The COVID-19 pandemic has exposed the longstanding structural drivers that underpin health and social inequality. The World Bank suggested that by the end of last year, a further 500 million people will enter extreme poverty because of out-of-pocket payments for healthcare. When household incomes are constricted, often luxury items, and even period products, are deprioritised. This impacts an individual’s ability to attain menstrual health – and the risk of experiencing period poverty.

Menstrual health refers to a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation to the menstrual cycle.

So, what happens when women and adolescent girls cannot attain their menstrual health? It results in period poverty.

Period poverty occurs when women, adolescent girls, transgender men, or non-binary individuals that menstruate don’t have access to:

  • private and appropriate information,
  • affordable and safe period products,
  • or hygienic and private spaces to change or dispose of used products.

It is also a result of environments that perpetuate stigma and shame relating to menstruation.

How is COVID-19 impacting period poverty?

Globally, around 500 million women and girls experience period poverty every month. About 12.8% of women and girls worldwide living in poverty struggle to manage the resources necessary to maintain apt menstrual health. This could mean that they need to choose between buying food and fuel, or buying menstrual products.

Crisis situations can exacerbate period poverty making it more difficult for people to access the information and resources they need to manage their periods. This puts their health and well-being at risk.

The pandemic has limited people’s access to educational resources that were otherwise helping them manage their periods. Nationwide lockdowns caused the closure of schools and workplaces which previously distributed free menstrual products. This has directly impacted impoverished people relying on these supplies. Imposed travel bans and restrictions have made it difficult to access services need to manage periods. The negative impacts on the lives of adolescent girls and women include increased feelings of stigma and shame relating to their period, absences from school or work, and a lack of basic dignity.

Compromised access to period supplies can force individuals that menstruate to rely on unhygienic and unsafe means to manage their menstrual cycles. Poor menstrual health has been linked to multiple physical health risks mainly resulting in reproductive and urinary tract infections.

The inability to deal with their menstrual cycle in a safe and dignified manner can have profound consequences—particularly on an adolescent girl’s education.

It is not uncommon for adolescent girls to miss school during their menstrual cycles due to stigma and lack of access to menstrual health facilities, but the pandemic has made it even worse. Girls who don’t receive an education are more likely to enter child marriages and experience an early pregnancy, malnourishment, domestic violence, and pregnancy complications.

Restrictions linked to the COVID-19 pandemic have further exacerbated practices and stigma that subject women to shame, isolation, and discrimination during menstruation. Harmful menstrual traditions lead to exclusion and vulnerability even in normal circumstance, but they are increasing vulnerability during the pandemic.

In some traditions, menstruating people are made to stay in menstrual huts (“chhaupadi”) or separate rooms. Other traditions prohibit menstruating people from washing or touching their genitals as they believe that menstrual blood pollutes water sources or toilets. This could have implications for infection control measures like hand hygiene.

The lockdown is intensifying the impact of harmful household menstrual practices such as these, because families spend more time indoors. This makes it more difficult to manage periods without shame and discomfort in often confined spaces.

What can be done to address period poverty during this pandemic?

The COVID-19 pandemic has exacerbated the economic, social, environmental, and political drivers that underpin period poverty. Therefore, along with driving stronger sexual and reproductive health services, governments must prioritize menstrual health in the COVID-19 responses. This will support menstrual health during future pandemics and also help them to build back better and stronger for women and adolescent girls.

A short-term policy measure to address this inequity during the pandemic could be an urgent delivery of these basic supplies to areas in dire need via donation, price-reduction, subsidization, or tax exemption. However, we know that attaining menstrual health in not limited to access to products. There needs to be a focus on transformative policies that address stigma and shame relating to menstrual health. In addition, there should be more gender responsive policies that focus on alleviating some of the drivers.

Scotland became the first to provide free access to period products to all those who need them. Since 2004, many countries have abolished or reduced sales taxes on tampons and pads including Kenya, Canada, India, Columbia, Australia, Germany, and Rwanda.

As period poverty is not only about affordability of products, we also need to ensure that education and awareness around menstruation continues.

Addressing the stigma and lack of awareness around menstrual health in communities, families, and in the workplace is key. In addition to this, the facilitation of access to physical infrastructures – like access to running water, soap, appropriate disposal, and sanitation facilities – could address some of the issues that drive period poverty.

In the long run, an integrated and multi-sector approach is required to address period poverty during this pandemic. This should include collaborations from governments, the private and the public sectors, civil society, and other stakeholders. Better investments around cost-effective and sustainable interventions will support a world with menstrual equity.

Overcoming period poverty requires rights-based approaches that are co-designed through an intersectional lens. This would ensure that women, adolescent girls, transgender and non-binary individuals, people of colour, people living with disabilities, and those who are homeless, incarcerated, or living in crisis zones can have their needs met.

Everyone has the right to menstrual health, particularly in emergencies.

Overall, we appreciate that addressing period poverty is just a drop in the ocean when it comes to elevating the gender equality and human rights agenda. Nonetheless, with 800 million menstruating each day, we still wonder, why are governments and global health actors still not recognising the need for stronger programming?

At Pandemic Periods, we believe that understanding menstrual health during the COVID-19 pandemic starts with the realization that periods do not stop during pandemics. We need stronger menstrual health mainstreaming in all crisis response and public health programmes, so that those that menstruate can attain their menstrual health, even in crisis situations.

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