Period Poverty: The Truth Behind Menstruation in America

What does it take to create equal access to hygiene?

Brittany Atkinson
Sep 2 · 8 min read
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Photo by Gabrielle Rocha Rios on Unsplash

Menstruation is a natural process, but it isn’t always treated that way. There is a taboo around menstruation that has lead to not only misinformation, but a lack of discussion on the health disparities surrounding menstruation. When someone feels the need to stick a tampon in their sleeve when heading to the restroom, often hiding a shame or embarrassment they’ve culturally been ingrained to feel, how can we expect these same people to have discussions on the inaccessibility of period products? In order to address period poverty, we have to be willing to have open discourse on periods.

I want to make clear that period poverty and the taboo surrounding periods is found all over the world, but I’ll be specifically addressing problems in the United States. I know cultural stigmas vary greatly from culture to culture, so I want to focus on what I know best and the experiences I’ve seen first-hand, rather than trying to speculate on the experience of others. That said, the long-term solution I’ll bring up at the end is applicable to everyone suffering from period poverty, not just those in the United States.

Let’s start unraveling menstruation.

So, what does period poverty mean?

According to the American Medical Women’s Association,

Period poverty refers to the inadequate access to menstrual hygiene tools and educations, including but not limited to sanitary products, washing facilities, and waste management.

Where do problems with period poverty even start? As I already stated, the taboo behind menstruation is the first place to address. If we can stop labeling it as taboo, feeling the need to hide period products, and can have open conversations about the needs of those menstruating, we’ve already begun to work towards a solution. If we find someone feeling awkward asking for a period product, the first thing to do is just say, “Hey, it’s no big deal. What do you need?”

We need to undo shame and embarrassment not only through talk, but through action. What if we all whipped out tampons and pads instead of shoving them up our sleeves to travel to the bathroom? What if we didn’t make asking someone for a pad an an anxiety-inducing dilemma? If someone is offended by a tampon, or tries to make fun of someone for doing so, we need to have each other’s back. And anyways, if someone is upset and tries to poke fun of some else for using a tampon or pad, they should be embarrassed, not the other way around.

Along with deconstructing the taboo nature of menstruation, there is a responsibility to acknowledge that period poverty does not just affect those that are homeless or in a third-world country (which seems to be an assumption that floats around online). In fact, Penn Nursing advances the definition of those who can struggle because of period poverty, although this is of course not a fully comprehensive list:

Students, low-income and homeless women and girls, transgender and nonbinary individuals, and those who are currently imprisoned struggle with period poverty.

So we’ve addressed what period poverty means, who it affects, and the need to stop the stigma of menstruation, but what about the money?

The Pink or Tampon Tax

One problem on purchasing menstrual products is that there is a tax on menstrual hygiene products. According to an article by Karen Zraick in The New York Times,

Thirty-five states still tax the items, despite momentum to change that.

This article was written in July 2019, so it’s possible a few more have joined the train since then, but I couldn’t find any clear statistical data on states that have decided to eliminate menstrual product taxes since then.

Although this tax may not seem like a big deal, it can easily be the difference between someone getting a box of tampons or not.

Zraick goes on to ask an important question in her article that pushes the ethics of the tax further:

Why are tampons taxed when Viagra isn’t?

Sex is optional, and a period is not. But it isn’t just tampons: it’s pads and menstrual cups that also need the tax to be abolished. This alone is a great start to reduce period poverty, at least for some families.

So, if it’s clear that menstruation is necessary, and period products aren’t reaching the hands of everyone who needs them, what is the issue? Money.

In September 2016, Jeremy B. White wrote a reflection on tampon and diaper taxes in California. What did he find?

If he [Brown] had removed taxes on feminine hygiene products by signing AB 1561, it would have reduced state general fund revenue by about $10 million in the 2016–17 budget year.

We all know government change is a slow process, and even if we could get more states to relieve their tax, it still would exclude some families. The truth is, not everyone can afford a monthly box of tampons or pads.

The True Cost

A Huffpost article written by Jessica Kane does an excellent job of breaking down the cost of a lifetime of periods. Kane breaks down the cost in ways that don’t just include period products, but also new underwear to replace stained ones, heating pads, products for cramps, panty liners, and so much more. She also clearly breaks down the cost of tampons. Kane states,

There are other options, but 70 percent of women use tampons. You’re instructed to change your tampon every 4 to 8 hours, so we’ll use 6 hours as an average. A box containing 36 tampons costs $7 at Walgreens.

1 tampon every 6 hours = 4 tampons per day x 5 days of a period = 20 tampons per cycle x 456 periods = 9,120 tampons. At 36 tampons per box, that’s 253.3 boxes x $7 = $1,773.33

I think Kane’s estimates are actually on the safe side, as I’d say many use more than 20 tampons per cycle, depending on the length and heaviness of flow. I appreciated how in-depth Kane went into period costs, and although I won’t be addressing accessibility to everything mentioned in Kane’s article, I think it’s a good framework to have, and I feel the breakdown of tampon costs is effectively done

Sustainability: The Solution?

Although the definition of period poverty focuses on the multifaceted parts of “hygiene,” I’ll be addressing a long-term solution for how we can get sanitary products into the hands of those in need: sustainable period products.

Throughout this article, I’ve focused a lot on period products that include tampons and pads. I did this knowing that ninety-eight percent of American women use a combination of both products, whether that is just tampons, just pads, or both. This statistic makes clear why most fights for menstruation products thus far include distributing tampons and pads to those in need, allowing free access to tampons/pads in public spaces (like schools or bathrooms), and abolishing a period tax. But, I find a large flaw in these solutions: they aren’t sustainable and long-term.

Giving someone a box of tampons or pads for their period that month is a great temporary solution, but what about the month after that? They’re forced to buy a box, or again find a way to get access to a free box. From their first period, most people are given a tampon or pad to use. It makes sense that this is what people are comfortable with and in the habit of using. But, what if we could unlearn this behavior?

I understand that there is also a taboo around sustainable options, whether you’re looking at the menstruation cup or period underwear. But, as with the taboo in menstruation, can’t we work to unpack it and undo it? I’m not saying we don’t need free access to tampons and pads, as there will always be those that just don’t find a menstruation cup or period underwear comfortable, but what about those that just don’t know about the option? What about those that have false assumptions about reusable products? Could this be the long-term solution we’ve been searching for?

Sustainable Options are the Way Forward

So, why aren’t we already doing this on the same scale as tampon/pad donations? As with most new concepts, it just needs some normalization and power behind it. We need to normalize the behavior of using cups or period underwear. If it could help millions of people in-need to have have long-term period products, wouldn’t it be worth it? Of course it would.

So, why do people hesitate to use them? Emily Atkin, a writer for The New Republic, believes it’s because of stigma and contact with one’s own body:

At least with tampons, women can use long plastic applicators to insert them, and remove them with the tug of a string. But to insert a menstrual cup, users must push their fingers inside themselves, twisting the product until it fits right. Removing it requires even more skill. Users must then dump the cup out, rinse or wipe it off, and insert it again. Ew, many women think. Gross.

I understand this does not attack the problem many face in regards to other hygiene issues, such as running water or access to disposal services, but I think it’s a great start. In fact, the same article by Atkin states the following:

Those [benefits] not only include saving money — a $30 cup can apparently last up to 10 years, though most users report two to four years — but a decrease in general annoyance with one’s period. Citing a 2011 clinical trial of menstrual cups, the magazine Pacific Standard noted that regular tampon users reported ‘feeling more satisfied with menstrual cups than their usual means of menstrual management.’ Ninety-one percent of those who tried cups said they would recommend them to friends.

And with a greater demand and more people producing cups, that “$30 cup” could be eventually easily found for less. I’ve even seen some on the market for closer to $20 today. This means the price of two or three boxes of tampons that last two or three months could turn into one period product that could last someone years. And, if there was a demand, companies that currently make disposable period products would jump on the production bandwagon for sustainable products as well.

As for period underwear, it costs about the same and has the same goal in mind as cups: a reusable, long-term period product. You can check out a website such as Thinx for more information on how period underwear work, but the idea is to replace the tampon and pad with a sustainable option.

Closing Thoughts

I’ve seen a lot of recent campaigns regarding period poverty, and they usually address a “buy one tampon box and we’ll donate a box.” I love this initiative, but as with many campaigns and spaces of activism, I found great fault. One box of tampons is a great start, but only a temporary solution. This is why I began to brainstorm ways we could provide long-term, affordable access to those that don’t have access to menstruation products.

If we are able to collectively reduce the stigma of menstruation and menstruation cups (along with period underwear), we could bring forward an era where far less people go without period products. We can provide long-term solutions by donating cups or reusable underwear instead of a box of tampons. It may seem novel at the moment, but if we could get a growing audience behind the movement, we could change the way everyone thinks about menstruation. We could greatly reduce the period poverty crisis for years and years by a single switch: donating cups instead of tampons. It seems so simple, but could have a positive, lasting impact on the period crisis.

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Brittany Atkinson

Written by

Western Washington ‘22 MFA in Poetry // vegan poet who loves coffee and thrifting 🌿ig + etsy: thriftedpoet

Climate Conscious

Building a collective vision for a better tomorrow

Brittany Atkinson

Written by

Western Washington ‘22 MFA in Poetry // vegan poet who loves coffee and thrifting 🌿ig + etsy: thriftedpoet

Climate Conscious

Building a collective vision for a better tomorrow

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