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 periods.

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.