The costs for menstrual cups vary widely, from US$0.70 to $47 per cup, with a median cost of $23.35 (based on a 2019 review of 199 brands of menstrual cups available in 99 countries). [ 14 ]  Regulatory environment can have a strong effect on the price, because compliance may be time-consuming and costly. [ 137 ]  For manufacturing costs, see  manufacturing section , above.


Reusable menstrual products (including reusable menstrual cups) are more economical than  disposable  pads or tampons. [ 80 ] [ 150 ]  The same 2019 review looked at costs across seven countries and found that, over 10 years, a menstrual cup costs $460.25 less than 12 disposable pads per period and $304.25 less than 12 tampons per period. [ 14 ]


Despite the long-term cost savings, the upfront cost of a menstrual cup is a barrier for some. [ 108 ]


Since they are reusable, menstrual cups help to reduce solid  waste . [ 151 ]  Some disposable menstrual pads and plastic tampon applicators can take 25 years to break down in the ocean and can cause a significant environmental impact. [ 152 ]  Biodegradable sanitary options are also available, [ 153 ]  and these decompose in a short period of time, but they must be composted, and not disposed of in a landfill. [ citation needed ]


When considering a 10-year time period, waste from consistent use of a menstrual cup is only a small fraction of the waste of pads or tampons. [ 14 ]  For example, if compared with using 12 pads per period, use of a menstrual cup would produce only 0.4% of the  plastic waste . [ 14 ]


Each year, an estimated 20 billion pads and tampons are discarded in North America. They typically end up in landfills or are incinerated, which can have a great impact on the environment. Most of the pads and tampons are made of cotton and plastic. Plastic takes about 50 or more years and cotton starts degrading after 90 days if it is composted. [ 154 ]


Given that the menstrual cup is reusable, its use greatly decreases the amount of waste generated from menstrual cycles, as there is no daily waste and the amount of discarded packaging decreases as well. After their life span is over, silicone cups can be burned or sent to a landfill. [ 155 ]  Alternatively, one brand offers a recycling program and some hospitals are able to recycle medical grade silicone, including cups. [ 156 ] [ 157 ]  Cups made from  TPE  can be recycled in areas that accept  #7 plastics . Rubber cups are compostable. [ 155 ]


Menstrual cups may be emptied into a small hole in the  soil  or in  compost piles , since menstrual fluid is a valuable  fertilizer  for plants and any  pathogens  of  sexually transmitted diseases  will quickly be destroyed by soil microbes. [ 158 ] [ medical citation needed ]  The water used to rinse the cups can be disposed of in the same way. This reduces the amount of  wastewater  that needs to be  treated . [ citation needed ]


In developing countries, solid waste management is often lacking. Here, menstrual cups have an advantage over disposable pads or tampons as they do not contribute to the solid waste issues in the communities or generate embarrassing refuse that others may see. [ citation needed ]


Menstrual cups may have been inspired by other types of vaginal inserts used throughout history. [ 159 ]  Vaginal inserts had various purposes from birth control, enabling abortions, to supporting a prolapsed uterus. [ 159 ]  The first version of what we would now call a menstrual cup was a rubber sack attached to a rubber ring created by S.L. Hockert in 1867, which was patented in the United States. [ 159 ]  An early version of a bullet-shaped menstrual cup was patented in 1932, by the midwifery group of McGlasson and Perkins. [ 160 ]   Leona Chalmers  patented the first usable commercial cup in 1937. [ 161 ]  Other menstrual cups were patented in 1935, 1937, and 1950. [ 162 ] [ 163 ] [ 164 ]  The Tassaway brand of menstrual cups was introduced in the 1960s, but it was not a commercial success. [ 165 ]  Early menstrual cups were made of rubber. [ 166 ]  The first menstrual-cup applicator was mentioned in a 1968 Tassaway patent; there are also 21st-century versions, but they have not been a commercial success, as of 2024 [update] . [ 167 ]


No medical research was conducted to ensure that menstrual cups were safe prior to introduction on the market. [ 77 ]  Early research in 1962 evaluated 50 volunteers using a bell-shaped cup. The researchers obtained vaginal smears, gram stains, and basic aerobic cultures of vaginal secretions. Vaginal speculum examination was performed, and pH was measured. No significant changes were noted. This report was the first containing extensive information on the safety and acceptability of a widely used menstrual cup that included both preclinical and clinical testing and over 10 years of post-marketing surveillance. [ 24 ]


In 1987, another latex rubber menstrual cup, The Keeper, was manufactured in the United States. This proved to be the first commercially viable menstrual cup and it is still available today. The first silicone menstrual cup was the UK-manufactured Mooncup in 2001. Most menstrual cups are now manufactured from medical grade silicone properties.


An early menstrual disc, the Gynaeseal, was developed by Dr John Cattanach in 1989, but never found commercial success. [ 168 ] [ 14 ]  In 1997, the Instead Feminine Protection Cup began to be sold across the United States. [ 135 ] [ 169 ]  Designed by Audrey Contente, the disposable disc was made of  Kraton . [ 134 ] [ 135 ]  In 2018, reusable silicone discs were introduced. [ 170 ] [ 171 ]  As of 2021, there were ten brands of discs available for purchase in various markets. [ 170 ]


Menstrual cups are becoming more popular worldwide, with many different brands, shapes, and sizes on the market. [ 130 ]  Most are reusable, though there is at least one brand of disposable menstrual cups currently manufactured. [ 130 ]


Some non-governmental organizations (NGOs) and companies have begun to propose menstrual cups to women in developing countries since about 2010, for example in Kenya and South Africa. [ 172 ]  Menstrual cups are regarded as a low-cost and environmentally friendly alternative to sanitary cloth, expensive disposable pads, or "nothing" – the reality for many women in developing countries. [ 68 ]


In a randomized controlled feasibility study in rural western Kenya, adolescent primary school girls were provided with menstrual cups or menstrual pads instead of traditional menstrual care items of cloth or tissue. [ 173 ]  Girls provided with menstrual cups had a lower prevalence of  sexually transmitted infections  than control groups. Also, the prevalence of  bacterial vaginosis  was lower among cup users compared with menstrual pad users or those continuing other usual practice. [ 173 ]


The municipality of Alappuzha in  Kerala ,  India  launched a project in 2019 and gave away 5,000 menstrual cups for free to residents. [ 174 ]  The purpose of this was to encourage the use of these cups instead of non-biodegradable menstrual pads to reduce waste production. [ 174 ]


In 2022,  Kumbalangi , a village in Kerala, became  India 's first sanitary-napkin-free  panchayat  under a project called "Avalkkayi", which gave away 5,700 menstrual cups for free. [ 175 ]


In 2022, the Spanish government began distributing free menstrual cups through public institutions (such as schools, prisons, and health facilities). [ 176 ]


In March 2024,  Catalonia , in  Spain , started supplying free menstrual cups as part of the "My period, my rules" initiative. The  universal public healthcare system  supplied one menstrual cup, one pair of  period underwear , and two packages of reusable cloth menstrual pads per person, available through local pharmacies. The program covers 2.5 million people and cost the Catalan government €8.5 million (3.40 euros / 3.68 US dollars per person). The program was undertaken for equity, poverty reduction, taboo reduction, and environmental benefits. It is expected to reduce waste from single-use menstrual hygiene products, which had been 9000  tons [ clarification needed ]  per year, according to the Catalan government. [ 177 ] [ 178 ]


Menstrual cups can be useful as a means of  menstrual hygiene management  for people in developing countries where access to affordable sanitary products may be limited. [ 66 ] [ 179 ]  A lack of affordable hygiene products means inadequate, unhygienic alternatives are often used, which can present a serious health risk. [ 180 ] [ 181 ]  Menstrual cups offer a long-term solution compared to some other menstrual hygiene products because they do not need to be replaced monthly.


Menstrual hygiene products that need to be inserted into the vagina can be unacceptable for cultural reasons. There are myths that they interfere with  female reproductive organs  and that they cause females to "lose their  virginity ". [ 29 ]


There is no evidence that tampon use commonly causes trauma to the hymen. Hymens vary, and septate, cribriform or microperforate hymens, rarer physiological variations, may interfere with tampon use. [ 182 ] [ 183 ]  Some ring-shaped menstrual cups are no bulkier than a tampon when folded as recommended. [ 24 ]


Inserting objects (including penises) into the vagina may or may not affect the  hymen . [ 184 ]  Some cultures wrongly think that the state of the hymen can give  evidence of virginity , and wrongly believe that inserting anything into the vagina will "break" the hymen. [ 184 ] [ 182 ]  This can discourage youths from using cups. [ 185 ] [ 186 ]


Despite common cultural beliefs, the state of a hymen cannot be used to  prove or disprove virginity . Penile penetration does not lead to predictable changes to female genital organs; after puberty, hymens are highly elastic and can stretch during penetration without trace of injury. Females with a confirmed history of sexual abuse involving genital penetration may have normal hymens. Young females who say they have had consensual sex mostly show no identifiable changes in the hymen. Hymens rarely  completely cover the vagina , hymens naturally have irregularities in width, and hymens can heal spontaneously without scarring. Many women do not bleed on having vaginal sex for the first time, hymens may not bleed significantly when torn, and vaginal walls may bleed significantly when torn. [ 184 ]


There has been one news report of the stem of a bell-shaped cup passing outwards through a small side hole in a  septate hymen  (a hymen with more than one opening), causing pain on attempted removal. The woman had the problem diagnosed and the cup removed at a hospital. She had previously used the cup without problems for four years. [ 187 ]  Some examine their hymen with a mirror before using a menstrual cup. [ 188 ]


Menstrual hygiene management  ( MHM ) or  menstrual health and hygiene  ( MHH ) is the access to  menstrual hygiene products  to absorb or collect the flow of blood during  menstruation , privacy to change the materials, and access to facilities to dispose of used menstrual management materials. [ 1 ]  It can also include the "broader systemic factors that link menstruation with health, well-being,  gender equality ,  education , equity,  empowerment , and rights". [ 1 ]  Menstrual hygiene management can be particularly challenging for girls and women in  developing countries , where clean water and toilet facilities are often inadequate. Menstrual waste is largely ignored in schools in developing countries, despite it being a significant problem. Menstruation can be a barrier to education for many girls, as a lack of effective sanitary products restricts girls' involvement in educational and social activities.


An accepted definition of menstrual hygiene management (MHM) is:


The "value chain" related to menstrual hygiene management includes four aspects: awareness, access, use as well as waste management. [ 3 ]  The CLTS Knowledge Hub gives a definition that accounts for these four aspects as well as social and cultural factors:


Menstrual hygiene management’ is the way in which women and adolescent girls deal with their menstruation. (Good) MHM requires a minimum level of knowledge and awareness in women and adolescent girls to manage their menstruation effectively and hygienically by using a clean material to absorb or collect menstrual blood, by practicing good hygiene and personal care during their period, and by having access to facilities to wash or dispose of used menstrual management materials with dignity and in an environmentally responsible manner. MHM is not just about the management of the menstrual period but also the need to address societal beliefs and taboos surrounding the issue. Sufficient knowledge, guidance and support for girls and women in preparation for and during menstruation is also part of the definition. [ 4 ]


The term  “menstrual health” is broader than menstrual hygiene. It encompasses both the menstrual hygiene management practices and the broader systemic factors that link menstruation with  health , well-being,  gender ,  education ,  equity ,  empowerment , and  human rights  (in particular the  human right to water and sanitation ). [ 5 ]   UNICEF  now (since 2019) uses the term MHH for "menstrual health and hygiene". [ 1 ]


These systematic factors include accurate and timely knowledge, available, safe, and affordable materials, informed and comfortable professionals, referral and access to health services,  sanitation  and washing facilities, positive  social norms , safe and hygienic disposal, and advocacy and policy. [ 1 ] [ 4 ]


The oldest known records of menstrual hygiene products date to ancient Egypt, where people utilized softened papyrus as a means of absorbing menstrual blood. In resource-constrained Indigenous communities, organic materials were likely employed for this purpose. There is speculation that Vikings used bog moss. [ 6 ]


In the late 19th century, some suggest that menstruation was considered a form of illness. Doctor Edward Clark [ who? ]  believed that attending school during menstruation could potentially delay the development of reproductive organs. [ 6 ]


In 1897,  Johnson & Johnson  added sanitary napkins to its price list following a suggestion from Joseph Brown Cook. [ who? ] [ 7 ]  Despite limited acceptance of this product, [ 8 ]  it was the first commercially available sanitary protection product for women in the United States. These sanitary napkins were advertised minimally and in small print to maintain a sense of ‘modesty’. [ 7 ]


Sfag-Na-Kins, developed by the Sphagnum Moss Products Company, transformed sphagnum moss into sanitary napkins with the ability to absorb over 20 times their dry weight in fluids. [ 9 ]  In 1920, Johnson & Johnson introduced the discreetly named and plainly packaged Nupak brand, allowing women to make purchases inconspicuously. [ 7 ]


The success of  Kotex  napkins in 1921 can be attributed to extensive advertising in women's magazines and the use of cellucotton enclosed within a gauze sheath. [ 9 ]  In 1928, Johnson & Johnson introduced silent purchase coupons in magazine ads for MODESS sanitary napkins, providing women with a discreet means of acquiring products without engaging with salespeople. [ 7 ]


E.C. Haas filed a patent in 1931 for the Tampaz tampons, featuring a paper-tube applicator. Tampons had initially been used in medical practice to control bleeding in deep wounds. [ 9 ]


In 1957, Mary Davidson Kenner presented a patent for an adjustable sanitary belt designed to secure the pad, prevent menstrual blood leakage, and avoid stains. However, Kenner, a black woman, faced systemic barriers. [ 8 ] [ 10 ]


The popularity of belted sanitary napkins waned in the early 1980s with the advent of adhesive strips positioned on the bottom of sanitary pads, facilitating attachment to underwear linings. Since then, menstrual products have undergone substantial transformations, evolving to be more ergonomic, thinner, and incorporating diverse materials to enhance absorption. [ 9 ]


Menstrual hygiene management can be particularly challenging for girls and women in developing countries, where clean water and toilet facilities are often inadequate. In addition, traditional cultures make it difficult to discuss menstruation openly. This limits women's and adolescent girls’ access to relevant and important information about the normal functions of their own body. This directly affects their health, education, and  dignity .  Access to information can be considered a  human right . [ 11 ] [ 12 ]


Currently, there are about 3.73 billion women in the world. According to the World Health Organization (WHO), 52%, or 1.9 billion, of those women are of reproductive age, thus menstruating (WHO, 2018). [ 13 ]  Women at some point in their life will go through the reproductive age and thus, will experience menstruation. It has been estimated that daily 300 million women are menstruating; on average a woman will spend about 3,500 days during her life menstruating. [ 14 ]


Many adolescent girls and women of menstruating age live in poor socio-economic environments. 663 million people lack basic access to safe water, and 2.4 billion people lack adequate access to basic sanitary conditions. [ 15 ]  For women and girls, the lack of safe, accessible  water, sanitation and hygiene (WASH)  is particularly troubling during menstruation and  childbirth . It has been estimated that half a billion (or 13%) of women lacked a place to  defecate , have little to no privacy for menstrual hygiene management, and 3/4 of those lacked access to soap and water. [ 16 ]


In a 2014 study conducted in  India , the researchers found that as many as 42% of women who participated in the study did not know about sanitary pads or from where in their anatomy menstruation originated, and that "most of them were scared or worried on first menstruation." [ 17 ]  More recently, studies have shown that 50% of women in India have experienced a  urinary tract infection (UTI)  related to the inability to safely manage their period. [ 18 ]  When left untreated, UTIs can lead to kidney failure. Worldwide, in 2018, one in three women did not have access to a working  toilet  at all. [ 19 ]  Menstrual hygiene management issues have been ignored by professionals in the WASH sector, as well as in the health and education sectors. [ 20 ] [ 21 ]


Poor MHM may affect the  reproductive  tract, but the specific infections, the strength of effect, and the route of transmission remain unclear. [ 21 ]  In India, a majority of girls are at risk for  reproductive tract infections  (RTI) because of poor MHM. RTI can lead to various disabilities if not treated early on [ 22 ]  and are the cause of 30–50% of prenatal infection. [ 23 ]  Due to prejudices surrounding the issue, some women in India do not eat or take showers during their menstruation. [ 24 ]


Girls' self-image may be negatively impacted by adverse attitudes towards menstruation. [ 25 ] [ 26 ]


The  onset of menstruation  is challenging for school-aged girls in low-income settings. Impacts can include school  absenteeism , missed class time, reduced participation, teasing, fear and shame, and risky adaptive behaviors. [ 27 ]  Further challenges that menstruating school girls face are a lack of knowledge, communication, and practical guidance prior to menarche and during menstruation; inadequate water, sanitation, and hygiene (WASH) facilities; and ineffective or unavailable  menstrual management materials . [ 27 ]


In many parts of sub-Saharan Africa, girls can miss up to 5 days of school a month or drop out entirely due to insufficient access to water, sanitation and hygiene (WASH) facilities and menstrual hygiene products. [ 28 ] [ 29 ]  Improving access to WASH facilities can actually increase girls' attendance at school. A program for school sanitation in  Bangladesh  increased girls' enrollment at school by 11%. [ 30 ]


Menstrual waste is largely ignored in schools in developing countries, despite it being a significant problem. Girls' access to water and sanitation at school is only available at 47% and 46% of all schools globally. [ 11 ]  Often, school toilets for girls (if they even exist) are missing bins for menstrual waste collection with the result that pads may be spread all around the school compound area. [ 31 ]  This pollutes the environment and also causes embarrassment for the school girls.


In the United States, among other countries, girls who are unable to afford feminine hygiene products may miss school in order "to avoid the embarrassment of staining their clothes". [ 32 ]  According to a study done by INTIMINA surveying students across Ohio State University, University of Wisconsin at Madison, Harvard University, New York University, and University of Central Florida, 19% of female college students said they have felt forced to decide whether to buy period products or other necessities like food. [ 33 ]


Period poverty  is a term used to describe the lack of access to adequate menstrual hygiene management supplies and education, including sanitary products (e.g., tampons, pads, liners, menstrual cups), washing facilities, and disposal management. [ 34 ]  It also includes other  constraints such as taboos and myths, movement and food restrictions, shame and stigma around impurity and dirt which all contribute to the menstruator having an experience which is not dignified. [ 35 ]   Period poverty is a global health issue that affects many individuals living in low- and middle-income countries, with many young adolescents using materials such as mud, leaves, old paper, cotton, or animal skin to manage their periods. [ 36 ]  The use of alternative products, or using products longer than intended, can lead to health complications, infections, and long-term health issues. [ 37 ]  "In a 2018 study commissioned by  U by Kotex , one in four women surveyed struggled to purchase period products. In the same study, one in five low-wage women reported missing work, school or similar events due to lack of access to period supplies. These instances were linked to reported feelings of embarrassment, disappointment and depression." [ 38 ] [ 39 ] [ 40 ]


Despite known health consequences, period poverty is often overlooked and not discussed due to social and cultural stigmas and taboos. [ 36 ]  In recent years, many governments have actively increased access to affordable sanitary products and changing social norms towards menstruation. Scotland offers its residents free period products while Kenya and New Zealand offer free period products for students in public schools. [ 41 ]  In Australia, the state of  Victoria  and the  Australian Capital Territory  are rolling out access to free period products in public places, [ 42 ]  and period products have been freely available in Victorian government-run schools since 2020. [ 43 ]  Many organizations are spreading awareness to policy makers about the problem of girls missing school due to period poverty. [ 39 ] [ 40 ]


However, period poverty remains a prevalent issue in the United States. In the United States, federal aid programs including food stamps, SNAP benefits, and WIC benefits do not cover purchases of feminine hygiene products. [ 40 ] [ 34 ]  With the lack of government support and high taxes on menstrual products, many women choose forgo purchase of sanitary products for other needs. For instance, two-thirds of 16.9 million low-income women cannot afford sanitary products and have to choose between sanitary products and food. [ 44 ]  Currently, there are 14 states that ensure students have access to menstrual products in school bathrooms. [ 34 ]  But school closures during the early onset of the COVID-19 pandemic challenges low-income students’ access to pads and tampons. [ 34 ]


The homeless population also has difficulty accessing menstrual products. [ 37 ]   In a mixed-method study conducted from May to August 2019 in New York City with homeless individuals, many participants reported that they had uncertain access to safe, clean, and private spaces for changing period products. [ 45 ]  Many reported that the bathrooms in their homeless shelters were dirty or flooded. [ 45 ]   They also reported feeling shamed and embarrassed in the public with the possibility of menstrual leakage. [ 45 ]   While most of the research on period poverty in the United States has largely focused on the homeless population and low-income school students, college students also report high rates, affecting school attendance and mental health, respectively. [ 46 ] [ 47 ]  In 2021, approximately 14.2% of menstruating college students reported experiencing period poverty. [ 44 ]


In low-income countries, girls’ choices of menstrual hygiene materials are often limited by the costs, availability and social norms. [ 48 ] [ 49 ]


Absorption materials that may be used by women who cannot afford commercially produced materials include: sand, ash, [ 35 ]  small hole in earth, [ 50 ]  cloth, whole leaf, leaf fiber (such as  water hyacinth , banana,  papyrus , cotton fibre), paper (toilet paper, re-used newspaper, brown paper bags, pulped and dried paper), [ 51 ]  animal pelt (such as goat skin), [ 50 ]  double layer of underwear, socks, skirt, or  sari . [ 52 ] [ 53 ]


A lack of affordable hygiene products means inadequate, unhygienic alternatives are used, which can present a serious health risk. [ 54 ] [ 55 ]   Menstrual cups
offer a long-term solution compared to some other feminine hygiene products because they do not need to be replaced monthly. The quality of the material also makes them a reliable and healthy menstrual hygiene solution, as long as there is access to clean water for washing them.


Girls and women in the workplace often miss work because they don't have access to sanitary materials and places of employment in some countries do not provide resources for women or even have "proper toilets". [ 26 ]  Women in Bangladesh who work in factories have reported that due to the cost of sanitary products for menstruation which they could not afford, they have resorted to using "factory-floor rags in place of pads and tampons, leading to dangerous infections and missed work." [ 56 ]  The Christian sweeper community in Lahore who clean the roads do not have access to public washrooms because none or very few are available for women and because of this have to miss work when they have their period. [ 35 ]


Menstruation can be a barrier to education for many girls, as a lack of effective sanitary products restricts girls' involvement in educational and social activities. [ 57 ] [ 58 ]  Often they do not attend school due to fear of leaking, shame or embarrassment, period pain or inadequate sanitation facilities that do not allow them to wash or change in privacy. [ 59 ]  This applies mainly to schoolgirls from low-income families, since disposable hygiene products are a monthly expense that many people simply cannot afford. [ 60 ]


Adequate sanitation facilities and access to  menstrual hygiene products  are just one part of the solution to  menstrual taboos  that impede women's progress in many developing countries. Knowledge is critical for girls to feel comfortable with menstruation and to gain a positive awareness of their bodies. [ 61 ]


Access to menstrual hygiene products may be limited in prisons and correctional facilities where the services have been historically designed for the male population. In 2021 there were around 740,000 women in prisons around the world [ 62 ]  A woman incarcerated for five years in Pakistan spoke of how the prison authorities did not provide any menstrual products or pain relief medication to menstruating women. [ 35 ]


Many low-income and/or homeless girls and women in the inner cities of the United States cannot afford sanitary supplies. [ 32 ] [ 63 ]   Food banks  in  New York  report that feminine hygiene products are in high demand. [ 32 ]  Homeless women in the United States may face the challenge of not being able to shower or use the communal toilet in homeless shelters as often as they need to in cases where there are restrictions on toilet usage. [ 63 ]  In New York, proposals to help lower-income women access menstrual sanitary supplies include proposals to remove the sales tax on feminine hygiene products and "distributing free tampons in public schools." [ 32 ]  Sales tax are levied on menstrual supplies in 36 states. [ 64 ]  On May 1, 2018, the  National Diaper Bank Network , which provides millions of diapers to poor and low income parents and advocates for policy change around basic needs, launched the Alliance for Period Supplies and began distributing free period products through allied organizations across the U.S. [ 65 ]  Homeless women in other industrialized countries, such as the  United Kingdom , face problems affording tampons and sanitary napkins. [ 66 ]   Scotland  became the first country in the world to provide universal access to free period products in 2020. [ 67 ]  Research has shown that for  allotment  holders who menstruate, lack of access to sanitation at their plots can lead to challenges in hygiene. [ 68 ]


Homeless women in Pakistan use dried ash wrapped in cloth to help them during their period. They have no access to clean running water, public washrooms are few and mainly for men, there is no privacy, no place to rest and the women suffer from many infections. [ citation needed ]


A review in 2018 found that disposal of menstrual waste is often neglected in  sanitation  systems. This leads to improper disposal and negative impacts on users, the sanitation systems and the environment. [ 69 ]


Solid waste  disposal systems in developing countries are often lacking, which means women have no proper place to dispose of used products, such as pads. [ 70 ]  Inappropriate disposal of used materials also creates pressures on sanitation systems as menstrual hygiene products can create blockages of toilets, pipes and sewers. [ 71 ]


It is estimated that tampons, pads, and applicators, generates 200,000 tonnes of  plastic waste  in the  UK  each year. [ 72 ]


In developing countries, women experience a lack of access to affordable menstrual hygiene products in addition to a lack of access to other services such as sanitation and waste disposal systems needed to manage their menstrual cycles. Lack of access to waste disposal leads women to throw used products in toilet systems, pit latrines, or discarded into open areas such as bodies of water. These practices pose dangers to workers who handle these wastes as it increases possible exposure to bloodborne infections in soaked menstrual products and exposure to chemicals found in menstrual hygiene products. Inappropriate disposal also creates pressures on sanitation systems as menstrual hygiene products create sewage blockages. [ 71 ]  The effects of these inadequate facilities have been shown to have social effects on girls in developing countries leading to school absenteeism. [ 73 ]


Despite the fact that  menstruation  is a healthy biological process, it is approached with hesitance and misinformation because of deeply-rooted  cultural taboos  surrounding menstruation.


Cultural, [ 35 ]  religious and traditional beliefs — particularly in  developing countries  — can lead to restrictions that women or girls face during their period. In some societies, women do not wash their bodies, shower, or bathe during menstruation. They may not be allowed to use water sources during menstruation. Even if they have access to toilets, they might not use them because of the fear of staining the toilet bowls (in the case of  dry toilets  or  flush toilets  where the flush is not powerful). [ 60 ]  This impairs the use of menstrual cups compared to pads as the cups are normally emptied into toilets.


Expanding the discussion to include consideration of waste management is part of the attempt to "normalize" conversations about menstruation. [ 3 ] [ 4 ]


MHM in schools should not be a stand-alone programme but should be integrated with existing programmes on WASH in schools, school health and nutrition programmes, puberty education programmes, and emergencies. [ 74 ] [ 75 ]


In rural  Bolivia  a menstrual hygiene management game was developed for school girls that stimulated detailed responses, and diversified participatory activities in  focus group  discussions. The board game helped to ease girls’ discomfort discussing menstruation. [ 27 ]


In India, comic books  Menstrupedia Comichave  been used to educate children, street theatre performances to educate men and women, wall paintings and murals to engage community youth and art workshops and exhibitions to break the stigma and shame. [ 35 ]


In Bhutan, the Buddhist nuns, through the Bhutan Nuns Foundation have revolutionised the menstrual health of the nuns living in nunneries. [ 35 ]


In Pakistan, many new start ups in this area have contributed to improving access and making the subject easier to talk about. In Balochistan, a tribal area of Pakistan, the first ever menstrual health participatory workshop held in 2021, used poetry and art to raise awareness and change the discussion around the subject and make it more open. [ 35 ]


Improving MHM requires community-wide attitudinal changes. Involving men in MHM. [ 35 ]   is a key in order to get them to support their wives and daughters. [ 76 ]   Other organisations have also worked with games and stories to teach MHM, dispel common myths and start conversations. Games help to create a positive atmosphere around a topic generally associated with shame and embarrassment. [ 4 ]


An under researched area is how people living with disabilities cope with the challenges of menstruation, and how their care givers have to manage their menstrual hygiene and health for them. [ 35 ]


Further research investigation and practical assistance is also needed for those living in temporary shelters due to migration, climate change, flooding, earth quakes, communal riots or other such reasons of displacement. [ 35 ]


In 2014, Wash United initiated  Menstrual Hygiene Day  on May 28. Menstrual Hygiene Day creates an occasion for publicizing information about menstrual hygiene management issues in the media as a way to  raise awareness , celebrate and normalize menstruation and  menstrual hygiene . The day offers an opportunity to actively advocate for the integration of menstrual hygiene management into global, national, and local policies and programmes. [ 77 ]


A  menstrual pad [ a ]  is an  absorbent  item worn in the  underwear  when  menstruating ,  bleeding after giving birth , recovering from gynecologic surgery, experiencing a  miscarriage  or  abortion , or in any other situation where it is necessary to absorb a flow of  blood  from the  vagina . A menstrual pad is a type of  menstrual hygiene  product that is worn externally, unlike  tampons  and  menstrual cups , which are worn inside the vagina. Pads are generally changed by being stripped off the pants and panties, taking out the old pad, sticking the new one on the inside of the panties and pulling them back on. Pads are recommended to be changed every 3–4 hours to avoid certain bacteria that can fester in blood; this time also may differ depending on the kind worn, flow, and the time it is worn. [ 1 ]


Menstrual pads are made from a range of materials, differing depending on style, country of origin, and brand. [ 2 ]  The pads are not the same as  incontinence pads , which generally have higher absorbency and are worn by those who have  urinary incontinence  problems. Although menstrual pads are not made for this use, some use them for this purpose.


Although producers are generally reluctant to reveal the exact composition of their products, the main materials of  disposable  menstrual pads are usually  bleached   rayon  ( cellulose  made from  wood pulp ),  cotton  and  plastics . In addition,  fragrance  and  antibacterial  agents can be included. The plastic parts are the backsheet and  polymer  powder as an additional powerful  absorbent  ( superabsorbent polymers ) that turns into a  gel  when moistened. [ 3 ]   Procter & Gamble  advertise a proprietary material called Infinicel as the core of their napkins. [ 4 ]
In general, the layering is as follows: "an absorbent core material placed between a flexible liquid-pervious topsheet and a liquid-impervious plastic backsheet that has an adhesive on the outside for attaching the napkin to an undergarment". [ 5 ]  As is the case with disposable  tampons  and  diapers , recycling is difficult and rarely done due to cost reasons, although proof-of-principle solutions appear to exist. [ citation needed ]  When not dumped in a landfill where the non- biodegradable  parts may persist for thousands of years, conventional hygiene products can at best be " thermally recycled " (incinerated). [ 6 ]


There are several different types of disposable menstrual pads:


The shape, absorbency and lengths may vary depending on manufacturer, but usually range from the short slender panty liner to the larger and longer overnight. Long pads are offered for extra protection or for larger people whose  undergarments  might not be completely protected by regular length pads, and also for overnight use.


Other options are often offered in a manufacturer's line of pads, such as wings or tabs that wrap around the sides of underwear to add additional leak protection and help secure the pad in place. Deodorant is also added to some pads, which is designed to cover menstrual  odor  with a light fragrance. There are even  panty liners  specifically designed to be worn with a thong/ G-string .


Some people use a washable or reusable  cloth menstrual pad . These are made from a number of types of fabric—most often cotton flannel, bamboo, or  hemp  (which is highly absorbent and not as bulky as cotton). Most styles have wings that secure around the underpants, but some are just held in place (without wings) between the body and the underpants. Some (particularly the older styles) are available in belted styles. Cloth menstrual pads made a comeback around the 1970s, [ 7 ]  with their popularity increasing in the late 1980s and early 1990s. Reasons people choose to switch to cloth menstrual pads include comfort, savings over time, environmental impact and health reasons.


Washable menstrual pads do not need to be disposed of after use and therefore offer a more economical alternative. Reusable menstrual pads can be found on a number of websites, or are made at home (instructions are available online). They have become a popular alternative because they are allergen- and perfume-free, and can be more comfortable for people who experience irritation from using disposable pads.


There are many styles of cloth menstrual pads available today, ranging from panty liners to overnight pads. Popular styles of cloth menstrual pads include all-in-one, or AIO pads, in which the absorbent layer is sewn inside the pad, "inserts on top" style pads, which have absorbent layers that can be secured on top of the pad as needed, envelope or pocket style pads, which have absorbent layers that can be inserted inside the pad as needed, and a foldable style, in which the pad folds around the absorbent layers. Cloth menstrual pads can also have a waterproof lining, which provides more leak protection but may also be less breathable than those with no lining.


Menstrual pads are worn to absorb menstrual discharge, thereby protecting clothing and furnishings. They are usually individually wrapped so they are easier and more discreet to carry in a purse or bag. This wrapper may be used to wrap the soiled pads before disposing of them in appropriate receptacles. Some people prefer to wrap the pads with toilet paper instead of (or as well as) using the wrapper, which, often being made of slick plastic with a small tape tab, may not adequately stick. Menstrual pads of any type should not be flushed down the toilet as they can cause blockages. In  developed countries , public toilets almost always include a receptacle in which to place soiled pads. In first aid, they make excellent dressings for heavy bleeding due to their high absorbency if gauze is unavailable or inadequate. [ citation needed ]


Many people who experience  urinary incontinence  use menstrual pads to manage bladder leaks. However, since menstrual pads are designed to absorb menstrual flow, they are not as effective in absorbing urinary leaks;  incontinence pads  are designed for this purpose. [ 8 ]


If someone does not have menstrual pads on hand while menstruating, they might use  toilet paper  as a temporary substitution.


Through the ages societies have used different forms of menstrual protection. [ 9 ] [ 10 ]  Menstrual pads have been mentioned as early as the 10th century, in the  Suda , where  Hypatia , who lived in the 4th century AD, was said to have thrown one of her used menstrual rags at an admirer in an attempt to discourage him. [ 11 ] [ 12 ]  In ancient Egypt, women used softened papyrus, a grass-like plant, to absorb their menstrual blood. [ 13 ]  Before commercially available menstrual hygiene products, most women used pieces of cloth to absorb their menstrual flow. [ 14 ]  "On the rag" is a term that originally referred to menstrual rags, but its modern usage is as a menstrual euphemism. [ 15 ]


Until disposable menstrual pads were created, cloth or reusable pads were widely used to collect menstrual blood. People often used a variety of home-made menstrual pads which they crafted from various fabrics, or other absorbent materials, to collect menstrual blood. [ 9 ] [ 16 ]  Even after disposable pads were commercially available, for several years they were too expensive for many families to afford. [ 17 ]  When they could be afforded, people were allowed to place money in a box so that they would not have to speak to the clerk and take a box of  Kotex  pads from the counter themselves. [ clarification needed ] [ 18 ]  It took several years for disposable menstrual pads to become commonplace. For easier use, inventor Carolyn R. Mobley patented the tab construction for a sanitary napkin. [ 19 ]  Disposables are now used nearly exclusively in most of the industrialized world. [ 17 ]


The first of the disposable pads were generally in the form of a  cotton wool  or similar fibrous rectangle covered with an absorbent liner. The liner ends were extended front and back so as to fit through loops in a special girdle or belt worn beneath undergarments. This design was notorious for slipping either forward or back of the intended position.


Disposable  menstrual pads grew from a  Benjamin Franklin  invention created to help stop wounded soldiers from bleeding, [ 20 ] [ dubious  –  discuss ]  but appear to have been first commercially available from around 1880 [ 21 ]  with Thomas and William Southall's pad. [ 22 ] [ 23 ]  The first commercially available American disposable napkins were Lister's Towels created by  Johnson & Johnson  in 1888. [ 24 ]  Disposable pads had their start with nurses using their wood pulp bandages to absorb their menstrual flow, creating a pad that was made from easily obtainable materials and inexpensive enough to throw away after use. [ 25 ]   Kotex 's first advertisement for products made with this wood pulp (cellucotton) appeared in January 1921. [ 18 ]  Johnson & Johnson introduced  Modess [ 26 ]  Sanitary Napkins in 1926, [ 27 ]  researched by  Lillian Gilbreth . [ 28 ]  Lilian Gilbreth's market research report published in 1927 gives valuable information about American's experiences of menstruation in 1920s. [ 29 ]  The surveys she conducted on over 1000 people with periods reveal that "the most significant fact concerning the marketing angle of the sanitary napkin [...] is that it is availability that sells a napkin." [ 30 ]  Several of the first disposable pad manufacturers were also manufacturers of bandages, which could give an indication of what these products were like.


In 1956,  Mary Kenner  obtained a patent for an adjustable sanitary belt with an inbuilt, moisture-proof napkin pocket. [ 31 ] [ 32 ]  However, the company that first showed interest in her invention rejected it after they discovered that she was African American. [ 31 ]


Later an adhesive strip was placed on the bottom of sanitary pads for attachment to the crotch of the panties, and this became a favoured method. The belted sanitary napkin quickly disappeared during the early 1980s.


The ergonomic design and materials used to make pads also changed through the 1980s to today. With earlier materials not being as absorbent and effective, and early pads being up to two centimetres thick, leaks were a major problem. Some variations introduced were quilting of the lining, adding "wings" and reducing the thickness of the pad by utilising products such as  sphagnum  and polyacrylate superabsorbent gels derived from petroleum. The materials used to manufacture most pads are derived from the petroleum industry and forestry. The absorbent core, made from chlorine bleached wood pulp, could be reduced to make slimmer products with the addition of  polyacrylate  gels which sucks up the liquid quickly and holds it in a suspension under pressure. The remaining materials are mostly derived from the petroleum industry, the cover stock used is  polypropylene  non woven, with the leakproof barrier made from polyethylene film.


Pads, especially reusable ones, may be visible on  full body scanners . [ 33 ]


In  developing countries , makeshift pads are still used to collect menstrual blood as they are cheaper. [ 34 ]  Rags, soil, and mud are also reportedly used for collecting menstrual flow by people who cannot afford the more expensive disposable pads or tampons. [ 35 ]


In order to meet the need for achieving an inexpensive solution to reduce unsanitary and unhygienic practices in countries like India,  Arunachalam Muruganantham  from rural  Coimbatore  in the southern state of  Tamil Nadu , India, developed and patented a machine which could manufacture low-cost sanitary pads for less than a third of the former cost. [ citation needed ]   The Bill and Melinda Gates Foundation  awarded  Nairobi -based  ZanaAfrica  a grant of US$3 million. [ 36 ] [ 37 ] [ 38 ]  ZanaAfrica explores creative approaches to  menstrual health  education for adolescent girls. [ 39 ] [ 40 ]


In 2024 it was reported that a brand of menstrual pad was found to contain the toxic chemical  PFOA . [ 41 ]


A  merkin   is a  pubic   wig . Merkins were worn by  prostitutes  after shaving their  mons pubis , and are used as decorative items or erotic devices by both men and women.


The  Oxford Companion to the Body  dates the origin of the pubic wig to the 1450s. According to the publication, women would shave their pubic hair for personal hygiene and to combat  pubic lice . They would then put on a merkin. Also, sex workers would wear a merkin to cover up signs of disease, such as  syphilis . [ 1 ] [ 2 ]


The  Oxford English Dictionary  dates the first written use of the term to 1617. The word probably originated from  malkin , [ 3 ] [ 4 ]  a derogatory term for a lower-class young woman, or from  Marykin , a  pet form  of the female given name  Mary . [ 4 ]


Sometimes in filmmaking, merkins can be worn by actresses to avoid inadvertent exposure of the genitalia during nude or semi-nude scenes. The presence of the merkin protects the actor from inadvertently performing "full-frontal" nudity which can help ensure that the film achieves a less restrictive  MPAA rating . [ 5 ]


A merkin may also be used when the actor or actress has less pubic hair than is required, as in the nude dancing extras in  The Bank Job [ citation needed ] .  Amy Landecker  wore a merkin in  A Serious Man  (2009) for a nude sunbathing scene; clean shaving was not common in 1967 when the film is set. [ 6 ] [ 7 ]


Let me tell you,  The Reader  was not glamorous for me in terms of body-hair maintenance. I had to grow it in, because you can't have a  landing strip  in 1950, you know? And then because of years of waxing, as all of us girls know, it doesn't come back quite the way it used to. They even made me a merkin because they were so concerned that I might not be able to grow enough. I said, "Guys, I am going to have to draw the line at a pubic wig, but you can shoot my own snatch up close and personal."


Another Allure source (used here) also says she did not wear it.


Orikalankini  is an organisation and support group working to change narratives around menstruation and sexuality in India. [ 1 ] [ 2 ]  Founded in 2013, the conversations are through art and dialogue and was started by Dr Sneha Rooh. [ 3 ] [ 4 ] [ 5 ] [ 6 ]


The group has an annual 13-week fellowship, where the identified 13 teens and adults implement projects and initiatives were interested in. Orikalankini also collaborated up for a fellowship, Gender and Sexuality Lab with  Nazariya . [ 7 ]
 [ 8 ] [ 9 ]


Survivors at the Coffee Shop was comic published by fellow at Orikalankini to increase awareness about sex education and child abuse. It was a collection of 10 stories, edited by Tenzin Norwang and Khushi Patel, and illustrated by Sanika Dhakepalkar. [ 10 ]


In 2020, Pads Thats Last – Leave no one Padless was a fundraiser initiative by Orikalankini to collect funds to be able to make cloth pads for menstruators during the lockdown. [ 11 ]


As a part of this initiative, 25 workshops were conducted villages of Kargil and reusable cloth pads were distributed to 800 teachers, Anganwadi workers and young girls in Miyapur and Moosapet. [ 12 ]


A  pantyliner  (also  pantiliner ,  panty liner  or  panty shield, vaginal cover ) is an absorbent piece of material used for  feminine hygiene . It is worn in the  gusset  of a woman's  panties . Some uses include: absorbency for daily  vaginal  discharge, light menstrual flow,  tampon  and  menstrual cup  backup, spotting, post-intercourse discharge, and  urinary incontinence .
Panty liners can also help with girls who are having discharges and about to start their cycle.
Pantyliners are related to  sanitary napkins  in their basic construction—but are usually much thinner and often narrower than pads. As a result, they absorb much less liquid than pads—making them suitable for light discharge and everyday cleanliness. They are generally unsuitable for  menstruation  with medium to heavy flow, which requires them to be changed more often.


Pantyliners are found in an assortment of sizes, shapes, and portability options, ranging from tiny, compact liners to long, protective liners designed for heavy  vaginal discharge  and light days (light menstrual flow). There are also styles designed to fit with  thong  underwear.


Disposable pantyliners are made with a sticky adhesive on the back of the pad to hold them in place in the panties, and some styles have "wings" which wrap around the panties, providing additional stability.


A  papyrus sanitary pad , or  Makapad , is a  sanitary napkin  made from  papyrus , a natural material. It is reported to be 75 percent cheaper than a conventional  menstrual pad  and thus an advantage to the poor, as well as being highly absorbent. It is Africa's first hand-made  menstrual hygiene  product that is made completely with materials available locally, with its biggest production plant being in Kawempe. Makapad is an acronym used for menstruation, administration, knowledge, and affordability.  [ 1 ]


The papyrus sanitary pad aims primarily to help make sanitary pads an affordable and accessible necessity for young girls in developing countries. They help tackle the problem of girls'  absenteeism  in school owing to menstruation and associated behaviours for which they do not have adequate facilities (for example: lack of privacy for cleaning, poor availability of pads, lack of education about menstrual hygiene, lack of separate toilet facilities, and lack of access to water). Many women in the west of Uganda have to employ poor substitutes for sanitary pads, considering they are twice the cost of their average incomes ($1,25 a day). While only a handful few can afford this luxury, most others make use of cloth rags, banana leaves, or waste paper. Along with being ineffective options, they can also affect the women's menstrual hygiene negatively. They pose a risk to their health and contribute to their increasing absenteeism. In light of this situation, Makapads, being absorbent pads with up to 8 to 10 hours of usage, are not only better alternatives among other available menstrual products, but also help balance out the negative effect on the environment that conventional sanitary pads have.  [ 2 ]


The pads, developed by Dr. Moses Kizza Musaazi at  Uganda 's  Makerere University  Department of Technology, are targeted especially at rural primary school girls who have started  menstruating . These girls would normally find it difficult to attend school if they had no pads, and often cannot afford conventional pads. These sanitary pads also provide employment opportunities for the women of the rural communities in Uganda. They are made entirely by hand, using local materials. [ 3 ] [ 4 ]


This was part of the UN Refugee Agency ( UNHCR ) program to provide locally made Makapads to women and girls throughout refugee camps in Uganda. [ 4 ]


The pads are made out of dry papyrus and mixed with waste paper and then stitched with non-woven absorbent pieces of cloth. [ 5 ]  The papyrus fibres, once dried and pulverised, are mixed with paper and water to make a thick paste. The paste is then sun-dried, smoothed and cut to size into absorbent inserts. This is the only part of production which is performed mechanically with the help of machines. The rest of it mostly produced manually and is thus a form of employment for many. The pads are then exposed to ultra violet light to eliminate any germs or bacteria. Finally, they are combined into packs of three and are ready to be put up for sale. They are made almost entirely from natural materials, the rest being non-woven material and polythene paper. The main materials used in producing these pads are papyrus and waste paper. The energy consumed in their production is direct sunlight (350 W), through solar panels, making it a very environment-friendly and sustainable option. These pads are almost 100 per cent biodegradable, are chemical-free, and also affordable since their target audience are young girls in developing countries, mainly Sierra Leone and Uganda.  [ 2 ]


There are a few limitations in the production and distribution of Makapads. Presently, Makapads are not very popular in the commercial market, and are heavily dependent on the UNHCR for funding. Additionally, they can be produced only in very specific kind of environments which provide adequate water supply and suitable soil for growing papyrus. This makes their production a little less reliable than alternatives available  [ 6 ]


Period poverty  is a term used to describe a lack of access to proper menstrual products and the education needed to use them effectively. [ 1 ]  In total, there are around 500 million women and girls that cannot manage their periods safely due to lack of menstrual products and for fear of shame. [ 2 ]  The  American Medical Women's Association  defines period poverty as "the inadequate access to menstrual hygiene tools and educations, including but not limited to sanitary products, washing facilities, and waste management". [ 3 ]  The lack of access to menstrual hygiene products can cause physical health problems, such as infections and reproductive tract complications, and can have negative social and psychological consequences, including missed school or work days and stigma. [ 4 ]


The causes of consequences of period poverty intersect issues of  gender equality  and  economic justice , and there are diverse acts of legislation and perceptions of period poverty around the world. Moreover, social media,  consciousness raising ,  awareness campaigns, [ 5 ]  and the arts provide avenues for modern day advocacy regarding period poverty.


A variety of cultural factors contribute to period poverty.


One of the leading cultural factors that contributes to period poverty is  menstrual stigma , also known as period shaming. The  National Library of Medicine  defines menstrual stigma as “the negative perception of menstruation and those who menstruate, characterizing the menstruating body as abnormal and abject”. [ 6 ]  Menstrual stigma has significant impacts on the lives of those women including their health, education, economic opportunities, and participation in public and social life. The stigma can result in a lack of support for women and the propagation of harmful and misogynistic stereotypes. [ 6 ]  Period shaming can make women feel insecure about the menstrual process and thus less likely to carry period products on hand, as well as less likely to have conversations on menstrual health with friends and family members. [ 7 ]
This, if not mediated, can cause chronic mental illnesses to onset such as depression and anxiety. This is due to feelings of isolation and exclusion that menstruation may bring about if a menstruator feels they cannot adequately "handle" the situation.


Globally, women who menstruate often rely on euphemisms to discuss menstruation. For example, the use of these phrases such as “‘strawberry week’ in  Austria , ‘I'm with Chico’ in  Brazil , and ‘Granny's stuck in traffic’ in  South Africa  can contribute to the taboo surrounding  menstruation . [ 8 ]  In some cultures around the world, menstrual blood itself is seen as unholy and women are encouraged to hide signs of menstrual bleeding from their male counterparts. These beliefs can be traced far back to the early stages of civilization. For example, in AD 70  Pliny the Elder  wrote that menstruation was “productive of the most monstrous effects” and that crops would “wither and die” and bees would “forsake their hives if touched by a menstruous woman.” [ 2 ]  In 1694, books on midwifery likened menstruating women to “a mythical beast with venomous breath” on account of their shared ability to “disperse poison through the air.” [ 2 ]


In the US specifically,  Thinx  found that 80% of sampled 13- to 19-year-olds believe periods have a negative association. This same study found that 57% have felt personally affected by this negative association, and 64% think society generally teaches girls to be ashamed of their periods. [ 9 ]


Physical, mental health, and social costs arise when women have limited or inconsistent access to period products and adequate menstrual hygiene management.


A study from the Women's Health Group at  Boston Medical Center  centering on college-aged females in the  United States  reported that some women who could not afford  pads  or  tampons  used more cost-effective materials to prevent leakage, including rags, toilet paper, and children's diapers. [ 10 ]  If the materials are unsanitary, resorting to alternative methods to mitigate one's period can put them at higher risk of urogenital infections, such as  bacterial vaginosis  and  urinary tract infections  (UTIs). [ 11 ]  Moreover, women may leave tampons in their bodies longer than recommended and/ or use period products past their expiration dates. Using an unsterilised  menstrual cup  or leaving a tampon in for more than eight hours puts the user at risk for  toxic shock syndrome , a life-threatening condition which can cause flu-like symptoms, low blood pressure, and organ failure. [ 12 ]  Menstrual products can also cause vaginal itchiness, irritation, and increased discharge when used after expiration. While a menstrual cup should be replaced every two years, tampons and pads typically expire after five years. [ 13 ]  Period poverty can additionally impact reproductive health, as those with female anatomy who lack  access to adequate menstrual mitigation resources are at higher risk for  infertility , recurrent  abortions , and  ectopic pregnancies . [ 14 ]


Furthermore, the lack of access to menstrual hygiene products and facilities can have negative impacts on women's mental health. Issue Five of  HealthCare for Women International  featured a study conducted in  France  regarding the impact of period poverty on the development of  mental health  issues found that 49.4% of women experiencing period poverty in their sample reported at least one symptom of  anxiety  or  depression . [ 15 ]  Mental illnesses, in conjunction with period poverty, have the potential to exacerbate  substance abuse ,  self-harm , and related concerns. [ 14 ]


The stigma surrounding menstruation can also contribute to shame and social exclusion for those who experience period poverty. For example, women who cannot afford products to mitigate leakage may opt to miss school or work because of their period. According to  UNESCO 's 2013 Global Education Monitoring Report, around 10% of youth who menstruate miss school during their period due to lack of access to menstrual health management (MHM) resources. [ 16 ]


In addition, the economic costs of the  COVID-19  pandemic contributed to heightened inequity, specifically surrounding period poverty. A United States-based study published in 2023 found that 18.5% of the women surveyed struggled to afford menstrual products during the pandemic. [ 17 ]  Period poverty also relates to the " pink tax ", a hypothesis which alleges that health products marketed towards females are substantially more expensive than similar products marketed towards males. [ 18 ]  Specifically, a  Stanford  research study found that the average woman will spend approximately $18,000 on menstrual products in their lifetime. [ 19 ]  Students who menstruate also make up a large population of those who experience period poverty. Studies show that 19% of students who menstruate feel as though they need to decide between buying groceries or buying menstrual products each month. [ 20 ]


Period poverty is an intersectional issue and unhoused women experiencing it have trouble accessing menstrual products due to economic constraints. Single women makeup a quarter of those experiencing homelessness in the UK; in the USA, it is a similar percentage as women account for 28% of the homeless population. [ 21 ]  Women experiencing homelessness struggle with access to menstrual products; shelters either lack or run out of menstrual products, access to public toilets can sometimes be tricky and often homelessness women resort to theft to obtain menstrual products. [ 22 ]  Another common issues amongst homeless women is finding a safe space to effectively manage menstruation. It is difficult to find a clean, private space to utilize and change menstrual products. [ 23 ]  Homeless women report that public toilets are unsanitary and are not fit for changing their menstrual products. [ 21 ]  Additionally, the stigma around homelessness means often they are turned away from public and privately owned bathrooms. [ 23 ]  Sometimes makeshift pads constructed from clothing material, rags or waddled toilet paper are used as a substitute for menstrual products. [ 22 ]  Homeless women could feel uncomfortable asking staff at shelters for menstrual products; this can be a result of uneven power dynamics as well as the sociocultural stigmas around menstruation. [ 21 ]  Shelters themselves struggle with inconsistent supplies and can often resort to rationing menstrual supplies due to shipping failures. [ 22 ]  Improper period management can lead to adverse health effects, leaving a tampon in for too long can result in  toxic shock syndrome  or  urinary tract infections , infrequent washing can cause skin infections and many other complications. [ 22 ]  These issues are exacerbated when an individual is unhoused.


Globally, 740,000 women and girls are held in prison. [ 24 ]  The USA accounts for roughly 30% of the world's incarcerated women with about 211,375 female prisoners according to 2022 data. [ 25 ]  Countries with similar high rates of female prisoners are China with an estimated 145,000 (plus unknown women and girls held in pre-trial detention and administrative detention), Brazil (42,694), Russia (39,120) and Thailand (32,952). [ 25 ]  Understanding period poverty is to also acknowledge that not only women and girls menstruate but also transgender and non-binary people do as well. Period poverty in prisons arises from a penal system that weaponises menstruation as a form of oppression and punishment. [ 26 ]  Prisons often have an inadequate supply of menstrual products, increased pricing of menstrual products and poor quality of tools to manage menstruation. [ 27 ]


Allotments for tampons and pads don't take into consideration the different requirements and needs of individuals to effectively manage their menstrual cycle. [ 28 ]  This results in incarcerated individuals having to bleed through their clothes or resorting to use unsuitable measures to manage their periods. [ 28 ]  Limited or deprivation of access to menstrual products leads to women in prisons using ripped bedsheets, mattress stuffing, ripped bedsheets, socks, toilet paper and soiled, days-old tampons. [ 29 ]  In the  Ivory Coast , women have severely limited or no access to menstrual products and due to overcrowding, the risk of infections is incredibly high. [ 30 ]


As menstrual products aren't handed out freely and given at the will of prison staff, it has been documented that some prison guards have exchanged menstrual products for sexual favours or raped inmates. [ 28 ]  This demonstrates the unequal power dynamics between inmates and prison staff. In 2020, federal officer Colin Akparanta pled guilty to sexually abusing inmates in exchange for feminine hygiene products. [ 31 ]


The carceral system still operates on a sex-segregated manner whereby an individual's biologically assigned legal sex dictates where they will be placed in the facility. There's little regard for differential experiences according to sexual orientation, gender identity, or gender expression. [ 32 ]  Given that menstruation is often assumed to be a process largely experienced by women, access to menstrual products for transgender and non-binary is far worse and often non-existent. [ 28 ]  This intersects with the denial and misgendering of trans and non-binary identities in the carceral system.


In the 2018, The  First Step Act  was passed in the USA. This legislation states that all federal prisons should make tampons and sanitary products available free of charge. [ 33 ]


Period poverty is often discussed in the context of cisgender women. However, menstruation and period poverty itself extends its impact to transgender, non-binary, and intersex individuals. It's important to highlight the complexity of varying gendered experiences surrounding menstruation. For these marginalised groups, accessing safe and accommodating spaces to manage menstruation can be fraught with challenges that can exacerbate feelings of insecurity and exclusion.


Accessing inclusive and affirming healthcare remains a significant hurdle for transgender, non-binary, and intersex individuals experiencing menstruation. Despite efforts to accommodate diverse gender identities, misgendering and insensitive inquiries about menstruation persist, contributing to a sense of alienation and discomfort within healthcare settings.


Transgender, non-binary, intersex experience period poverty in tandem with discrimination and stigma due to their identities. [ 34 ]  Trans, non-binary, gender fluid, and intersex individuals have unique challenges when it comes to period poverty. First, is the lack of data collection as menstrual equity projects tend to only collect data related to women and girls. [ 34 ]  This makes it difficult to understand the intersectionality of period poverty and how menstruators who aren't women are impacted by their inability to access menstrual products and  WASH  facilities. There's often la ack of support and understanding of how period poverty impacts transgender, non-binary and intersex individuals. The consequences of this is the scarcity of targeted support programs and resources to address menstrual needs and hygiene requirements. [ 35 ]


Financial barriers add to the difficulty of accessing menstrual products as trans, non-binary and intersex people who already face economic constraints related to their gender identity, such as healthcare and other gender-affirming expenses. [ 34 ]  Transgender and non-binary people are more likely to live in poverty than cisgender people, this exacerbates issues related to period poverty. [ 35 ]  Trans, non-binary, gender fluid, and intersex individuals face challenges accessing gender-affirming healthcare, such as hormone replacement therapy (HRT) and gender-affirming surgeries, which can be costly and leave them with fewer resources to effectively address their menstrual health needs. [ 35 ]  Menstruation isn't the only reason trans and non-binary people need menstrual products; trans women and non-binary people may also need pads and liners after vaginoplasty or for other reasons. [ 36 ]


Gendered bathrooms present significant safety concerns for transgender, non-binary, and intersex individuals during menstruation. Men's restrooms often lack discreet disposal options for period products, while women's restrooms may not feel safe for those who do not conform to traditional gender expectations. [ 21 ]  A study done on menstruation management for queer individuals found that 66% of respondents who used men's bathroom felt unsafe using them to change menstrual products; 39% of respondents who used female bathrooms felt uncomfortable doing so. [ 37 ]  Menstrual products are gendered as products for women thus they are often not placed in men's bathrooms. [ 21 ]  This dilemma underscores a critical aspect of period poverty: the lack of accessible and safe restroom facilities for all gender identities.


The experience of menstruation intersects deeply with gender identity, shaping how transgender and genderqueer individuals perceive themselves and are perceived by others. Social interactions, public spaces, and even healthcare encounters can reinforce gender norms, complicating the already challenging experience of menstruation for these individuals. [ 21 ]  Packaging, designs, commercials, and “feminine product” aisles in stores serve as indicators to transgender, non-binary and intersex people that a biological aspect of their bodies is deeply tied to social norms and expectations of femininity and womanhood. [ 21 ]  In 2020,  Always  removed the Venus female symbol from the packaging from their menstruation products after protests from LGBTQI activists. [ 38 ]  LGBTQI activists pleas to remove the symbol was a call to make the brands labelling more inclusive for transgender and non-binary customers. [ 38 ]


As of 2023, 26 US states have passed or enacted menstrual equity bills related to solving period poverty. The breakdown for where these bills exist is as follows:


The bulk of these bills are concerned with providing menstrual health products to incarcerated people, as well as providing them in nurse's offices and bathrooms within that state's school districts. Additionally, many states have passed bills to lessen (or remove entirely) sales taxes on feminine hygiene products.


Globally, proposals to reduce or eliminate taxes on menstrual products or their inputs have gained prominence, and an increasing number of countries have taken different approaches. [ 39 ]   Developing countries  are adopting diverse approaches to combat period poverty, reflecting a growing recognition of menstrual health as a vital  public health  and  gender equality  issue. In general, a common legislative approach adopted by many developing countries in the fight against period poverty is the reduction or elimination of taxes on menstrual products.


Bangladesh  decided to waive the  value-added tax  (VAT) on raw materials temporarily to encourage more local production of these goods. [ 39 ]  In 2004, Kenya started eliminating taxes on menstrual products and by 2016, it had also removed VAT on imported menstrual items and the raw materials needed for their production. [ 39 ]   Likewise,  Nigeria  exempted locally made products from VAT. Several countries including  Malaysia ,  Lebanon ,  Tanzania ,  Colombia , and  Mexico  have eliminated VAT on menstrual products entirely. In the  Philippines , deputies from different parties separately filed similar bills this year proposing a two-day  menstrual leave  for female employees in the workforce. [ 39 ]   The Philippine government has also provided education and information about menstrual health across 60 percent of schools. [ 40 ]


Approaches in developed countries not only include tax reductions or eliminations but also range from providing free menstrual products and the implementation of supportive policies. For instance,  Scotland  created a significant milestone by being the pioneer in providing free menstrual products for everyone, marking a groundbreaking move to tackle the crucial matter of menstrual equality. [ 41 ]  Alongside this, educational reforms have been introduced in several countries, incorporating menstrual health education into school curricula. In the  UK , as part of the Department for Education's guidance, all primary schools are required to teach pupils about menstrual health under the new Relationships and Health Education curriculum (RSHE). [ 42 ]  In  Canada , B.C. has committed $750,000 in funding to the United Way to establish a task force that will look at long-term solutions for period poverty. Approximately half of the funding will go toward supporting the task force and half will go toward supplying free menstrual products for people who need them. [ 43 ]


International organizations also play a global role.  The World Health Organization  (WHO) calls for menstrual Health to be recognized, framed, and addressed as a health and human rights issue, not a hygiene issue. Activists, including the youth, along with nonprofit organizations, have made significant efforts to bring attention to menstrual health concerns. [ 44 ]   The United Nations Population Fund  (UNFPA) raised four approaches to promoting and improving menstrual health around the world: [ 45 ]


There is an argument to be made that the  descriptive representation  of women in executive and legislative bodies may bring about more government-level remedies to period poverty. For example,  Sarah Childs  and Julie Withey investigated the decision of  Great Britain's  Labour Party -led government to reduce the  value-added tax  on sanitary products in their 2000 budget. They found that, although it was then-Chancellor  Gordon Brown  who put forth the budget, it was the actions of MP  Christine McCafferty  that spearheaded this decision. In the years leading up to 2000 the Parliamentary Labor Party Women's Group put the VAT reduction at the forefront of their agenda, and it was McCafferty's membership on this group that perhaps compelled her to table 3  early day motions  (EDMs) in the months leading up to budgeting on this same topic. In the run-up to the budget session McCafferty conducted an interview on  BBC Woman's Hour , implying that this reduction would be made in the upcoming budget. This shifted the conversation surrounding the VAT from its own policy measure to a budget commitment, which made it easier to get passed. [ 46 ]


A lack of media coverage regarding period poverty and its consequences is said to have further propagated the negation of how severe the issue is. Period poverty began receiving increased acknowledgment in media and news outlets around the early to mid-2010s. It gained more significant attention and traction as a social and public health issue in the latter part of the decade, with a notable increase in coverage and discussion in mainstream media, advocacy campaigns, and public policy initiatives.


Sociocultural attention to period poverty in the  UK  has increased since 2016, attributed to factors like the dismantling of the welfare state, menstruation-focused feminism, and support from high-profile individuals. Digital activism including celebrity endorsements and political commitments have encouraged period poverty discourse. Analysis displays how period poverty mediates discussions around impoverishment and class in contemporary  UK  society. [ 47 ]  The  BBC  published a compilation of articles regarding period poverty authored by a diverse range of individuals with personal interest to the issue. [ 48 ]  While in the  US ,  MSNBC  aired  Morning Joe , centralized on period poverty hosted by  Morgan Radford . [ 49 ]  An additional example is a news article published by the  UN  News regarding  The Gambia  and  UNFPA 's efforts to address period poverty by distributing sanitary pads and pressing for international acknowledgement through Menstrual Hygiene Day. [ 45 ]


Social media  have publicized discussion surrounding  menstruation  and period poverty in a unique manner that encourages open dialogue. Campaigns like #tweetyourperiod and #Periodsarenotaninsult unify menstruators globally, igniting discussions about sustainability and menstrual health among diverse audiences. [ 50 ]  Nadya Okamoto, founder of the organization PERIOD., [ 51 ]  utilized  TikTok  to reach a vast demographic of consumers to drive advocacy efforts. Her venture, August, selling sustainable menstrual products, exemplifies  social media's  role in mobilizing support for social causes like menstrual equity. [ 52 ]  Candice Chirwa, 'The Minister of Menstruation,' and Siv Ngesi, co-founder of The MENstruation [ 53 ]  Foundation, utilize social media to combat period poverty in South Africa. Through platforms like  Instagram  and  Twitter , they raise awareness and engage communities in education and product distribution efforts. [ 54 ] [ 55 ]


The academy award-winning Netflix documentary, " Period. End of Sentence. ," elucidates the period poverty prevalent in rural  India  and the transformative impact of making menstrual products accessible. Through the innovation of a  sanitary pad  machine in a village adjacent to  New Delhi , women were empowered to manufacture and market their own pads. This catalyzed the emergence of a female-dominated industry deterring menstrual and  gender inequality , especially in the workforce. [ 56 ]  " Pandora's Box: Lifting The Lid On Menstruation " is another instance of film displaying menstrual equity struggles globally. Led by a predominantly female team, the production exposes the struggles faced by women due to the lack of access to menstrual products, while simultaneously stressing the activism and advocacy efforts driving change. [ 57 ]


Roof and Roots in  Lebanon , sustained by organizations like  ACTED  and  UN Women , revolve around  grassroots  action and economic empowerment. Continued research, policy advocacy, and community-based interventions are exercised to address period poverty and promote menstrual justice. [ 58 ]  PERIOD. [ 59 ]  annually distributes menstrual products and engages in efforts such as authoring menstrual health curriculum and empowering young, developing leaders to advocate for menstrual justice policies. The organization prioritizes women's autonomy and the effort of eradicating period poverty through policy.  Amika George , the founder of the Free Periods campaign, advocated for free sanitary products in  UK  schools at 17 years old. George emphasizes the potential for  grassroots  political involvement , embodying the value of individual activism on policy outcomes. [ 60 ]  Damaris Pereda, national programs director at PERIOD., played a significant role in advocating for menstrual equity in  California , leading to the passing of AB 367 for free period products in academic institutions. This achievement reflects a global movement to increase access to menstrual products and combat menstrual inequity. [ 61 ]


Period underwear  (also known as  menstrual underwear  or  period panties ) are absorbent garments designed to be worn during  menstruation . Period underwear is designed like conventional underwear but it is made up of highly absorbent fabrics to soak up menstrual blood. Most commercially manufactured period underwear makes use of  microfiber   polyester  fabric. It is recommended that period underwear should be changed every 8-12 hours to avoid leakage and infection.


The market for period underwear has developed as a response to consumer preference moving away from traditional  menstrual hygiene management  products, such as  sanitary pads  and  tampons . [ 1 ]  Different brands use different, often patented, technology for anti-microbial action, moisture-wicking [ 2 ]  and optimal absorption.


Julie Sygiel [ 3 ]  was cited by the  BBC  in 2015 as an early developer of the technology, with her company 'Dear Kate'. [ 4 ]


Period underwear is considered to be an eco-friendly way to cut down on waste [ 5 ]  and reduce spending. [ 6 ]  It is estimated that  tampons, pads, and applicators, generates 200,000 tonnes of  plastic waste  in the United Kingdom each year. [ 7 ] [ 8 ]  In the United States it is estimated that  sanitary products  generate more than 200,000 tonnes of waste annually. [ 9 ]


A reviewer in the  New York Times  described the product's features: "some menstrual-underwear styles are gorgeous but leaky, and others have  Hoover Dam –level security but diaper-like silhouettes. The style that will be best for you depends on your period flow and preferences". [ 10 ]


Some manufacturers of period underwear are extending their ranges into other leak-proof clothes such as swimsuits, sportwear and sleepwear. [ 11 ]


In the UK, period underwear was subject to  value-added tax  at 20% until 2024, despite the fact that other menstrual products were exempted from the tax in 2021. [ 12 ]  The exemption for period underwear was brought in after  tampon tax  campaigners had raised the issue in an attempt to get the tax removed. [ 13 ]


Some companies (like  Thinx , Ruby Love, and Knix) are facing class action lawsuits [ 14 ]  for period underwear products that contain potentially harmful toxins like  per- and polyfluoroalkyl substances  (PFAS) which may be linked to adverse health outcomes like cancer. Thinx settled a lawsuit in January 2023 [ 15 ]  but made no admission of guilt or wrongdoing in the settlement. Some brands of period underwear have been found to contain silver used as an antimicrobial agent. Concerns have been raised about the possible health impact of silver migrating into the body, but limited research has been done and little scientific data exists. [ 16 ]


Period. End of Sentence.  is a 2018 documentary short film directed by  Rayka Zehtabchi  about  Indian  women leading a quiet  sexual revolution .  The film stars  Arunachalam Muruganantham , Shabana Khan, Gouri Choudari, Ajeya, and Anita. [ 3 ] [ 4 ]  The documentary short follows a group of local women in  Hapur , India, as they learn how to operate a machine that makes low-cost, biodegradable  sanitary pads , which they sell to other women at affordable prices. This not only helps to improve feminine hygiene by providing access to basic products  [ 5 ]  but also supports and empowers the women to shed the  taboos  in India surrounding  menstruation  – all while contributing to the economic future of their community. [ 6 ]   The film is inspired by the life of Arunachalam Muruganantham, a social activist from  Coimbatore , India. [ 7 ]


Women are in charge of a tremendous change in a Kathikera village in the Hapur district which is 60 km away from Delhi, India. They battle the pervasive shame associated with menstruation. The lack of access to pads among these women for centuries resulted in health issues, school absences, and eventual dropout of the girls. However, when a sanitary pad factory is set up in the hamlet, the women are taught how to produce and sell their own pads, which empowers the women there. They chose the brand name "FLY" for their company because they want women "to arise". [ 8 ]


Period. End of Sentence  has an approval rating of 75% on  review aggregator  website  Rotten Tomatoes , based on eight reviews, and an average rating of 6.3/10. [ 9 ]


The  pink tax  refers to the tendency for products  marketed specifically toward women  to be more expensive than those marketed toward men.  This phenomenon is often attributed to  gender-based price discrimination , however research shows that the primary cause is women sorting into goods with higher  marginal costs . [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ] [ 7 ]  The name stems from the observation that many of the  affected products are pink .


A 2015 study by the New York City Department of Consumer Affairs on the cost of being a female consumer concluded that women's products are typically more expensive than men's without reasonable cause. [ 3 ]  It concluded that products marketed specifically toward women cost on average 7% more than products marketed toward men. This discrepancy applies to apparel, toys, and healthcare products, among other things. In the toy sector, girls' toys cost on average 7% more than boys' toys. The study showed a side-by-side comparison of a  Radio Flyer  scooter where the red scooter costs $24.99 and a pink scooter, identical in all ways but color, costs $49. In children's apparel, girls' clothes were 4% more expensive than boys'. Women's clothing was 8% more expensive than men's clothing. The largest discrepancy came to personal care/hygiene products, where women's products cost 13% more than men's. [ 3 ]


Other countries where the pink tax has been investigated include Argentina, [ 8 ]  France, Germany, the UK, [ 9 ]  Australia, and Italy. [ 10 ] [ 11 ]  In the UK, women and girls were being charged on average 37 per cent more for toys, cosmetics and clothes than their male counterparts. [ 12 ]  The UK also faces the Pink Tax in school uniforms. Girls' school uniforms are 12 percent more expensive than boys' uniforms. This goes for both primary and secondary school-age children that must face this problem. [ 13 ]  In Singapore, a check by  The Sunday Times  on ten companies found that women pay more for some products and services, like dry cleaning and razors, offered by about half of these companies. [ 14 ]  Additionally, women in Singapore have to pay more premiums for Careshield Life, a national long-term care insurance scheme introduced by the government. [ 14 ]  In recent times Argentina women pay 12 percent more than men for the same products. In 2021 the gap was at 11 percent and went up the following year in 2022. [ citation needed ]


There are many reasons why the pink tax exists, including  tariffs , product discrimination, and  product differentiation . There are many suggested causes of this discrepancy, including  price elasticity  and the belief that women are more prepared than men to pay higher prices for their purchases. [ 3 ] [ 6 ] [ 15 ] [ 16 ]  Other reports suggest that marketing targets women to pay higher prices as ethical consumers. [ 17 ]  Certain types of clothing, footwear, and gloves made for women and men are taxed at different levels when first entering the United States. [ 15 ]  While some tariffs are higher for men's clothing, others are higher for women's.


According to  The Washington Post  article [ 18 ]  women are more likely to spend more money on improving their appearance, because not doing so is associated with the risk of losing revenue. Some studies showed that  attractive  people tend to earn higher salaries, [ 19 ] [ 20 ]  receive higher grades in school, [ 21 ]  receive  shorter prison sentences , [ 22 ]  and are more likely to be hired and promoted in the workplace. [ 23 ]


Some people argue that product differentiation can account for a portion of the difference between the prices of men's goods and women's goods. Products like the Radio Flyer scooter [ 24 ]  may cost more due to the cost of slightly changing the product. For example, a pink scooter may cost more than a red scooter because it is more expensive to paint a scooter pink than red, assuming such a large difference for this reason of production would be because the red scooters are the larger production, and pink scooters are in the minority. However, there has never been any evidence presented, for example, that pink paint costs more than red paint or blue paint, thereby creating cost differentials in color-coded items geared toward different genders.  The Pink Tax also arises in services like haircuts or dry cleaning. Likewise, in  dry cleaning , some people argue that men's clothing tends to be more uniform while women's clothing tends to have a lot of variabilities which can make it harder to clean. They also argue that pressing machines, normally made for men's clothing, are more difficult to use on women's clothes, which results in the dry-cleaners resorting to hand-pressing the clothing. [ 25 ]


The reason those who campaign against the pink tax claim it to be so problematic is that higher prices for goods and services arise from gender alone, with no underlying economic justification such as higher costs of production in goods. Women's and men's razors are essentially the same, and distinguishing between them is simply a  marketing strategy . [ 25 ] [ 26 ]  People who have a greater need to buy a product are often willing to pay much more, leading to price discrimination. [ 27 ]  Women are often subjected to this in the tampon and  menstrual pad  market creating a marginalized group among women who are "period poor". [ 27 ] [ 28 ]


One significant cause is the gendered segmentation of consumer markets, where products are specifically marketed towards either men or women. Which are often packaged and branded distinctly to the directed gender. This segmentation allows companies to justify charging higher prices for products marketed towards women, exploiting the perception of femineity as a marketable attribute. Additionally, historical gender roles and expectations regarding personal care and hygiene contribute to the pink tax, women are often expected to invest more in grooming and appearance maintenance. Following this, the lack of transparency in pricing and limited competition in certain product categories also enable companies to implement the pink tax. Overall, the pink tax reflects much bigger systematic issues of gender inequality and discrimination in consumer markets.
 [ 29 ]


Criticism of the pink tax includes the principle that the idea robs women of agency and choice by suggesting that women are so easily brainwashed by marketing that they are prevented from choosing the lesser-priced but otherwise "identical" male-marketed alternative. Instead, critics have attributed the pricing disparity to  market forces , [ 30 ]  and stated that if women continue to buy a more expensive pink razor, it is because they see some utility or additional aesthetic that they are willing to pay for. [ 31 ]  Substantive differences in price may indicate differences in the marketability of different products.  Critics argue that although seemingly identical products and services may be differently priced, the emotional experiences and perceived value are different. [ 32 ]


A more recent study pointed out methodological flaws in the influential 2015 study from the New York City Department of Consumer Affairs: "First, the products considered in the report account for less than 6% of category sales and were not selected at random. Second, while the sample was constructed by subjectively pairing men’s and women’s products, we find that most pairs in the sample differ in their ingredients." [ 33 ]  They argue that a systematic analysis of the evidence reveals when comparing products made by the same company with the same leading ingredients, men's products were more expensive in 3 out of 5 categories. "These findings do not support the existence of a systematic price premium for women’s products." [ 33 ]


Activists and politicians argue that the economic impact of the pink tax is that women have less  purchasing power , especially paired with the gender-based  pay gap . [ 26 ]  Wage gaps and  pension gaps  already put women at a disadvantage when it comes to purchasing power. Women currently make a statistical average 89 cents for every $1 a man earns in the United States, meaning women statistically, on average, have less income to spend on goods and services. [ 34 ]  This alone gives men more money and, ultimately, more buying power. The pink tax further contributes to the  economic inequality  between men and women. It is also argued that paying more for goods and services marketed to women while women earn less than men means men hold the majority of the purchasing power in the economy. [ 34 ]  Taxes on feminine hygiene products that men do not need further contribute to this discrepancy. [ 35 ]


By putting higher prices on essential products like menstrual products, personal care products, and overall increases the cost of living for women compared to men. This added financial burden exacerbates existing gender inequalities, as women already earn about 20% less than men on average. More so, the pink tax contributes to the phenomenon of "period poverty" where many women struggle to afford basic menstrual products which can affect social, emotional, and physical health. Studies have shown that women can pay thousands of dollars more over their lifetimes because of the pink tax, which furthers the wealth gap between genders. Efforts to address the pink tax, such as state-level bans and campaigns aim to alleviate some of these economic burdens faced by women, but a federal solution is still lacking. Therefore, the economic impact of the pink tax highlights the urgent need for comprehensive measures to promote gender equity and financial empowerment for all.  [ 36 ]


Representative  Jackie Speier  was a member of the  California State Senate  from 1998 to 2006. In 2008, she was elected to the  U.S. House of Representatives , representing California's 12th Electoral District until 2013 and California's 14th Electoral District from 2013 to 2023. Speier, a  Democrat , is a member of the  House Committee on Energy and Commerce . [ 37 ]  She also speaks out for equal rights and LGBTQ rights, and involves herself in many related organizations. [ 38 ]


On July 8, 2016, Speier introduced H.R. 5686, Pink Tax Repeal Act, to the House floor. The overall intention of the Pink Tax Repeal Act is to end gender-based price discrimination. She was the bill's primary sponsor. This was widely considered an early version of the bill. [ 39 ]


On April 10, 2018, Speier introduced a revised version of the Pink Tax Repeal Act, H.R.5464. The  115th Congress  (2017–2019) was expected to review the 2018 version. Skopos Labs, a technology company that predicts risks and opportunities, gave the bill a 1% chance of being enacted. [ 39 ] [ 40 ]  The Pink Tax Repeal Act would mandate that any comparable products that are marketed toward men and women must be priced equally. Additionally, this bill was meant to target public policy as well as gendered marketing initiatives. [ 41 ]  A 2015 study done on U.S. tariff rates found that on average, even tariffs paid for women's goods are higher than those for men. [ 42 ]  Even average imported clothing taxes for men were 11.9% compared to 15.1% for women. [ 42 ]  These discrepancies were also included in the bill. [ 41 ]  Although Speier said she did not expect the bill to pass, she tried to push forward the conversation about gender-based price discrimination.


The effects of increasing women representation are substantial. A 10% gain in seat share decreases the pink tax by approximately 0.44%. [ 43 ]


In June 2021, Speier reintroduced the Pink Tax Repeal Act, a bipartisan bill that pursues to end gender discrimination in the pricing of goods and services. [ 44 ]


While in the California State Assembly, Speier introduced Assembly Bill No. 1088, also known as the Gender Tax Repeal Act, in 1995. It was similar to the Pink Tax Repeal Act, except it focused on gender-based price discrimination in services. The bill stated that businesses such as tailors, barbers, hair stylists, dry cleaners and laundries would not be permitted to discriminate for "standard services" due to a person's gender or the gender the clothing is intended for, without a valid, prominently placed written justification. [ 45 ] [ 46 ]  The bill passed in 2001 and remains in effect. [ 47 ]  The Equal Gender Pricing Bill was proposed in 2016 aimed at consumer goods, specifically prohibiting businesses from gender biased pricing. [ 48 ]  The main opposition argument was that a bill proposed on goods would lead to  litigation , especially since the process of identifying gendered pricing remains ambiguous and subjective. [ 49 ]


Democratic California State Sen.  Ben Hueso  of  San Diego  proposed a new version of the Gender Tax Repeal Act, SB-899, in 2016, but withdrew the bill after pushback from the California Retailers Association. [ 50 ]  It would have banned businesses in California from charging customers different prices for similar goods on the basis of gender. [ 50 ]


Jennifer Boysko , a Democrat of the  Virginia   House of Delegates , in 2018 submitted HB 24, [ 51 ]  which would exempt menstrual supplies from sales and use taxes, [ clarification needed ]  in response to the Tampon Tax in Virginia. [ 35 ]


On September 30, 2020, a new law went into effect in  New York State  as a part of the FY 2021 budget that prohibited businesses from charging different prices for "substantially similar" consumer goods or services that are marketed to different genders. It was a key element of Governor  Andrew M. Cuomo 's 2020 Women's Agenda. [ 52 ] [ 53 ]


In England, the UK Government is funding free period products to be accessed in schools, councils and public buildings. [ 54 ]


An  Early day motion  directly citing the Pink tax was raised in the UK parliament by Scottish Liberal Democrat  Christine Jardine  in 2020 to highlight MPs concerns that women and girls pay more for basic products (including toiletries, clothes, and haircuts) than men do. [ 55 ] [ 56 ]  Jardine proposed The Gender-Based Pricing (Prohibition) Bill . [ 57 ]  Jardine highlights that in the UK  " women on average pay £200 more annually than men for the same every-day consumer goods and services" and that in some cases the only difference is the color of the item. [ 58 ] [ 26 ]


A private member's bill to make period products freely available was introduced by  Baroness Boycott , but it died on the order paper. Boycott, Rosie (2020-02-04).  "Period Products (Free Provision) Bill [HL]" .  UK Parliament . Retrieved  2024-08-15 .  A Bill to provide for the provision of free period products


The Scottish Government is funding a scheme to put free period products in public places like schools, colleges, universities, youth club and pharmacies. [ 59 ]


Under the  Period Products (Free Provision) (Scotland) Act 2021 , people can access period products freely through  the premises of any local council. [ 60 ]