffany Cabán. It follows up on legislation the council passed in 2016 to increase menstrual product access.

All elementary and secondary public schools in New York State that serve sixth through 12th graders are required to provide free feminine hygiene products in school restrooms and buildings, as mandated by a bill that took effect in 2018.

"We must have laws and policies that ensure menstrual products are safe and affordable and available for those who need them," Cabán said at the hearing. "We are here to revisit these laws and highlight the potential shortcomings and implementation to ensure we address them adequately to meet the needs of people who menstruate in the city."

The hearing was attended by representatives from the city's Department of Education (DOE), Department of Correction (DOC), and Department of Citywide Administrative Services.

Bronx Council Member Amanda Farías (D-18), who is co-leading the efforts to pass five bills related to menstrual products, also spoke at the hearing. Farías said that the Council is working to remedy the historical neglect of access to menstrual products.

"Menstrual equity is centered on removing barriers to access and removing the long-ingrained stigma surrounding our periods, who uses them, and how available they are to us," Farías said.

Melanie Weniger, the deputy executive director for policy and programs for the city's Commission on Gender Equity, is leading a team that monitors policy and legislation, develops and implements programming, and conducts research related to the commission's three areas of focus, which includes health and reproductive justice.

Weniger shared comments on the five bills being discussed: Intro 1055, Intro 1056, Intro 1057, Intro 1058, and Intro 1059.

Intro. 1055 would require the DOE to annually report on its supply of menstrual products to students in its facilities.

Intro 1056 would expand the number of schools and school grades required to provide menstrual products to students.

Intro 1057 would require the DOC to annually report on the distribution of menstrual products to incarcerated or detained people in its custody.

Intro 1058 would require the city's Department of Mental Health and Hygiene to create educational materials on menstrual products.

Intro 1059 would expand the term "feminine hygiene products" to include menstrual cups, a reusable product that collects blood.

"The administration appreciates the intent of the legislative package and looks forward to discussing these bills further with Council," Weniger said. "The Adams administration recognizes that access to period products, particularly for vulnerable New Yorkers, is a vital step toward gender equity."

Weniger said that the administration has expressed "concern" regarding two of the bills: Intro 1057's requirement to produce an annual report on the supply of menstrual products to incarcerated people and Intro 1059's proposed use of menstrual cups.

Kat Thomson, the chief of staff with the DOC, told the Council that the agency currently offers pads and tampons in its housing area, aid stations, intake areas, and court commands. There is a commissary where people can purchase tampons and maxi pads, according to Thomson.

The DOC recently ordered more tampons in the last three years because of a lack of availability for incarcerated and detained people.

Questions were raised about the ability of incarcerated individuals being able to afford menstrual products, which cost $15.60 for a 40-count supply of Playtex tampons and $3.90 for a 10-count supply of Tampax tampons, according to Thomson. She noted that incarcerated individuals can earn hourly wages between 55 cents to $1.55, depending on which one out of three wage structures they are in.

"They would have to possibly work 15 hours to afford one box of tampons," Cabán pointed out. "The wage doesn't reflect the need to have sufficient funds to cover the cost of what are necessary products."

Weniger said that the city administration does support Intro 1055's aim to pivot to using the term "menstrual products" on documents and materials, as opposed to "feminine hygiene products" because it is more gender neutral.

"The administration supports the use of the gender-neutral term "menstrual products," Weniger said. "The administration also recognizes the importance of increasing product access to students and is happy to discuss our shared goals further with council."

There already have been steps towards meeting the legislation proposed by a couple of the new bills, according to Weniger.

She told the Council that the administration "has already taken the steps to expand product access" to schools that serve fourth and fifth graders and that dispensers for pads have been installed in single-occupancy restrooms and public schools this summer.

Farías pointed out that every time she visits a school in her district, there "they are always empty pads and tampon dispensers."

"I've gone into every bathroom in the school that I visited, and there's not a single menstrual product available," Farías said. "My question lies with how are we actually enforcing it and ensuring that principals understand that free accessible products are indeed mandated by law for our students, and it needs to be followed?"

John Shea, the CEO of the DOE's Department of School Facilities, responded to the inquiry stating that school custodians have "clear direction that they are supposed to maintain stocks of all of these products at all times in their bathrooms."

"What you have described is unacceptable," Shea said. "If there is an issue with dispensers not being stocked, there's an escalation process that starts with the school. If that's not successful, people can always escalate that beyond the school to my office."

Responding to Intro 1058, Weniger said that the DOE's Office of School Wellness already disseminates a brochure on period facts to schools and its principals.

"Schools can request these brochures for their students," Weniger added. "The Menstrual Equity Workgroup is working on developing more materials for students on these issues."

Despina Zaharakis, the senior director in the DOE's Office of School Wellness Programs, said that starting in the sixth grade, students are taught about the types of menstrual products that are available.

When menstrual products were supplied in all of New York's schools in 2018, a brochure - albeit somewhat outdated now - providing period facts was also distributed. As of last week, only 11 schools in the DOE system had reached out requesting the brochure.

"We need to update things," Zaharakis said. "It's not an in-house brochure, and it's only in English and Spanish."

Zaharakis said that the DOE's health team is thinking about how to "include menstrual product information" within lessons in fourth and fifth grade that focus on developmental growth.

"We are creating a flyer that will be available in all languages," Zaharakis said. "Principals will be able to print and post that there are free products and where they are available."

Weniger said the city is relaunching its Sexual Health Education Task Force to ensure that New York City students "are able to access high quality, comprehensive sexual health education."

"Every agency is doing what it needs to do to ensure that their clients know about their rights to access products," Weniger said. "We know that that is going to be part and parcel of this work to reduce shame and stigma and to help more New Yorkers be aware of their rights to access products and where they can find those products available to them."

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City Council tackles bills that aim to boost menstrual product access for students and inmates | amNewYork

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A City Council committee scrutinized five bills Monday aimed at increasing access to menstrual products for both students and individuals in the criminal

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CouldYou? is a New York-based non-profit dedicated to curating, proving and
scaling solutions to poverty.

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Help Always #EndPeriodPoverty So No Period Holds Her Back

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Help Always #EndPeriodPoverty So No Period Holds Her Back

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A recent study conducted by Always revealed that, since the COVID-19 pandemic, over 1 in 3 young people feel less confident because they've missed after school activities1 nearly 1 out of 3 parents are worried about their ongoing ability to afford period products - an issue known as period poverty.2

When girls don't have access to period products, not only do they not feel protected, but it also puts their confidence, dignity and education at risk. They're less likely to be able to participate in their education & other activities, and if they are, they're likely to feel distracted and unable to focus on reaching their full potential.
Despite the ongoing challenges, Always wants to show girls that they're #SupportedAlways and help #EndPeriodPoverty, so that periods don't hold young people back.
Always has championed girls' confidence for 35+ years and has donated more than 50 million pads since they started their #EndPeriodPoverty campaign in the US. This spring, Always continues the good work.

You can help us do more! Join Always to help keep girls focused on learning and engaging in the activities that help them build their confidence.

2 Ways You Can Help #EndPeriodPoverty
during March - June 2022

Participating Retailers & Dates of their #EndPeriodPoverty Support:

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Meta Description Always is committed to help #EndPeriodPoverty by donating 15 million period products to girls in need. Learn more here and join our mission!

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https://www.menstruationresearch.org/about/#mission

the source of guidance, expertise, and ethical considerations for researchers, practitioners, policy makers and funding resources interested in the menstrual cycle.

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Menstruation Gets a Gen Z Makeover (Published 2022)

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Young people want alternatives to disposable tampons and pads — and they’re not embarrassed to talk about it.

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Power Point, Menstrual Literacy and Advocacy in Libraries

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Power Point, Menstrual Literacy and Advocacy in Libraries

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027 to 612.662:  Libraries and Menstrual Literacy

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Distributing menstrual products to people in need.

PERIOD. donates product in bulk to over 400 organizations across the country and around the world who directly serve people who menstruate. Additionally, PERIOD.'s 400+ chapters work to eradicate period poverty in their own communities.

Join our service community or learn how to take action against period poverty through service.

Providing educational resources for menstruators and allies to explore intersectional approaches to menstrual equity.

Menstrual equity combats both period poverty and stigma. PERIOD. empowers local activists with grassroots training and education to find an approach that is compatible with their community. Our global network can be a tool for young activists to learn how to best serve those experiencing period poverty.

Learn more through: period-action.org/education

Read More on The Rag

Advocating for systemic change through policy & legislation.

Menstrual health is a matter of human rights. People who menstruate deserve affordable and accessible menstrual products, untaxed and available in public places like schools, shelters and prisons. Our youth-powered movement will make systemic change through law and policy to end period poverty in our lifetime.

Looking for a policy tracker? Find out where period products are still taxed and where they are mandated in public places below: advocacy.period.org

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Working to end period poverty and period stigma.

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Recommended Period Power and Sex Ed Books for Kids, Teens and Adults

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Recommended Period Power and Sex Ed Books for Kids, Teens and Adults

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Recommended Period Power and Sex Ed Books for Kids, Teens and Adults

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Green Orange Blue Colorful Simple Summer Bingo Instagram Story

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It's not acceptable that because of a natural bodily function women and girls continue to be prevented from getting an education, earning an income and fully and equally participating in everyday life.

While Menstrual Hygiene Day is on 28 May, our team and our partners work all year round to:

Break the taboos and end the stigma surrounding menstruation

Raise awareness about the challenges regarding access to menstrual products, education about menstruation and period-friendly sanitation facilities

Mobilise the funding required for action at scale

All of this contributes to our overarching goal: to build a world where no one is held back because they menstruate by 2030.

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It's not acceptable that because of a natural bodily function women and girls continue to be prevented from getting an education, earning an income and fully and equally participating in everyday life.

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https://www.linkedin.com/in/rakishawhite/

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Rakisha Kearns-White established the Cycle Alliance, a teen advocacy group that fights period poverty and the stigma of menstruation. Since spring 2020, more than 170 teens have attended workshops, helped with distribution days, or volunteered for Cycle Alliance programs. The Cycle Alliance has partnered with international and local organizations to offer period-product distribution days and safe-sex workshops, giving out 200 period kits since 2021.

CURRENT POSITION
Senior Young Adult Librarian, 3, Brooklyn Public Library, NY
DEGREE

MLIS, Pratt Institute, 2004

DEGREE

Six months of pandemic lockdown left Kearns-White depressed, bored, lonely, and burned out. Then she discovered the K-pop group BTS, and they reinvigorated her.

FOLLOW

Twitter @Rakisha72; bklynlibrary.org/cycle-alliance; goodreads.com/rakishabpl
Photo by Gregg Richards, Brooklyn Public Library

In 2018, a young Brooklyn Public Library (BPL) patron began menstruating unexpectedly. They approached two male employees before receiving help from Rakisha Kearns-White, a senior librarian who offers puberty workshops at the library. Kearns-White learned that BPL's bathrooms lacked much-needed menstrual protection products and that many youths cannot afford or access menstrual hygiene products privately.

Kearns-White established the Cycle Alliance, a teen advocacy group that fights period poverty and the stigma of menstruation. Since spring 2020, more than 170 teens have attended workshops, helped with distribution days, or volunteered for Cycle Alliance programs. The Cycle Alliance has partnered with international and local organizations to offer period-product distribution days and safe-sex workshops, giving out 200 period kits since 2021. In 2023, BPL's Youth Wing began offering both the Period Pantry, stocked by in-kind product donations of menstrual pads, tampons, incontinence protection, and menstrual cups, and an official condom distribution site in partnership with New York City's Health Department. Product dispensers in staff and public bathrooms provide free supplies across all 61 branches of the BPL system. Kearns-White also spearheaded a postcard-writing campaign asking federal representatives to make diapers and menstrual products electronic benefit transfer-eligible.

"Rakisha embodies the role of librarianship in improving access to essential information and services, particularly those withheld because of discomfort, stigma, or bias," says Lisa Goldstein, division chief of BPL's Central Youth Wing. Kearns-White has a specific reason for that approach: "When I plan programs for teens, I'm planning programs for my two children."

Get Print. Get Digital. Get Both!

Brooklyn Public Library public library

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Rakisha Kearns-White | Movers & Shakers 2023-Change Agents

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Rakisha Kearns-White established the Cycle Alliance, a teen advocacy group that fights period poverty and the stigma of menstruation. Since spring 2020, more than 170 teens have attended workshops, helped with distribution days, or volunteered for Cycle Alliance programs. The Cycle Alliance has partnered with international and local organizations to offer period-product distribution days and safe-sex workshops, giving out 200 period kits since 2021.

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Recommended Period Power and Sex Ed Books for Kids, Teens and Adults

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Recommended Period Power and Sex Ed Books for Kids, Teens and Adults