The average woman has her period for 2,535 days of her life. That’s nearly seven years’ time of making sure you have a pad or tampon, finding a makeshift solution if you don’t, and managing pain and discomfort.
And lately, women — and transgender and nonbinary people who menstruate — are talking about it in public more than ever before. There are new products and services on the market, from menstrual cups to period underwear to medicinal cannabis and “period coaches.” Globally, advocates are pushing for recognition of a woman’s right to manage her period with dignity. And in the United States, activists are bringing the concept of “menstrual equity” into the public debate.
Let’s unpack that.
“Menstrual equity” refers to equal access to hygiene products, but also to education about reproductive health. And it’s the focus of a variety of new laws and policies to provide menstrual products in prisons, shelters, schools and even on Capitol Hill.
Advocates are also urging states to exempt menstrual hygiene products from sales tax, arguing that they’re a necessity.
A frequent refrain: Why are tampons taxed when Viagra is not?
Increased media coverage and some high-profile episodes — like Kiran Gandhi bleeding freely as she ran the London Marathon in 2015 and a backlash over Instagram deleting a photo of a period stain — have accelerated the shift.
Last month, a member of Britain’s Parliament announced in the House of Commons that she was menstruating, to make a point about “period poverty.”
A New York congressman recently got into a spat with House administrators over whether he could expense $37.16 worth of tampons for his staff and visitors.
And India said on Saturday that it would eliminate a controversial 12 percent tax on sanitary pads after a campaign by advocacy groups and celebrities. Canada also abolished a sales tax on such products in 2015, and an Australian push to do the same made progress this year.
Here’s an overview of the issues that women’s health advocates are talking about.
The fight for equal access to menstrual products
Laws in several states now mandate access to menstrual products in correctional facilities, shelters and schools. Two prison reform bills in the Senate — including the First Step Act, which is backed by the White House — include provisions on access to menstrual hygiene products, after complaints that the facilities were not providing an adequate supply. And the Justice Department directed federal prisons to provide inmates with free menstrual products last year.
In the House, Representative Grace Meng, Democrat of New York, has introduced two related bills. One aims to make periods more affordable, in part by allowing employees to use flexible spending accounts to buy pads and tampons, and requiring companies with more than 100 employees to provide them. The other would require manufacturers to disclose ingredients in such products.
“Interest in this issue grows every single day,” Ms. Meng said. “It’s really about accessibility and equity.”
That’s the same argument that Representative Sean Patrick Maloney, Democrat of New York, made after he was ordered to reimburse the Committee on House Administration for menstrual products.
The committee rebutted Mr. Maloney’s account. But that didn’t stop him and Ms. Meng from writing a letter to House Speaker Paul Ryan about the matter.
“We applaud you for making toilet paper available,” they wrote. “We implore you, however, to go one step further and make feminine hygiene products available to those who need them.”
Pressing to end ‘the tampon tax’
In the last two years, New York, Illinois, Florida and Connecticut have abolished sales tax on menstrual products. That brings the number of states that tax such products to 36 — and lawmakers in two dozen of those states have introduced bills to nix the tax.
“That menstrual equity and health would be such a prominent, bipartisan and very public matter is, in my mind, not just really heartening but enormously telling,” said Jennifer Weiss-Wolf, author of the 2017 book “Periods Gone Public.”
There are similar efforts underway around the world, including in Britain, where the campaign to “ax the tax” got caught up in the Brexit debate. Laura Coryton, a young British activist, started a petition called “Stop Taxing Periods” in 2014 that amassed over 300,000 signatures.
But lawmakers were unable to repeal the tax because of European Union rules, and it became a rallying point for the pro-Brexit camp. Lawmakers have pledged to abolish the tax once Brexit is complete. Until then, taxes from menstrual products are being put into a special fund for women’s health.
Bold moves around the world
Dr. Julitta Onabanjo, the regional director for the United Nations Population Fund in East and Southern Africa, said there has been a groundswell of advocacy around menstrual health management.
In May, the organization hosted the first regional symposium on the issue, with leaders from local governments and the nonprofit sector.
Some countries in the region have made bold moves: Kenya and Uganda abolished sales tax on menstrual hygiene products, while Zimbabwe subsidizes local manufacturers. The Kenyan government also provides funding for pads in schools.
But Dr. Onabanjo cautioned that access to products is only one factor. Clean water and sanitation facilities, information and medical treatment are all important. Poverty, of course, greatly complicates the effort to manage periods with discretion and dignity. And some symptoms, like heavy bleeding or debilitating pain during menstruation, can indicate a more serious condition requiring medical attention.
Girls and women around the world must also contend with cultural stigma, shame and social isolation. A recent report published by Dr. Onabanjo’s agency noted that there is powerful evidence that girls are more likely to miss school or even drop out if they’re unable to manage their cycle, sometimes because of teasing over their periods.
Even more troubling, studies in Kenya have found that poorer girls may trade sex to afford pads, making them vulnerable to sexually transmitted diseases.
“We really want to ensure that going forward, this is seen as a sexual and reproductive health and rights issue,” Dr. Onabanjo said.
Can technical innovation ‘solve’ the problem of periods?
New products and services are promising to make periods less burdensome, from period-tracking apps and coaching on nutrition and self-care, to items like environmentally friendly reusable pads, absorbent underwear and cups.
The creators of the popular app Clue say they have 2.5 million users in 180 countries, and share anonymized data with women’s health researchers from top universities.
Product developers are working on the next generation of devices. The creators of Livia, an electrical stimulation device touted as “the off switch for menstrual pain” collected $1.7 million in orders on the crowdfunding site Indiegogo. While some online reviewers found it helpful, many of the comments on Indiegogo focus on shipping delays, device malfunctions and customer service complaints.
In the coaching realm, there’s been greater attention to the role that diet and exercise can play in one’s period. Many coaches also suggest acupuncture, herbal remedies, meditation and massage.
“What I do is help women become more informed about how their bodies work,” said Erica Chidi Cohen, co-founder and chief executive of LOOM, a reproductive health center in Los Angeles that recently introduced a period coaching program.
That includes being aware of hormonal changes throughout the month, and how one’s energy might ebb and flow at different points. Some of her clients plan big events, like business trips, based on their cycle.
“It can actually be a very positive thing if we learn what’s happening and lean into it,” she said.