By Meerab Malik
Meerab Malik discusses the struggle many low-income women and girls face while trying to afford menstrual products. She uses data from primary and secondary sources to try and understand the consequences of this ‘period poverty’ in their daily lives.
Period poverty is a relatively new term in medical literature which has been defined as inadequate access to menstrual supplies, menstrual hygiene awareness, education, and tools, including but not limited to washing facilities, waste management and sanitation. Almost half of the world population is female—this single statistic powerfully illustrates that half the world bleeds and hence period poverty has a damaging impact on women.
The ‘tampon tax’ or the ‘pink tax’ is charged specifically on sanitary products in almost every country.
This makes it a financial burden and reduces access to menstrual supplies for many menstruators.
However, stigma, taboos and restrictions around menstruation also heavily contribute to period poverty.
For example, when young girls and women are not equipped with the knowledge on how to manage their periods safely and with dignity, the notion that periods are ‘impure’ is further forced, creating a never-ending cycle where no one talks about it, eventually paving way for misconceptions, myths and misinformation.
This makes women extremely vulnerable to gender-based violence, child marriages, gender discrimination, health issues, and negative economic well-being. Therefore, period poverty is not only an economic issue but also a social and political one.
Aim and Rationale
The reason I chose to research this topic is that growing up, my parents never educated my siblings or me about puberty, sex and all that entails it. This meant that we learnt through our friends and other sources. Naturally, we came to believe that it was a forbidden topic to discuss and thus never mentioned it. However, for me personally, this brought up feelings of shame and embarrassment only.
Fortunately, in 10th grade, I ended up attending a seminar on sexual and reproductive health for women and the first thing they addressed was the very feeling of shame and embarrassment within me that I could not understand. Since that day, I have been actively advocating for normalizing conversation about periods so that no girl has to feel inferior or disadvantaged because of a basic, biological process.
Pandora’s Box is a documentary film where issues pertaining to achieving menstrual equity and therefore eliminating period poverty are discussed from a global point of view.
Period poverty is investigated in the US, the UK, India, Canada, Uganda, and Kenya. It reveals how period poverty is not only an issue in developing nations but also prevalent in some of the most well-developed nations.
For example, according to Plan International’s report, 1 in 3 Canadian women under 25 had struggled to afford sanitary products.
The film went on to explore how eliminating period poverty doesn’t end with only providing sanitary products; barriers to education and information must also be eradicated.
Personal stories from Kenyan Christine Khamasi and American Topeka K. Sam further emphasized the urgency of eliminating period poverty.
Other than exposing the harsh reality of period poverty, the film also highlights ways in which nations have progressed: in 32 US states, measures to eliminate the tampon tax have been introduced, with 8 states being fully successful in removing it, and Kenya has also committed to providing free period products in schools to girls (Snow, 2020).
Our Menstrual Manifesto: how we change the conversation about periods is a blog written by Rachel Crews, the content manager for Plan International UK, where she examines the approach needed to break the stigma around periods.
The six ways listed in her menstrual manifesto are backed by research conducted by Plan International UK where they found that negative talk surrounding periods affects a girl’s self-esteem which puts her physical health at risk.
They also found that in the UK, 40% of girls used toilet rolls since they couldn’t afford sanitary napkins. Furthermore, 14% of the girls weren’t aware of what was happening when they started their period. Therefore, in order to combat the issue of period poverty, the menstrual manifesto calls for the following
‘Commitment to listening to girls and other menstruators’ where voices of those experiencing menstruation are at the forefront;
‘A change in the conversation about periods’ where menstruation is a normalized topic;
‘Real world education’ where knowledge alongside menstrual supplies are available and provided to all primary and secondary students and parents;
‘An end to period poverty’ which will be done through introducing p-card scheme similar to the c-card scheme where, just like contraceptives, sanitary products will be made available to women and young girls;
‘Companies acting as part of the solution’ where they advertise products in a way that shifts the focus to the empowerment of women; and
‘Investment in research’ where government entities take charge by funding menstrual hygiene management research and pilot projects (Crew, 2018).
Nepal’s menstrual huts: what can be done about this practice of confining women to cow sheds is an article which investigates the practice of exiling menstruating women from their homes; it is known as ‘chaupadi’ and is practiced not only in Nepal but also globally.
This is an extreme example of stigma around menstruation which stems from deeply rooted cultural beliefs about periods being impure leading to women being seen as inferior.
Young girls internalize these feelings and this negatively impacts their self-esteem.
Further restrictions are also placed on women when menstruating, for example, not coming in contact with men and/or entering the kitchen or the temple.
To challenge the menstrual stigma which is a contributing factor to period poverty, the authors of the article have heavily emphasized collaborating with local communities and partners, making use of media, photography and films to empower young women to use their voices and be active changemakers rather than passive victims. Government ministries should also support these events and activities to catalyze change (Vaughn, 2019).
Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia is a study where knowledge about what periods are and determinants of menstrual hygiene—whether girls have access to toilets, sanitary napkins etc.—are examined to see their effect on school absenteeism among adolescent school girls.
In this study, it was found that only half of the sample, 51.36% had information about menstruation and its management.
This eventually meant that the majority of girls experienced negative reactions when they went through their first menstruation.
The qualitative data of the study supports these findings; girls went through psychological trauma and misconceptions about periods since they didn’t have prior knowledge about it.
They also found that only 38.5% of the girls used disposable sanitary napkins during their last cycle, and the rest used rags, old cloth, paper etc.
Therefore, school absenteeism was observed to be higher amongst girls who didn’t use disposable sanitary napkins; over half of the girls, around 54.51% had been absent from school (BMC Public Health, 2014).
Period. End of Sentence. is a documentary highlighting the causes of period poverty and its impact on women of a small, rural village called Kathikhera in India.
They interviewed women of all ages—from married to unmarried and old to young—and found that a majority of them weren’t aware of why menstruation occurs and, in turn, how to properly manage it. They had also never heard of a pad.
Some women, who knew what pads were from seeing them on the TV or in stores, talked about how they couldn’t afford them due to high prices.
The documentary explored how in a male-dominated and patriarchal society, women found it difficult to voice out their needs and talk about their rights. These women had to discreetly throw their pads away from the male gaze and continue being embarrassed and ashamed about it.
The fact they didn’t have the correct information regarding sanitary products and adequate access to them resulted in many young girls dropping out of school and getting married at an early age.
Apart from this, those who continued their education were in constant fear of leakage during their periods and then being teased by their classmates.
Period poverty not only affected their health but also hindered their economic development.
Arunachalam Muruganantham invented a low-cost, sanitary napkin machine and created a sustainable by-women, for-women business where females were employed, trained and educated.
They named their sanitary napkins “fly” because they wanted women to soar and reach their full potential (Zehtabchi, 2022).
State of the period is a survey report commissioned by Thinx Inc., a period solutions company known for its creation of period-proof underwear, and PERIOD, a youth-led nonprofit group focused on combating period poverty and stigma.
The survey looked at the widespread impact of period poverty on US students from the Harris poll of 1,000 US teens who menstruate between the ages of 13 to 19.
They found that across all demographic groups (including, age, household income, living in both urban and rural areas, and attending public and private schools), there was a lack of access to period products which led to two-thirds of teens feeling stressed amongst other consequences. Feelings of shame were also reported which led to increased emotional anxiety; 66% of the sample did not want to be at school whilst on their period.
Furthermore, lack of education about periods and educational repercussions due to a lack of access to period products were also examined and it was found that 79% of the sample felt that they needed more in-depth education around menstrual health (Thinx & PERIOD, 2021).
Period poverty and mental health implications among college-aged women in the United States is an academic research/study which examines the frequency of period poverty among university students and associations with poor mental health.
From the sample, 14.2% of women had experienced period poverty in the past year with 10% of women experiencing period poverty every month.
Women who experienced period poverty scored higher on the depression PHQ-9 scale. This leads to the conclusion that many young women who are unable to afford sanitary napkins and thus properly manage their periods suffer from poor mental health.
For example, 63% of college students felt “overwhelming anxiety” in the previous 12 months according to the 2018 American College Health Assessment. 12.7% had also considered suicide in that same time period.
Therefore, in order to support women, sanitary products should be made available for free in schools, colleges, universities and public restrooms (Cardoso F. Lauren et al, 2021).
Break the Taboo. Period. is a short drama film which depicts how the stigma and taboos surrounding periods undermine the well-being of girls and young women. It instills not only feelings of shame but also restricts their access to sanitary products.
In an office environment which is heavily male-dominated, as seen in the film, the stigmas are further forced with no one talking about periods.
When the need arises, women feel ashamed to communicate why they may be in pain or may need sanitary products. Not communicating and silently suffering greatly affects one’s mental health. Women also miss out on work and job opportunities which makes them financially vulnerable.
We need to make sure that the masses are equipped with the correct reproductive and sexual health knowledge so they don’t shy away from having conversations about periods which is a natural, biological process.
The film powerfully depicts the fact that period blood is the only blood that is not born out of violence yet it is the one we find to be most disgusting! (Subramanian, 2020)
In order to investigate the impact of period poverty on women, a short survey, created on google forms, consisting of 9 quantitative response questions and one open-ended question to collect qualitative responses, was sent out to people who menstruate using various online platforms.
This was done so that the responses could easily turn into statistical data and be analyzed objectively to make the results more reliable, as well as to ensure the validity of results by allowing participants to type individual comments if they wished to do so.
The survey was answered by 84 participants:
7.1% were under 15
47.6% were between the ages of 15 – 20
27.4% were between the ages of 20 – 25
8.3% were between the ages of 25 – 30
9.5% were above the age of 30
48% of girls said that overusing a sanitary product impacted their health because they couldn’t afford a fresh one (Leonard, 2018). 49% of girls have missed an entire day of school because of their period, of which 59% have made up a lie or an alternate excuse (Leonard, 2018).
Over 1,000 British women, half of them between the ages of 18-24, admitted that their ability to work had been affected by period pain and gave a different reason to their employer for their poor performance at work.
If people are embarrassed to talk about periods, the associated problems will not be raised or analyzed, and therefore continue to be poorly understood and addressed (YouGov, 2016).
From the data collected, as well as the literature review, we have concluded that there are adverse consequences of period poverty on women.
Stigma, taboos, superstitions, myths, tampon tax and lack of education are the most important contributing factors to period poverty.
The fact that in our research, 85.7% of respondents knew of people in their community who were suffering from period poverty and 91.7% of those members suffered from a lack of menstrual hygiene awareness shows the severity of the problem.
Its impact on women in terms of their mental health, physical health and economic repercussions are supported by the literature review and the secondary data provided.
Therefore to support women, the tampon tax needs to be removed, stigma and taboos need to be overcome, and education needs to be made mandatory.
In our research, 73.8% strongly agree that stigma and taboos are harmful to women; 91.7% believe pads should be free and 95.2% believe that menstrual hygiene education should be taught to every student regardless of gender.
From the qualitative responses collected, we can further assess that more people see period poverty as an important social issue and have shared stories of how period poverty has affected their lives or the lives of their community members.
Meerab Malik is currently an A2 student at The Lyceum College, Karachi studying sociology, psychology, economics, and global perspectives and research.
She is the founder of The Pink Light Project which advocates, educates, and empowers women and people through informative sessions, donation drives, etc. with the hope of eliminating period poverty in Pakistan.