Period poverty is the lack of sufficient access to menstrual products, menstrual health education, and adequate sanitation facilities. It affects millions of people worldwide and carries real consequences for physical health, mental well-being, education, and economic participation. While often associated with low-income countries, period poverty is a significant issue in wealthy nations too, including the United States.
More Than Just Affording Products
The term “period poverty” is easy to reduce to a simple money problem, but it has three distinct components. The first and most visible is financial: the inability to afford pads, tampons, or other menstrual products on a regular basis. The second is educational, meaning a lack of knowledge about menstrual hygiene practices, available product types, and how to manage symptoms like cramps and odor. The third is infrastructural: the absence of clean, safe restrooms with running water, soap, and waste bins.
All three components interact. A person experiencing homelessness may have no private space to change a pad. A teenager in a school without menstrual health education may not know that alternatives to disposable products exist. Someone living paycheck to paycheck may stretch a single tampon far longer than is safe because they can’t afford a new box. In sub-Saharan Africa, only 1 in 8 schools provide menstrual materials for free or for purchase. Globally, less than 1 in 3 schools have waste bins for menstrual products in girls’ restrooms, and only about 2 in 5 schools offer any menstrual health education at all.
Who It Affects in the US
Period poverty is not limited to developing countries. In the United States, low-income individuals, people experiencing homelessness, incarcerated people, and college students all face barriers to managing menstruation with dignity. Government assistance programs like SNAP (food stamps) do not cover menstrual products, and as of mid-2023, 21 US states still charge sales tax on pads and tampons, with rates ranging from 4% to 7%. States like Indiana, Mississippi, and Tennessee have some of the highest rates. While these taxes may seem small per purchase, the cumulative cost over decades of menstruation adds up, particularly for those already stretched thin financially.
Physical Health Risks
When people can’t afford or access enough menstrual products, they improvise. In some parts of the world, that means using newspaper, rags, or even coconut husks. In wealthier countries, it more commonly means wearing a single pad or tampon for far longer than recommended.
Prolonged use of any menstrual product increases the risk of urinary tract infections and bacterial vaginosis. A study in Odisha, India found that people using reusable cloth pads without adequate sanitation facilities were more likely to develop these infections than those using disposable pads. Skin irritation, vaginal itching, and abnormal discharge are also common when products are worn too long or when hygiene conditions are poor. The risk is compounded for people without private, clean spaces at home: those with higher incomes and personal bathrooms are significantly more protected against infection than those without adequate sanitation.
The Link to Depression and Anxiety
Period poverty takes a measurable toll on mental health. A study of college-aged women in the United States found that those who experienced period poverty every month were more than twice as likely to report moderate or severe depression compared to those who had never experienced it. Among monthly sufferers, 68.1% showed symptoms of moderate or severe depression, compared to 43.4% of those who had always been able to afford products.
The relationship followed a gradient: the more frequently someone couldn’t afford menstrual products, the worse their depression scores. This pattern held even after researchers adjusted for other factors. Shame and stigma around menstruation intensify the effect. Not being able to manage a period discreetly can trigger anxiety about leaks, odor, and social judgment, creating a cycle of avoidance and isolation that feeds into broader mental health struggles.
Missing School and Falling Behind
For students, period poverty translates directly into lost classroom time. A study of high school students in St. Louis, Missouri found that one-third of participants (33.6%) had missed school because they lacked period products. That’s not an occasional absence. Over the course of a school year, repeated missed days create gaps in learning that compound over time, affecting grades, test scores, and long-term academic trajectories.
The problem is self-reinforcing. Students who miss class fall behind, which increases stress and disengagement, which makes it harder to catch up. For students already facing economic hardship, missing school for a preventable reason like lacking a $5 box of pads is a particularly frustrating barrier to educational equity.
Impact on Work and Productivity
The effects extend well beyond school. In a cross-sectional survey of US employees, 45.2% reported missing work days due to their menstrual cycle in the previous year, averaging 5.8 missed days. A larger survey of roughly 33,000 respondents found that 13.8% reported absenteeism during their period and a striking 80.7% reported showing up to work but being unable to function at full capacity. Together, these effects accounted for an average of 23.3 days of lost productivity per year.
While not all of this productivity loss is caused by period poverty specifically (menstrual symptoms like pain and heavy bleeding play a role regardless of income), inadequate access to products and clean facilities at work makes everything worse. Someone who can’t afford to change a pad midday, or whose workplace lacks a private restroom, faces compounding barriers that higher-income workers simply don’t encounter.
What’s Changing
Legislative efforts are slowly addressing the problem. In the US, 29 states and Washington, D.C. have eliminated the sales tax on menstrual products, though 21 states still tax them. Several states have passed laws requiring free menstrual products in public school restrooms, and similar bills have been introduced at the federal level. Scotland became the first country to make period products free for anyone who needs them in 2022, and New Zealand began providing free products in all schools the same year.
Community-level efforts also make a difference. Period product drives, school-based distribution programs, and nonprofit organizations that supply free products to shelters and food banks help fill gaps that policy hasn’t yet closed. Some organizations also focus on the education component, providing menstrual health information alongside products so that recipients understand their options and can manage their periods safely.
Reusable products like menstrual cups and period underwear offer potential long-term savings, since a single cup can last years. But they require clean water, private space, and upfront cost, all of which can be barriers for the people who would benefit most. Without addressing the infrastructure and education gaps alongside affordability, reusable products alone won’t solve the problem.