- Period poverty is the inability to access period supplies like pads, tampons, and menstrual cups.
- A number of factors during the pandemic led to a rise in period poverty, including income loss and closures of schools and public bathrooms.
- Advocates say legislation can play an important role in assuring individuals in need can access period products.
When COVID-19 first hit the United States in early 2020, items like toilet paper quickly became a hot commodity. It made Marni Sommer, a Doctor of Public Health and researcher on menstruation, curious if the same was happening with period supplies.
“I saw the run on toilet paper and thought, ‘well what about menstrual products?’ and noticed people were grabbing those, as well,” she said. “Most of us were staying home at the time and I wondered what that meant for people with perhaps less privacy living in constrained environments to be able to manage their period with dignity.”
Sommer and her colleagues at the Columbia University Mailman School of Public Health set out to quantify the impact of the pandemic on people who menstruate.
In partnership with the CUNY School of Public Health, they recently published a study that found income loss during COVID-19 led to a significant rise in the number of people unable to access menstrual supplies in the United States. The results were published in the American Journal of Public Health.
The study is part of a growing effort to shed light on period poverty, or the inability to access period supplies like pads, tampons, and menstrual cups, both globally and in the United States.
The World Bank estimates that period poverty affects 500 million people across the globe.
While data is lacking in the U.S., research published in 2019 found that two-thirds of American women with low income had been unable to afford period products during the previous year. One-fifth of participants experienced this monthly.
“When we speak about vulnerable populations, we talk openly about housing insecurity and food insecurity, but we don’t talk about menstrual products,” Sommer said. “We have very little data on how people manage their periods and what people’s needs are around these issues.”
For the new study, Sommers and her colleagues collected information on nearly 1,500 individuals who menstruate from March to October 2020.
Half of the participants reported an economic loss during the pandemic.
The study authors reported that the odds of not being able to afford period products for those who experienced income loss was 3.6 times that of those who had no income loss.
Unsurprisingly, lower-income participants were nearly 4 times as likely to experience period poverty as higher-income participants.
“Our key finding was that any type of income loss associated with the pandemic’s arrival, whether that was the person themself or whoever brought income into the household, was a strong predictor of menstrual product insecurity,” Sommer said.
In addition to loss of income, the inability to leave home due to underlying health conditions, challenges with transportation, and a lack of internet access or credit to purchase period supplies online also contributed to period poverty, the researchers reported.
Closures of many public services also played a major role.
“Food pantries, public spaces, public bathrooms, libraries, these are some of the common areas that people were normally able to go and access period supplies, but they no longer had access to them,” said Jennifer Gaines, director of the Alliance for Period Supplies Program.
Angie Wiseman, executive director of Dignity Period, a non-profit organization that distributes menstrual supply kits to middle and high schools across the U.S., said school closures during the pandemic greatly impacted access to period supplies among young people.
“Many students rely on school ‘community closets’ or backpack programs for supplies,” she said. “Likewise, many teachers and nurse offices carry a supply of pads for those in need. However, when schools were closed, there was no way to access the supplies.”
Research done by U by Kotex, the founding sponsor of the Alliance for Period Supplies Program, also found a significant rise in period poverty during the pandemic.
The study published in May 2021 found that 2 in 5 people struggled to purchase menstrual products, a 35 percent increase from the brand’s initial research in 2018.
The research also showed that Black and Latinx communities are disproportionately affected.
Not having access to adequate period supplies can have a number of negative effects on a person’s life.
“Globally, lack of access to menstrual products has prevented menstruating girls and women from attending school or being able to go to work due to shame and stigma surrounding their cycles and anxiety surrounding bleeding,” said Dr. Tara Shirazian, a gynecologist at NYU Langone Health and founder of Saving Mothers, a non-profit organization dedicated to minimizing health disparities and empowering women and girls. “This anxiety can have lasting consequences on education and even job opportunities.”
When teaching menstruation and global health courses at Columbia University, Sommer asks her students what decisions they would make if they had no access to period supplies or restrooms.
“[I’ll ask] ‘How many of you would have ridden the subway or taken a bus or driven here today and be willing to sit in class or a meeting all day long and go about doing those quick errands on the way home if you had no products or if you have no place to change?’” she said. “I think it just fundamentally alters your ability to go about your daily life.”
The expense of period supplies each month also means many people with limited income must decide between basic necessities like groceries and menstrual products.
“If you’re living in a household and you have children to feed, as a mother myself, I’m going to choose food over a product that I need for myself,” Gaines said.
In households where multiple people menstruate, adults often provide menstrual products for their children and forgo supplies for themselves.
Members of the transgender community also face unique barriers.
“Even if period products are available in [school or public] bathrooms, they might just be available in the women-identified bathroom, which doesn’t help to provide products for all,” Gaines said.
When period supplies are scarce, many are left to resort to makeshift items to manage their blood flow, such as rags, old clothes, and rolled-up pieces of toilet paper, paper towels, or tissue. These items are less than ideal and may lead to leaks on clothing, exacerbating feelings of anxiety and embarrassment.
Advocates say the first step to addressing period poverty is to raise awareness of its existence both in the U.S. and around the world.
“It’s raising awareness in your local communities, with co-workers, with friends, with your local elected officials, and educating them on what period poverty is, what are the different aspects of it, and how people are impacted,” Gaines said.
The Alliance for Period Supplies created an annual Period Poverty Awareness Week in May to educate and raise awareness on the issue and the impact it has on people who menstruate in the most vulnerable populations.
After awareness, a major area of focus is legislation.
“Once we continue to educate legislators and elected officials, we can start making more progress to pass more menstrual equity bills,” Gaines said. “That means passing bills that provide free period products in schools so that students don’t have to worry about where they’re getting their products from. It means passing bills that provide period products in prisons and jails systems because that is also a huge issue.”
Menstrual products are not included in most American public assistance programs. They cannot be purchased under the Supplemental Nutrition Assistance Program (SNAP) or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
The Coronavirus Aid, Relief and Economic Security (CARES) Act in 2020 enabled certain segments of the population to use health savings accounts and health reimbursement arrangements for menstrual products.
However, this represents only limited progress, Sommer said.
“I think government has a role to play to make sure that menstrual products are perceived as essential items so that when you go to a food bank or a service organization or you get some kind of credit to purchase basic necessities, subsidized or free, menstrual products are recognized for what they are as essential items,” she said.
Recognizing period supplies as essential items, like food and medicines, would also mean they wouldn’t be taxed. Currently, period products are still subject to state sales tax in 27 states. After a national campaign launched in 2015, many states introduced measures to eliminate the so-called “tampon tax.”
Groups like Period Equity are working to make menstrual products tax-exempt in all 50 states.
If you’re having trouble affording period supplies, there are resources that can help.
Individuals in need of menstrual products can contact 211 either by visiting 211.org or calling 2-1-1 for local assistance.
Gaines also recommends contacting local social services providers, such as churches, shelters, and food pantries.
The Alliance for Period Supplies lists community-based nonprofit organizations that collect, warehouse, and distribute menstrual supplies in local communities across the United States.