What happens when you can't afford menstrual products? Period poverty explained

You likely don't think twice when you need to pick up a box of tampons at your local drugstore. But for many people who menstruate in the U.S., menstrual products are an expense they simply can't afford — at least not every single month.

It's called period poverty — and it affects more people than you might think. "Period poverty is a shorthand term that is used to refer to when women, girls and anyone who menstruates doesn't have the resources they need to manage their menstruation hygienically," Anne Sebert Kuhlmann, an associate professor of behavioral science and health education at Saint Louis University, tells Yahoo Life.

Kuhlmann continues: "We immediately think of products — pads, tampons, liners — but it's also not having a place to go to the restroom in privacy, not having access to water to wash yourself or your underwear and [not having a place] where you can dispose of those products in a hygienic way. It's broader when we're thinking about all of the resources people might lack."

Emily Bell McCormick, founder of the nonprofit organization the Policy Project whose work includes the Period Project, focused on ending period poverty, tells Yahoo Life that period poverty is "typically related to other forms of poverty, like food insecurity."

That's because period products are "actually pretty expensive," Amanda Safi, a menstrual equality activist and student at the University of California, Santa Cruz tells Yahoo Life, "and can mean the difference between getting another meal for their family and another basic need."

The average woman spends about $20 on menstrual hygiene products per cycle, according to the National Organization for Women. "If one tampon is used every six hours and four tampons are used every day, you're looking at 20 tampons for every five-day menstrual cycle totaling 9,120 tampons in your life," states Pandia Health. "If one box costs $7, and there are 36 tampons per box, the cost for a lifetime equals $1,773.33."

That doesn't include the cost of panty liners, pads or ruined underwear from leaks. Pandia Health estimates that "assuming you use three to five pads a day over a five-day period, you likely spend around $4,752 in [your] lifetime just on pads."

Access to menstrual products is particularly hard for vulnerable populations, including families of low-income and homeless women. According to the ACLU, "Currently the cost of these products is not included in health insurance or flexible spending accounts or health savings accounts, nor in public benefits programs such as the Supplemental Nutrition Assistance Program (SNAP) or Women, Infants and Children (WIC) benefits."

This is why several organizations, including the ACLU, and advocates argue that menstrual products should be available the same way toilet paper and paper towels are in public restrooms at schools and workplaces — because they are all necessities.

How does not having access to menstrual products affect people's lives?

Studies show that a lack of access to essential period-related products has wide-reaching effects. "Not having access to menstrual products can disrupt lives through disruptions to their work, school and social lives," Jhumka Gupta, an associate professor in the department of global and community health at George Mason University, tells Yahoo Life.

As McCormick puts it: "It's a massive public health issue that affects education and the workforce."

According to the Centers for Disease Control and Prevention, more than half of girls have started their period by age 12. "That's way below the legal age to work and yet they're asked to manage [their period] themselves every single month," says McCormick. "So if you don't have a parent that can manage that, you're absolutely screwed."

A 2019 study conducted by the menstrual nonprofit Period and period underwear company Thinx found that 1 in 5 teens can't afford period products in the U.S. Another study, conducted by Gupta and published in the journal BMC Women's Health in 2021, found that more than 14% of college-age women had experienced period poverty in the past year, with an additional 10% reporting that they experience it every month.

That lack of access also takes a mental health toll. The same 2021 study found that compared to those who had never experienced period poverty, women who deal with period poverty every month were the most likely to report moderate to severe depression.

"If you're a young menstruating person in school, oftentimes you'll see your education will be affected by lack of access to period products," says Safi. "You either have to miss class or leave class or sports practice early or miss school entirely. That's not OK. We shouldn't have to have our education affected because this basic need is not being provided in educational institutions."

Kuhlmann agrees, saying that anyone who has ever menstruated can relate to your period coming unexpectedly and having to use a makeshift pad, such as folding up toilet paper or paper towels in your underwear just to get through the day, until you could head home or go to the store. "But then think about if that's how you managed your period for the entire cycle — not just a few minutes but every cycle for the year," Kuhlmann says. "Multiply out that fear and anxiety and discomfort for that little bit of time in terms of makeshift [products] and that's how you manage your period because those are the options that are available to you."

The problem is even worse for disadvantaged families. A 2019 study, led by Kuhlmann, of 183 low-income women in St. Louis revealed that nearly two-thirds (64%) couldn't afford menstrual products during the previous year. About 21% of the women experienced period poverty every month.

What do people use when they don't have the menstrual products they need?

People who don't have consistent access to menstrual products use a variety of homemade, makeshift methods to get by. "Women figure out a way," says Kuhlmann.

Gupta's study found that one-third of low-income women resorted to "rags, toilet paper or children's diapers," cutting them up to create an improvised pad, to get through their periods. Safi adds that some use a "towel or sock" — neither of which is a hygienic option.

McCormick says that if they're able to get their hands on a tampon, "some will wear a tampon for 12 hours because it's expensive." But that's far beyond the recommended amount of time — the Food and Drug Administration advises changing your tampon every four to eight hours, with eight hours being the maximum for a single tampon — and that can put them at risk for toxic shock syndrome, a rare but life-threatening condition brought on by bacterial infection.

"You have to have specific products to manage it," says McCormick. "You can't just use anything when you menstruate."

What are organizations doing to change things?

The good news is that things are finally starting to change — "It's gaining a ton more momentum," says McCormick — but there's still a long way to go, advocates say. Currently, only a handful of states in the U.S., including California, Virginia and most recently Utah, provide free menstrual products to students in public school. In October 2021, California Gov. Gavin Newsom signed A.B. 367, which expanded that requirement to include public colleges and secondary schools by the start of the 2022-2023 school year.

Another focus is ending the "tampon tax" (or "pink tax") — a sales tax that many states impose on menstrual hygiene products — which could help make them more affordable for some. McCormick points out that certain men's products, such as hair growth products and Viagra, are excluded from these extra sales taxes. "Those are wants and not needs," says McCormick. "Period products are needs. Take the tax off tampons."

How can people help?

There are several things you can do to help improve access to menstrual products for people in need — namely, "educate, advocate, donate," says Kuhlmann.

"Education helps by increasing awareness and talking about" period poverty, "bringing it to people's attention," she says, along with advocating for legislative changes and supporting initiatives that would provide free access to menstrual products in school, workplaces and homeless shelters.

Gupta agrees, recommending that people "write to their elected representatives to advocate for policies that address period poverty — both locally and nationally, as well as at their own schools, workplaces or other public places."

That's something Safi knows firsthand: As a high school student in San Mateo, Calif., she founded the Period Equity Project, launching a local initiative that led to three high schools in her county providing free period products in their girls’ and gender-neutral bathrooms, and then advocated for the same provisions at her college.

Gupta points out that "there are a lot of great organizations working in this space and there are ample opportunities to get involved," such as by volunteering or donating. They include Period, Free the Period, Dignity Period and the National Diaper Bank Network's Alliance for Period Supplies.

Safi suggests starting a fundraiser with friends to raise money for these organizations or for period products to donate to a local homeless shelter. "Ask people to donate $5 or $10 and it goes a long way," she says. "Even donating $5 can help two to three menstruators get through the month."

McCormick says for people to make a difference in their own community, simply notice "all the touch points for your life and start advocating for period products to be available in bathrooms in those places," she says. "Your church, school, place of work, where you go shopping."

She adds: "If we all did that and pushed for months, every single bathroom in the U.S. would have period products."

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