A correction has been applied to this article in:
Corrigendum: Editorial: Period poverty
Lea Sacca
Christine Margaret Markham
Jhumka Gupta
Melissa Peskin- 1Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
- 2Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
- 3Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States
Editorial on the Research Topic
Period poverty
Each month, half of the world's female population, estimated at 1.9 billion individuals, experience menstruation (1). Yet, as normal as it seems, menstruation is still stigmatized around the world, particularly in low-income countries with inadequate access to menstrual health and hygiene management resources (1, 2). Menstrual health is a critical global public health issue that has been impacting the physical, mental, and socioeconomic health of both women and girls (2). However, there still exists social, cultural, economic, and political barriers to accessing menstrual products, menstruation educational material, and sanitation facilities when needed (3, 4).
The American Medical Women's Association defines period poverty as the lack of accessibility or affordability of menstrual hygiene tools and educational material, such as sanitary products, washing facilities, and waste management (5). The term also refers to the increased economic vulnerability menstruating people face due to the financial burden posed by menstrual supplies, which are not only limited to menstrual pads and tampons, but also include costs accrued from pain medication and underwear used during the menstruation cycle (6–8). Such resource-limited settings drive women and girls to improvise with unsanitary alternatives such as old blankets, chicken feathers, old rags, newspapers, and cow dung (4). Difficulty affording menstrual products can cause women and girls to stay home from school and work, with lasting consequences on their education and economic opportunities. It can also exacerbate existing vulnerabilities, pushing individuals closer toward dangerous coping mechanisms (9, 10).
Period poverty does not only affect menstruating people in lower income countries; it also affects them in higher income countries (11). It is estimated that 16.9 million menstruating women in the United States live in poverty, two-thirds of which are low-income and food-insecure women who cannot afford basic menstrual products such as pads, tampons, and menstrual products. One national survey among college students found that 14.2% of respondents reported experiencing period poverty in the year preceding the survey, while an additional 10% experienced it every month (12). The same study documented period poverty being associated with higher likelihood of symptoms consistent with moderate/severe depression (12), with those reporting monthly period poverty at greatest risk for reporting such symptoms. Period poverty has also been associated with mental health issues and urinary tract infections (3, 4).
The gap in the literature and the lack of data on period poverty is a continuous challenge to measure its deteriorating impact on women's health. The following special issue aimed to address this gap by including a diverse set of qualitative, cross-sectional, and review studies exploring the menstrual experiences of girls and women from different regions across the world. For instance, the menstrual health challenges reported by adolescent girls in Myanmar ranged from access to information and social support, to behavioral restrictions, stigma surrounding menstruation, and difficulties managing menstrual bleeding and pain (Swe et al.). These findings were similar to those highlighted in the systematic review by Patel et al. on period poverty in lower and middle income countries, which included three emerging themes:
1. Availability and affordability of menstrual products, and accessibility to water, sanitation and health (WASH) services,
2. Availability of support system and coping with “period poverty,” and
3. Gender dimensions of menstrual hygiene management.
Age appropriate education, using innovative approaches such as interpersonal practical guidance (IPG) as face-to-face communication and mediated practical guidance (MPG) as social and behavior change communication (SBCC), was successful in improving menstrual health and hygiene management (MHHM) knowledge, attitudes, and practices in India, while addressing the existing menstrual health challenges in similar settings (Block et al.). Another country that suffered drastically from the consequences of period poverty amidst an economic recession and political turmoil was Lebanon (Elhage Hassan et al., 11). A qualitative study exploring stakeholders’ perspectives on the Lebanese public health policy regarding menstrual health emphasized the need to decrease the monetary burden by subsidizing menstrual products or by implementing a coupon system. The study also reported the need for proper education on multiple levels, cooperation between key players in the private and public sectors, and encouragement of local production to ensure future sustainability (Elhage Hassan et al.).
When it comes to the United States, low-income menstruating adults were seen to be disproportionately affected by period poverty during the COVID-19 pandemic because the pandemic acted as a barrier to period supplies and an underlying factor for missing work due to the lack of such products (Hunter et al.). Similarly, adults working with U.S-based communities of color revealed tension between school responsibility and family authority in providing menstruation and puberty education in schools, school- and teacher-related delivery challenges, and inadequate and disengaging menstruation and puberty content (Schmitt et al.).
Social, physical, and mental issues imposed by period poverty and encountered by females globally are inhumane and require immediate attention of policymakers and healthcare professionals to attain positive and sustainable menstruation outcomes. Findings from this issue will provide the readers with an overview about the current situation of period poverty in high-income and low-income countries. It will also guide research experts in the design and implementation of interventions seeking to address structural, social, and individual factors among populations impacted by such a phenomenon.
Author contributions
LS and CM: development of the editorial. JG and MP: critical review of the editorial. All authors contributed to the article and approved the submitted version.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
1. Alvarez A. Period poverty. American Medical Women’s Association (2019). Available at: https://www.amwadoc.org/period-poverty.
2. Rodriguez L. 9 Wins for menstrual equity in 2021. Global Citizen (2021). Available at: https://www.globalcitizen.org/en/content/wins-for-menstrual-equity-in-2021/.
3. ACMHM. The ark by KrTC. ACMHM (2021). Available at: https://acmhm.org/2021/06/28/the-ark-by-krtc/.
4. What is period poverty? Medical News Today (2021). Available at: https://www.medicalnewstoday.com/articles/period-poverty.
5. Vardapetyan A. Period poverty: the belittling of a basic need. American Medical Women’s Association (2021). Available at: https://www.amwa-doc.org/periodpoverty-the-belittling-of-a-basic-need/.
6. Hennegan J, Montgomery P. Do menstrual hygiene management interventions improve education and psychosocial outcomes for women and girls in low- and middle-income countries? A systematic review. PloS One. (2016) 11(2):e0146985. doi: 10.1371/journalpone.0146985
7. Michel J, Mettler A, Schonenberger S, Gunz D. Period poverty: why it should be everybody’s business. J Glob Health Rep. (2022) 6:1–4. doi: 10.29392/001c.32436
8. United Nations Population Fund. Menstruation and human rights - frequently asked questions. United Nations Population Fund (2022). Available at: https://www.unfpa.org/menstruationfaq.
9. Michel J, Tanner M. Poverty is not poverty: the reality on the ground including the rural-urban divide and how we can turn the tide on NCDs. In: Monyeki KD, Kemper HC, editors. Lifestyle and epidemiology: The double burden of poverty and cardiovascular diseases in African populations. London, UK: IntechOpen (2021).
10. Tull K. Period poverty impact on the economic empowerment of women (2021). Available at: https://assets.publishing.service.gov.uk/media/5c6e87b8ed915d4a32cf063a/period.pdf.
11. Sacca L, Maroun C, Khoury S, Maroun V, Khoury J, Bouery P. Period poverty in Lebanon: a call for action. Womens Reprod Health. (2022):1–16. doi: 10.1080/23293691.2022.2079965
Keywords: period poverty, menstrual equity, women's rights, sanitary facilities, menstrual hygiene, menstrual health, human rights
Citation: Sacca L, Markham CM, Gupta J and Peskin M (2023) Editorial: Period poverty. Front. Reprod. Health 5:1140981. doi: 10.3389/frph.2023.1140981
Received: 9 January 2023; Accepted: 19 January 2023;
Published: 7 February 2023.
Edited and Reviewed by: Pamela Stratton, National Institutes of Health (NIH), United States
© 2023 Sacca, Markham, Gupta and Peskin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Lea Sacca lsacca@health.fau.edu
Specialty Section: This article was submitted to Gynecology, a section of the journal Frontiers in Reproductive Health