Author’s Note: When we discuss the topic of menstruation, many colloquialisms and commonly used language slants heavily toward those who identify as women. In this article, I use the more inclusive phrase, “people who menstruate.”
At its core, sustainability is a mission: to conserve and protect the society we live in now so that it remains the place we want to live in for years to come. We should consider sustainability in every facet of our lives. However, when it comes to something as taboo as menstruation, we may not find an obvious connection to sustainability—nor feel comfortable enough talking about it to find one.
That’s where the concept of menstrual hygiene management (MHM) comes into play. According to the World Health Organization, one major component of MHM is a supply of menstrual products that are clean, readily accessible, and dignified for the “more than 300 million [people] worldwide” who menstruate every day (World Bank, 2022). This vast number of people, coupled with the fact that individuals may experience a menstrual cycle for up to 40 years, means that MHM clearly matters in the sustainability conversation.
By definition, sustainability refers to “meeting the needs of the present without compromising the ability of future generations to meet their own needs,” and a global push to provide reliable and secure access to menstrual products must be part of this goal (“Sustainability,” n.d.). However, if the current infrastructure to distribute these products is insufficient to meet present needs, how can it possibly support the needs of future generations? This is the question we need to ask.
Around the world, challenges to people who menstruate include “secrecy around purchasing sanitary items, high financial costs, and [in]sufficient…infrastructure” (Pednekar et al., 2022). For example, as journalist Linda Carroll points out in an article for Reuters, in 2017 “nearly two-thirds [of women in poverty in the U.S.] couldn’t afford menstrual hygiene products such as tampons or pads” (2019). Rather, individuals had to improvise with “cloth, rags, tissues, toilet paper and sometimes even diapers or paper towels taken from public bathrooms,” she notes. This is an unsustainable way to live, both because the substitute products are not adequate and also because of the inconsistency and uncertainty perpetuated by this haphazard approach.
In addition, even as recently as 2023, “period products were not covered by government grocery-assistance programs such as WIC and SNAP,” according to the National Conference of State Legislatures (Fouladi, 2023). Among young girls who menstruate, anxiety and uncertainty about their supply of menstrual products can result in an inability to concentrate and poor attendance at school and/or at an after-school job. The numbers don’t lie: in one study, “33% of students surveyed reported missing school due to a lack of period products,” and an estimated loss of “$1,692 annually per person” was attributed to employees being unable to come in for work due to inadequate support when struggling with cramps or heavy flow (Davies et al., 2023).
With such a wide range of challenges, the most important question becomes: what solutions are we currently pursuing? We have made some progress. At least 30 U.S. states now have laws expanding accessibility to menstrual products. These states include Delaware, where a 2021 law required “all public and charter schools with students in grades 6 to 12 to provide free menstrual products in 50% of female bathrooms”; and Alabama, where a grant program—which received $200,000 in 2022—empowers “a female school counselor, female nurse or female teachers in certain schools” to provide menstrual products to people who menstruate in middle and high school (Fouladi, 2023). Policy makers should work to revise the language of these initiatives to be more inclusive of all individuals who menstruate, but these are still steps in the right direction.
Beyond young students, other populations historically have struggled to obtain access to these essential resources, including individuals in jail and those who live in poverty. Arizona passed a law in 2021 to provide “tampons, sanitary napkins, menstrual sponges and menstrual cups … free of charge upon request” to inmates, and New York passed a law in the same year “to provide menstrual products at no cost to individuals receiving temporary housing assistance” (Fouladi, 2023). These efforts, again, highlight one of the most significant barriers to access of period products: cost.
Other sources point out that in 2023, 20 states had what was called a “tampon tax,” (Davies et al., 2023), an additional sales fee ranging “from 4% to 10% of the price of the product,” because menstrual products were classified as “nonessential” goods (Fouladi, 2023). This tax puts a financial strain on individuals who already may be struggling to pay for other essentials, like food and water. To address this problem, the Children’s Hospital of Pennsylvania has some advice for state legislators: either eliminate the tax altogether, or designate menstrual products as medical necessities rather than as nonessential goods, therefore circumventing the possibility of this additional sales tax (Davies et al., 2023).
Providing more products at lower costs or for free solves only the immediate supply issue, however. In order to establish a truly sustainable system, we must change the culture around reproductive health and increase the support individuals receive for their menstrual health.
Pednekar and coauthors put it best: “There is a growing need to provide [people who menstruate] with…necessary knowledge, facilities and culturally safe practices…to manage their periods with dignity” (2022). This ability to maintain dignity and safety is absolutely crucial because it speaks to that first part of sustainability: meeting the needs of the present. For example, as the authors assert, in order to minimize “girls’ absenteeism in schools/educational institutions during menstruation, institutions and the government must ensure… adequate and functioning toilet facilities with availability of water and soap, privacy for changing pads and proper disposal facilities.”
The primary way to ensure that such facilities are available is to educate the educational system: teach school administrators what young, menstruating people need for safety, dignity, and security, and teach young people to speak up when they do not feel that they have adequate resources. After all, as Davies and coauthors notes, nearly 40% of young people surveyed in 2021 shared “a desire to learn more about reusable pads and durable products,” so it is clear that young people are aware of the resources they need and want to know what is best for their menstrual health (2023). Thus, it is imperative to educate key stakeholders about what other resources beyond just pads and tampons are necessary for young people to maintain optimal health during menstruation.
So, what’s next as we advance our sustainability goals? What areas should we prioritize, and what challenges do we still need to address? Money certainly remains key. According to the Council of State Governments, “most states requiring menstrual hygiene products in schools utilize district funding…[but others] rely on grant programs” (Harrison, 2023). More funding, either from the government or outside stakeholders, is crucial to sustain initiatives that provide menstrual products for free. Pednekar and coauthors identify one unique model solution, the Eco Femme initiative in Tamil Nadu, India, in which “women are earning their livelihood through the production of reusable, washable cloth pads” (Pednekar et al., 2022). Innovative approaches like this not only empower women to become more financially autonomous and therefore able to acquire the menstrual products they need, but also maintain a steady supply of resources for all people who menstruate.
Additionally, the World Bank provides many recommendations for governments to follow in facilitating more sustainable infrastructure for MHM, ranging from “helping period product entrepreneurs manufacture at a lower price” and providing “subsidies for small/ medium enterprises” to improving “quality standards in sanitary pad producers.” Davies and coauthors note that education around these issues and resources can be provided through social media, rather than solely through traditional health education, although the risk of misinformation is a significant factor (2023). In addition, organizations like Period.org are fighting to break stigmas around menstruation, to educate young people about their menstrual health, and to empower the next generation to advocate for what they need and to speak up when their needs are not being addressed.
Most important of all, you can join the global effort to turn the tide for a more sustainable, equitable, and accessible distribution of menstrual products. For example, the United Nations suggests that “if you see an interesting social media post about women’s rights…share it so folks in your network see it too” (“The Lazy Person’s,” n.d.). The UN also suggests that if you’re in the workforce, you can “encourage your company to…find ways to help local communities” achieve an equitable supply of menstrual products. Finally, one of the most powerful ways that you can help is simple: by donating products. The Pad Project, Helping Women Period, Period Project NC, and the Alliance for Period Supplies represent just a fraction of the many organizations working in the United States and beyond to provide a steady supply of pads, tampons, and other supplies to people who menstruate, and their websites streamline the process for you to donate these products easily and quickly.
In the end, sustainability starts with you. Even if menstruation is not a challenge that you personally face, you can provide support that will bring society one step closer to a future in which access to the proper menstrual products no longer brings shame, fear, or anxiety to the people for whom menstrual hygiene is a regular struggle.
Aynsley Szczesniak (she/her) is a first-year Bob and Janitta Carithers Honors Carolina Scholar at the University of North Carolina at Chapel Hill, where she studies Biology and Mathematics on the premedical track. She’s the Founder and Executive Director of the global nonprofit Speak Out Sisterhood and the Student STEM Programs Chair of AWIS North Carolina.
This article was originally published in AWIS Magazine. Join AWIS to access the full issue of AWIS Magazine and more member benefits.