Period Poverty in U.S. College Students

The menstrual cycle is an integral component of women's health. ¹ Each month, an estimated 1.9 billion individuals experience menstruation, yet proper access to adequate menstrual health and hygiene management resources remains limited in scope. ^1,2 Despite the adverse socioeconomic, mental, and physical consequences imposed by poor menstrual health on both women and girls globally, multilevel barriers hindering access to menstruation products, educational resources, and sanitation facilities persist, along with new emerging challenges that are contributing to its wide scale detrimental impact. ^{3 –6}

According to the American Medical Women's Association, the term “period poverty” refers to the lack of proper accessibility and limited affordability of menstrual health and hygiene resources including educational tools, sanitary products, washing facilities, and waste management. ⁵ Period poverty stems from an increased economic vulnerability imposed on menstruating individuals by the high costs of menstrual supplies. ^{5 –10} During the coronavirus disease 2019 (COVID-19) pandemic, low-income menstruating individuals were disproportionately affected by period poverty due to the shortage in supplying period products and the subsequent increase in their prices. ^{11 –13} Limited accessibility to such products was disclosed as a major underlying factor for missing work. ¹² Moreover, Schmitt et al. emphasized the need for designing and providing evidence-based menstruation and puberty education in schools since the integration of menstruation in curriculums remains a multilevel challenge for teachers and school authorities. ¹³ This in turn will contribute to misconceptions and disengaging menstruation and puberty content in institutional settings. ^12,13

Another educational setting with significant disparities in menstrual health are U.S. colleges. ¹¹ In 2021, a national survey carried out among U.S. college students highlighted that 14.2% of respondents reported experiencing period poverty since the start of the COVID-19 pandemic, while an additional 10% experienced this phenomenon recurrently on a monthly basis. ¹¹ Moderate/severe depression was also reported among survey participants, with those reporting monthly period poverty being at greater risk of mental health disorders. ¹¹ Although a widespread public health issue, there is a significant gap in the literature exploring menstrual health and hygiene management disparities in U.S. college students to assess the deteriorating impact of period poverty on women's health. ^{11 –14}

In their study, Palovick et al. aimed to examine data from a recently emerged national database, which documents period product insecurity. The authors of this study carried out logistic regression analysis to compare trends in reported period poverty among two nationally representative samples of U.S. adults in 2018 and 2021. ¹⁵ Result highlight major predictors of experiencing period product insecurity including race/ethnicity, educational level, and economic status. ¹⁵ Findings from this study will inform policies for improved accessibility and affordability of menstrual health products, particularly in underserved communities who are at higher risk of suffering from the consequences of menstrual inequities. ¹⁵ Additionally, evidence-based interventions are needed to reduce sales tax on menstrual hygiene products and provide products at no cost to students in schools, similar to the legislation passed in Washington, D.C. requiring budget allocation to ensure free menstrual products in schools as well as the exemption of all period products from taxation. ¹⁵ Understanding city, state, and national level trends in period poverty is essential to combat its disproportionate impact on U.S. women's sexual and reproductive health. ¹⁵