Period poverty: The perceptions and experiences of impoverished women living in an inner-city area of Northwest England

Period poverty: Menstrual information, product selection, and disposal among urban female nursing students in Bangladesh

Period poverty, the lack of access to menstrual hygiene products, sanitation facilities, and education, remains a pressing issue in low- and middle-income countries. This study explored the emotional and practical challenges faced by nursing students, focusing on menstrual education, product accessibility, and disposal practices. A qualitative approach was adopted, involving 35 female nursing students (aged 26 ± 3.3 years) from seven government nursing colleges across three regions of Bangladesh. Data was collected from June to July 2023 through Focus Group Discussions (FGDs) and In-Depth Interviews (IDIs). Purposive sampling was employed for FGDs, while convenience was sampling used for IDIs. Thematic analysis, facilitated by MAXQDA2023 software, identified key themes and subthemes related to menstrual experiences. Three major themes emerged: (1) fear and confusion during first menstruation, (2) barriers to menstrual product accessibility, and (3) challenges in menstrual hygiene management. Many students reported fear and confusion during their first menstruation, largely due to inadequate information from female family members, especially mothers. Sanitary pads were the preferred menstrual product, but the embarrassment of buying products in front of men often made purchasing them difficult and they used old clothes. Additionally, a lack of proper disposal facilities and embarrassment in managing menstruation in public were significant concerns. This study underscores the need for comprehensive menstrual education and improved Water, Sanitation and Hygiene (WASH) infrastructure in educational institutions. Addressing these issues is critical to promoting safe and dignified menstrual management, reducing stigma, and enhancing health outcomes for menstruators.

Analysis of harmful menstruation beliefs and practices: a systematic review

Women have inadequate access to menstrual health and hygiene, and there is astigma associated with menstruation. A systematic literature review of menstruation-related beliefs, myths, taboos, and harmful practices was conducted on Scopus, Web of Science, PsycINFO, and PubMed. Fourteen articles were included, of which eleven were in relation to beliefs, myths, and taboos, and nine to harmful practices, during menstruation. The results show that menstruation is associated with dirtiness and impurity beliefs and with restrictive and possibly harmful practices that go against human rights. Specific educational and hygiene content about menstruation is necessary for programs and interventions to address women's health.

"Basically, my answer is, there needs to be options!" Recommendations for the delivery of free menstrual products to the public: A qualitative exploration among marginalised groups in Victoria, Australia

OBJECTIVE

Governments have announced free menstrual product provision policies. Our research aimed to inform these initiatives by understanding menstrual product insecurity amongst marginalised groups and their recommendations for product provision.

METHODS

We undertook in-depth interviews with participants experiencing menstrual product insecurity, who identified as belonging to one or more marginalised groups, alongside key informants working for organisations serving these populations. Groups included those on low income, people experiencing housing insecurity, people living with disabilities, multicultural groups, gender-diverse people, and young people. Qualitative content analysis was undertaken using a framework approach.

RESULTS

Thirty participants and five key informants participated. Participant recommendations for service delivery emphasised convenience, product choice and prioritisation of those with the greatest need whilst preventing misuse. Participants also considered the balance between the privacy and visibility of delivery mechanisms and the opportunity to address other menstrual needs including education and stigma through product provision policies.

CONCLUSIONS

No single delivery approach best suits the needs of all people. Delivery mechanisms must consider how to provide participants' recommended features.

IMPLICATIONS FOR PUBLIC HEALTH

To best reduce menstrual product insecurity, governments should consider delivering products through multiple mechanisms. Co-development of policy implementation methods with intended beneficiaries, and thorough evaluation, will support uptake.

Menstrual cup acceptability and functionality in real-world use: A cross-sectional survey of young people in Australia

BACKGROUND

Menstrual cups offer a cost-effective and environmentally sustainable product for many young people. While clinical trials have shown their safety and effectiveness, no studies have investigated their performance in real-world use.

AIMS

To describe the acceptability and functionality (continuation, discomforts, leakage, and adverse events) of menstrual cups and investigate the supportive role of product knowledge.

MATERIALS AND METHODS

A cross-sectional online survey of 530 people aged 15-24 living in Australia who had ever used a menstrual cup, recruited via a menstrual cycle tracking application.

RESULTS

More than half of participants (55%) were still using their first menstrual cup at the time of the survey, 16% had switched to an alternative cup, and 29% had discontinued use. In their first cycle of use, 54% of participants reported leakage and 25% reported pain or discomfort with the cup in place. Many participants (45%) reported being unable to remove the cup on their first attempt, with subsequently 17% requiring help to remove it, and 2% reported displacement of an intra-uterine device during removal. These figures decreased for subsequent cycles. Half of the participants were aware prior to using a cup that different cup models may offer a better fit for different individuals. This knowledge was associated with decreased odds of needing help to remove the cup (adjusted odds ratio 0.57, 95% CI 0.35-0.94) or discontinuing use (adjusted relative risk ratio 0.66, 95% CI 0.44-1.00).

CONCLUSIONS

Difficulties using menstrual cups are common in real-world use and higher than reported in clinical trials. Improved education provision may support more positive user experiences.

Menstrual products: culprits or bystanders in endometriosis and adenomyosis pathogenesis?

Products that may reduce menstrual flow from the endometrial cavity to the vagina (i.e. tampons and menstrual cups) could facilitate retrograde menstruation and the spillage of blood into the myometrium, two mechanisms which could be major determinants in endometriosis and adenomyosis pathogenesis. The aim of this narrative review is to summarize the evidence regarding the mechanical role menstrual products may have in the pathogenesis of these two conditions. Evidence in this regard is inconclusive. While Darrow and colleagues observed that 14 or more years of tampon use were associated with endometriosis (OR 3.6; 95% CI, 1.04-13.5); in Meaddough and colleagues' retrospective study, the percentage of women using pads only was significantly higher among those with endometriosis than among those without the condition (31% vs 22%). Three further groups failed to find an association between endometriosis/adenomyosis and any type of menstrual product. The only case that may be considered as a sort of proof-of-concept of the association between products potentially reducing anterograde menstrual flow and endometriosis was reported by Spechler and colleagues, who described the case of a 41 year-old who developed endometriosis after having used a menstrual cup on a regular basis. However, the number of studies on the subject is scarce, study populations are exiguous and a greater attention to temporality of endometriosis onset in relation to when women started habitually using a specific menstrual product is needed. Confounding variables including type and quantity of endocrine disruptors contained in menstrual products should also be addressed. At the present moment, no recommendation can be provided on the safety of one type of menstrual product compared to another.

Prevalence and factors associated with unmet need for menstrual hygiene management in six countries in Sub-Saharan Africa: A multilevel analysis

BACKGROUND

Menstruation is a normal biological process experienced by more than 300 million women globally every day. Women require clean menstrual absorbents that can be changed as often as needed in a private and safe place with proper hygiene and disposal facilities. These needs must be met consistently throughout the duration of the menstrual cycle. Access to menstrual needs is crucial for women's health, wellbeing, and dignity. This study assessed the prevalence and factors associated with unmet need for menstrual hygiene management (MHM) in Ethiopia, Kenya, Uganda, Burkina Faso, Ghana, and Niger.

METHODS

We used data from the Performance Monitoring for Action (PMA) 2020 surveys. We defined the unmet need for MHM as the "lackof resources, facilities and supplies for MHM." Sample characteristics were summarised using frequencies and percentages, while prevalence was summarised using proportions and their respective confidence intervals (CI). Factors associated with unmet need for MHM were assessed using multilevel logistic regression models.

RESULTS

The study included 18,048 women of reproductive age from the six countries. The prevalence of unmet need for MHM was highest in Burkina Faso (74.8%), followed by Ethiopia (69.9%), Uganda (65.2%), Niger (57.8%), Kenya (53.5%), and lowest in Ghana (34.2%). Unmet need for MHM was consistently higher among uneducated and multiparous women, those who reused MHM materials, practiced open defecation, and lived in rural areas across all six countries. The odds of unmet need for MHM were higher among younger women under 35 years, unmarried women, those with lower education levels, and those from poorer households. Similarly, the reuse of MHM materials, use of shared or non-improved toilet facilities, and open defecation increased the odds of unmet need for MHM. In contrast, the presence of handwashing facilities reduced the odds of unmet need for MHM.

CONCLUSION

More than half of the women in five of the six countries have an unmet need for MHM, with significantly higher odds among younger women, those with low wealth status, the unmarried, and those with inadequate access to sanitary facilities. This study highlights the state of period poverty in Sub-Saharan Africa. Efforts to end period poverty should consider MHM needs as an integrated whole, as addressing each need in isolation is insufficient.

The Impact of Saline Water on Women's Health in the Coastal Region of Bangladesh: Special Attention on Menstrual Hygiene Practices

Introduction Salinity intrusion is the most common global concern along coastlines, but it can happen inland also. The lack of freshwater is the primary issue affecting the coastal areas. Many health problems are prevalent among the inhabitants due to their frequent use of salted water. The health of women living along the coastline is getting progressively compromised due to salinity intrusion. Objectives The study aims to determine menstrual health practices and other health problems faced by women in the coastal region of Bangladesh. Methods The study was conducted using a survey research design from May 2023 to October 2023 on rural women aged 18 to 45 years, who lived in the Bangladeshi village of Koyra Upazila in the Khulna district. The sample size of the study was 101. Open- and closed-ended questions from a planned interview schedule were used to gather primary data. Additional information from appropriate sources, e.g., newspapers, publications, and books, was utilized to enhance the comprehensiveness of statistical analysis and support rationality. A p-value of 0.05 was considered significant. Statistical analysis was performed using STATA version 15 (StataCorp LLC, College Station, TX). Results Menstrual hygiene practices showed a higher prevalence of using fabric rags and reusing them after rinsing them in salt water (72.3%) than sanitary pads (25.7%). It was observed that the risk of diarrhea among tubewell water and rainwater users was significantly lowered by 0.25 times (95% CI = 0.06, 0.99; p = 0.049) and 0.06 times (95% CI = 0.01, 0.43; p = 0.005), respectively, compared to pond water users. Conclusion Salinity has a significant impact on the livelihoods and health of coastal women. The village women are unaware of the health risks of excessive saline water use. Establishing an adequate supply of freshwater reservoirs for the entire community throughout the year is an alternative for women to use as a source of water for hygiene necessities.

Menstrual health: Inequities in a cohort of menstruating people in the Brazilian southeastern region

OBJECTIVE

To assess menstrual hygiene management (MHM) and period poverty in a group of low- and medium-income menstruating people.

METHODS

A cross-sectional study was conducted at the University of Campinas, Brazil, from January to June 2022 with 535 participants aged 18-49. For data collection, we used the abbreviated version of the WHO Quality-of-Life questionnaire (WHOQOL-BREF) and a pre-tested questionnaire with items regarding MHM and period poverty.

RESULTS

We found an inverse relationship between the risk of no access to supplies to perform menstrual hygiene, which increased by 2.5% and each point less in the environmental domain of quality of life (QoL), and this risk increased by up to 3.1 times among participants who reported difficulty making ends meet. The risk of not having adequate conditions to perform menstrual hygiene at home increased by up to 2.6% for every one-point drop in the environmental domain of QoL. The risk of not having adequate conditions to perform menstrual hygiene outside the home increased by up to 1.3% for less points in the psychological domain of QoL, and 44.4% of those who indicated inadequate conditions for menstrual hygiene reported two or more childbirths.

CONCLUSIONS

Menstruating people who have an increased risk of lacking menstrual supplies and have an increased risk of inadequate conditions for MHM at home and outside the home, as well as those who have two or more deliveries and those having difficulties making ends meet, scored low on the QoL, especially in the environmental and psychological dimensions.

Menstrual characteristics and associations with sociodemographic factors and self-rated health in Spain: a cross-sectional study

BACKGROUND

Evidence on how menstrual characteristics may differ based on socioeconomic factors and self-rated health is significantly scarce. The main aim of this study was to investigate the associations between menstrual characteristics, sociodemographic factors and self-rated health among women and people who menstruate (PWM) aged 18-55 in Spain.

METHODS

This cross-sectional study includes data from an online survey collected in March-July 2021 across Spain. Descriptive statistical analyses and multivariate logistic regression models were performed.

RESULTS

The analyses included a total of 19,358 women and PWM. Mean age at menarche was 12.4 (SD = 1.5). While 20.3% of our participants experienced a menstrual abundance over 80 ml, 64.1% reported having menstrual blood clots; 6.4% menstruated for longer than 7 days. 17.0% had menstrual cycles that were shorter than 21 days or longer than 35 days. Reports of moderate (46.3%) and high (22.7%) intensity menstrual pain were common. 68.2% of our participants experienced premenstrual symptoms in all or most cycles. The odds for lighter menstrual flow, shorter bleeding days and menstrual cycles were higher as age increased, and amongst participants with less educational attainment. Caregivers presented higher odds for abundant menstrual flow and longer menstruations. Reporting financial constraints and a poorer self-rated health were risk factors for abundant menstrual flow, menstrual blood clots, shorter/longer menstruations and menstrual cycles, premenstrual symptoms, moderate and intense menstrual pain.

CONCLUSIONS

This study suggests that age, educational attainment, caregiving, experiencing financial hardship and a poorer self-rated health may shape or mediate menstrual characteristics. It thus highlights the need to investigate and address social inequities of health in menstrual research.

Period Product Insecurity Is Increasing in the United States: Trends from 2018 to 2021

Background: Data documenting period product insecurity, or an inability to access products, in the United States have recently emerged. With multiple years of data now available, we assessed trends in period product insecurity among two nationally representative samples of U.S. adults. Materials and Methods: Data from nationally representative, cross-sectional online surveys conducted in January 2018 and April 2021 were used to run weighted logistic regressions. Those aged 18-49 years and who had menstruated in the past year (n = 922 in 2018; n = 1037 in 2021) were included. Results: In 2021, 59% experienced period product insecurity compared with 53% in 2018. In 2018 (adjusted odds ratio [aOR] 1.91, confidence interval [95% CI]: 1.29-2.83) and 2021 (aOR 1.53, 95% CI: 1.06-2.21), Hispanic respondents were more likely to find products unaffordable. Some college attainment was associated with finding products unaffordable in 2018 (aOR 1.53, 95% CI: 1.00-2.34) and 2021 (aOR 1.97, 95% CI: 1.35-2.88). Participants struggling to purchase products had higher odds of experiencing period product insecurity in 2018 (aOR 11.78, 95% CI: 8.07-17.20) and 2021 (aOR 7.71, 95% CI: 5.44-10.93). Conclusions: Hispanic ethnicity, lower educational attainment, and struggling to purchase period products were strong predictors of finding products unaffordable and experiencing product insecurity in both 2018 and 2021. Policies that improve access to or affordability of period products in the United States are needed to help those most vulnerable.

"For men, by men": Menstrual victimization and the weaponization of period products in carceral settings

BACKGROUND

The literature on menstruation defines period poverty as the inability to access sufficient period products, education, and sanitary facilities needed to manage menstruation healthily and effectively. While research has identified shortcomings of healthcare in the carceral setting, period poverty behind bars has remained largely absent from criminal legal discourse.

OBJECTIVES

The current study examines the interplay of period poverty and carceral control to introduce the novel concept of menstrual victimization, defined as the physical, emotional, and financial victimization that results from period poverty perpetuated through carceral control.

METHODS

The study uses qualitative content analysis to systematically gather and code journalistic accounts pertaining to the menstrual experiences of incarcerated and previously incarcerated females, criminal justice practitioners, and journalists. The analysis uses literary pieces (n = 99), which were coded deductively and guided by concepts related to structural violence and radical feminist criminology.

RESULTS

The findings shed light on the unique structural harms incarcerated menstruators face and reveal the dearth of needed empirical research on period poverty in carceral spaces. The narratives in the sample revealed how manufactured scarcity of period products within carceral spaces is used as a means of oppression by institutional agents. The emergent themes highlight how the intersection of period poverty and carceral control led to menstrual victimization characterized through shame, humiliation, control, and coercion.

CONCLUSION

Potential outcomes associated with understanding menstrual victimization in the carceral setting are discussed, including reducing menstrual stigma, disseminating health education, minimizing health disparities, and ultimately, shifting modes of holding accountability away from oppressive, retributive, and controlling tactics.

A pilot survey of students' menstrual attitudes, experiences, and needs on an urban university campus

BACKGROUND

In the United States, many menstruators face barriers to period management, such as period poverty, or the lack of access to relevant knowledge and affordable menstrual products. Our current understanding of the social, emotional, and physical impacts of period poverty on students in post-secondary institutions is largely limited.

OBJECTIVES

The purpose of this pilot study is to assess period poverty, period-related class disruption, and avoidance of menstrual hygiene management on campus among students and to identify recommendations for action at the University of Illinois Chicago and other urban universities.

DESIGN

An online cross-sectional study from February to May 2023.

METHODS

Enrolled students who were at least 18 years old completed an anonymous, self-administered online survey. Through descriptive statistics and chi-square tests in SAS version 9.4, we analyzed the sociodemographic, academic, and menstrual characteristics of those who had a period in the past 12 months. We also performed a thematic analysis of students' open-ended responses regarding their menstrual experiences on campus.

RESULTS

Of our sample (N = 106), 17.1% of students have faced period poverty, 55.8% experienced period-related class disruption, and 47.5% avoided changing their menstrual products on campus. The relationships between the three menstrual experiences were statistically significant. In the open responses, students reported that their personal experiences with menstruation were largely painful and disruptive. We identified the following themes: (1) inadequate water, sanitation, and hygiene facilities; (2) understocked, empty, or non-existent menstrual product dispensers; (3) a desire for additional resources for menstruation; and (4) the unpredictability of menstruation.

CONCLUSION

Our findings indicate that students continue to face obstacles to menstruation management due to inadequate support related to menstrual infrastructure, products, and pain. We outline several recommendations for university/college institutions to prioritize a more inclusive and supportive educational environment for all students.

Research priorities for improving menstrual health across the life-course in low- and middle-income countries

BACKGROUND

Research on menstrual health is required to understand menstrual needs and generate solutions to improve health, wellbeing, and productivity. The identification of research priorities will help inform where to invest efforts and resources.

OBJECTIVES

To identify research priorities for menstrual health across the life-course, in consultation with a range of stakeholder groups from a variety of geographic regions, and to identify if menstrual health research priorities varied by expertise.

METHODS

A modified version of the Child Health and Nutrition Research Initiative approach was utilized to reach consensus on a set of research priorities. Multisector stakeholders with menstrual health expertise, identified through networks and the literature, were invited to submit research questions through an online survey. Responses were consolidated, and individuals were invited to rank these questions based on novelty, potential for intervention, and importance/impact. Research priority scores were calculated and evaluated by participants' characteristics.

RESULTS

Eighty-two participants proposed 1135 research questions, which were consolidated into 94 unique research questions. The mean number of questions did not differ between low- and middle-income country (LMIC) and high-income country (HIC) participants, but significantly more questions were raised by participants with expertise in mental health and WASH. Sixty-six participants then ranked these questions. The top ten-ranked research questions included four on 'understanding the problem', four on 'designing and implementing interventions', one on 'integrating and scaling up', and one on 'measurement'. Indicators for the measurement of adequate menstrual health over time was ranked the highest priority by all stakeholders. Top ten-ranked research questions differed between academics and non-academics, and between participants from HICs and LMICs, reflecting differences in needs and knowledge gaps.

CONCLUSIONS

A list of ranked research priorities was generated through a consultative process with stakeholders across LMICs and HICs which can inform where to invest efforts and resources.

What socio-demographic factors support disposable vs. sustainable menstrual choices? Evidence from India's National Family Health Survey-5

For over a decade, improving menstrual hygiene among poor girls and women in low-and-middle-income-countries has been a prominent global goal. Towards this, governments in the Global South have worked to promote the uptake of disposable sanitary pads. Despite this, we continue to see a high prevalence of period poverty mainly because disposable pads require monthly purchasing that may be burdensome for many women. Not only are pads financially unsustainable but also represent a heavy environmental burden which has kindled an interest in re-usable innovations like menstrual cups that present a sustainable solution. However, there is little understanding of factors that promote the take-up of disposable vs. sustainable products at population levels. In this paper, we draw on India's National Family Health Survey-5 to understand the socio-demographic determinants of period product usage among girls and women, differentiated by their sustainability quotient. Our findings suggest that awareness of sustainable products and cultural factors are the key driver to promote their use. Women with exposure to menstrual cups either via education or mass media were more likely to use them. Belonging to urban areas and to disadvantaged social categories are other driving factors, at least partly because taboos of vaginal insertion are less of a concern among these groups. These findings suggest that improving the uptake of menstrual cups requires a paradigm shift in menstrual health policies from the promotion of disposable pads alone to spreading awareness of sustainable period choices among women via innovative use of mass media and community networks. Some micro-level evidence of change supports our conclusions.

The heat goes on: Simplifying the identification of energy hardship

Energy hardship affects over 6% of households in New Zealand, defined as the inability to afford and obtain energy services. In late 2021, the Ministry of Business, Innovation and Employment proposed 26 indicators to identify energy hardship. However, this study aimed to explore the leading causes and consequences of energy hardship in the following year, including relevant variables not included in the proposed indicators. A survey of 1278 Kiwi respondents was conducted to understand their demographic and energy consumption patterns. Using 17 of the proposed indicators, the severity of energy hardship was measured and related to other important variables. Results showed that energy unaffordability, poor housing quality, and choosing between food expenses or energy bills were the main drivers of energy hardship. Consequences included feeling cold due to restricted energy consumption and accumulating energy debt. This study provides valuable insights to simplify the identification of households experiencing energy hardship and highlights the main areas of focus for policy development aimed at eradicating this problem.

Period poverty and mental health in a representative sample of young women in Barcelona, Spain

BACKGROUND

The intersection between poverty and mental health is clear. Period poverty, understood as the lack of access to menstrual products, has been gaining attention especially among low and middle-income countries as an overlooked aspect of gendered poverty. Less is known about the incidence of period poverty in high-income countries and its association with mental health. The purpose of this study is to examine this association in a representative sample of young women living in an urban setting in southern Europe.

METHODS

This is a cross-sectional study. Data were obtained from a representative survey of individuals aged 15 to 34 in the city of Barcelona (Spain), with a sample group of 647 young women. Subjects were selected through a systematic stratified random sampling method. A proportional quota sampling was used. The information was registered using CAPI data collection method. Period poverty was measured by a combination of three questions about the lack of access or misuse of menstrual products for economic reasons. The GHQ-12 was used to measure the risk of poor mental health. The analysis was carried out using multivariable logistic regression.

RESULTS

From our sample, 15.3% of young women reported having experienced period poverty. Higher odds of poor mental health were estimated for women facing period poverty (AOR = 1.85 p < 0.05). This effect is statistically significant after controlling by their income status and level of deprivation. Young women living in poorer households have a higher probability of poor mental health than those living in high-income households (AOR = 0.47 p < 0.05). Finally, material deprivation was associated to an increased risk of poor mental health among young women reporting period poverty (AOR = 2.59 p < 0.01).

CONCLUSION

We found that a considerable number of young women living in an urban setting in a high-income country cannot afford menstrual products, and this may have an impact on their mental wellbeing. The relationship between period poverty and respondents' mental health is significant when controlling for factors known to confer an increased risk of poor mental health. If confirmed by further research, the public health burden of poor mental health in young women could be reduced by policy-level interventions to improve access to menstrual products.

Spanish menstrual literacy and experiences of menstruation

There is growing recognition of the important role menstrual health plays in achieving health, education, and gender equity. Yet, stigmatisation and taboo remain present and negative emotions like fear and shame dominate the narrative when speaking about periods. This paper analyses how formal and informal menstrual education is received in Spain, to understand the role of menstrual health literacy in the way menstruation is experienced, and to identify what information would be useful to integrate into formal menstrual education. An online survey with more than 4000 participants (aged between 14 and 80, both people who will/do/have previously menstruate/d and those who do not menstruate) was conducted. Data was gathered using the digital platform Typeform, descriptive and inferential statistical analyses were performed with SPSS software and qualitative data was thematically analysed using Nvivo. Many participants declared not having received sufficient information on menstruation prior to menarche, particularly about how to physically manage it. Furthermore, negative emotions like shame, worry, and fear were recurrently reported to describe menarche; this has not changed between generations. Interestingly, we saw an increase in stress and sadness with an increase in perceived knowledge of the reproductive role of menstruation. We did observe a reduction in negative emotions when people who menstruate perceived they had sufficient information on how to manage their first bleeding. It is recommended that menstrual education beyond reproductive biology, particularly including how to physically manage periods, is integrated into school curricula. Menstrual education of everyone - including those who do not menstruate-can improve how periods are experienced in Spain.

The implications of a cost-of-living crisis for oral health and dental care

A cost-of-living crisis is currently affecting the UK. While this has been explored in terms of the effect on dental practice, the dental implications for patients and for population oral health have not received sufficient attention. This opinion piece discusses how: i) financial pressures leading to hygiene poverty may limit the ability to afford the basic products necessary to maintain oral hygiene; ii) food insecurity is associated with a diet high in sugar and lacking in appropriate nutrition; and iii) reduced disposable income may limit the ability to attend and successfully engage with dental care. The impact of the cost-of-living crisis on the lowest paid members of the dental team is also considered.The most common dental diseases are closely correlated with social and economic deprivation and the points discussed here act as a reminder of how the present financial circumstances have significant potential to widen oral health inequalities.

COVID-19 made it harder to access period products: The effects of a pandemic on period poverty

Background

Prior to the COVID-19 pandemic, a few studies started to highlight the extent of period poverty in the U.S., especially among low-income women and girls. Preliminary data documenting the effects of the pandemic, subsequent economic downturn, and closure of schools and businesses on menstrual hygiene management are now emerging.

Objective

This study explores the relationship between the effects of the COVID-19 pandemic and period poverty among a nationally representative sample of U.S. adults.

Methods

Cross-sectional, secondary analyses of a 2021 nationwide, self-administered, online panel survey used weighted logistic regressions to assess the relationship between the COVID-19 pandemic making it more difficult to access products and missing work due to a lack of products. Responses from 1,037 menstruating individuals age 18-49 were included.

Results

Overall, 30% of the sample indicated the COVID-19 pandemic made it more difficult to access period products, 29% struggled to purchase period products in the past year, and 18% missed work due to a lack of period products. Those who identified as Hispanic (aOR 2.06 95% CI 1.29-3.29) and had children under 18 (aOR 15.3 95% CI 1.03-2.26) were more likely to indicate that the pandemic made it harder to access period products. Subsequently, those who indicated that the pandemic made it more difficult to access period supplies were more likely to report missing work due to a lack of period products in the past 12 months (aOR 4.32 95% CI 4.69-6.94).

Discussion

The COVID-19 pandemic exacerbated period poverty, especially among those in the U.S. who struggle with accessibility and affordability of products. Future pandemic response planning should consider period products as a basic need for vulnerable households. In addition, policies that increase the affordability and accessibility of period products for all should help reduce menstruation-related absenteeism from work.