A Look Into American Society’s Neglected Public Health Issue

“Sleep outside tonight if you were sweating today.” How would you react if you heard a statement like that? What if that statement were expanded to include even more constraints such as not touching plants or other people, not entering areas such as the kitchen or places of worship, and not participating in certain activities?1 If everyone around you normalized this, you may begin to think that sweating is analogous to a contagious disease or believe that what your body did is shameful or bad. Hopefully, it’s evident that excluding people for their normal bodily processes is unreasonable. However, those are real examples of restrictions around the world that are placed on individuals when they are menstruating.1
Persistent myths related to menstruation have frequently been rooted in concepts such as impurity and uncleanliness.1,2 Proponents of such misinformation will often back their beliefs with cherry-pickings of religion or blatant misinterpretations of biology.1, 3 However, most inaccuracies about menstruation are not rooted in malice, but rather a lack of quality sex education.4 It is estimated that in-class education on reproductive anatomy was only required in 39.5% of schools in the U.S.5 Whether it be intentional or unintentional, such misinformed discourse has nonetheless led to significant negative impacts on people who menstruate, with menstrual stigma becoming deeply ingrained in the sociocultural norms of societies all over the world.1 Shame has unfortunately become a common outcome of menstrual stigma and has, in dire consequence, led many individuals to suffer silently in numerous ways.2 Among these are difficulty in accessing menstrual products, reaching suitable hygiene facilities, and receiving pertinent education; also known as period poverty.4 Nearly 16.9 million people in the U.S. who menstruate are experiencing poverty.6 Due to menstrual stigma, discussions and widespread knowledge about period poverty become limited, which stresses the need for reproductive advocacy, quality sex education, and efforts to normalize menstruation.6
Promote Her, Period. is one such organization that is working to change the stigmatized narratives about menstruation. They are a non-profit organization that seeks to combat period poverty and destigmatize menstruation through distributing menstrual hygiene products, organizing campaigns, and being a platform for people with periods to have a voice. We interviewed founder Anaya Andre and she describes their approach as being twofold. On one end, they strive to normalize periods: “We're promoting her period. We're promoting her menstrual cycle, the importance of it, and the importance of destigmatizing everything surrounding it.” Their second objective is honing in on the strength that exists within communities of women to promote feminism. Andre states: “In a way, we're flipping the script and we're creating our own narrative, making it positive, and using that to empower each other.”Alleviating a complex issue such as period poverty requires a multi-faceted approach, which is something that Promote Her, Period. has clearly taken into consideration.
Poverty is a crisis that is widely recognized,but what about period poverty? Similar to poverty, period poverty disproportionately impacts individuals in marginalized groups.16 However, period poverty faces unique barriers to support and discourse because social stigma has been a deterrent to open communication about the matter.2 It is important that period poverty is discussed openly because it is an issue concerning personal dignity, public health, and human rights.4 Having limited or no access to menstrual hygiene products has led people who menstruate to stay home from work, be absent from school, and/or wear menstrual hygiene products longer than what is recommended, leading to a higher risk of infections, such as toxic shock syndrome.7, 8 It is estimated that 1 in 5 girls in the U.S. have had an absence or early release from school due to period poverty.9 The resulting consequences of period poverty have been vast, with negative implications on individuals’ employment, performance in school, and health.7, 8 These consequences can affect the confidence of those experiencing period poverty by making it more difficult to achieve success and excluding them from participating in society.7, 16 In order to produce effective solutions to period poverty, we first have to talk about the issues at hand in a direct and honest manner.2 By opening up positive conversations about menstruation, Promote Her, Period. is helping lay the foundations for reducing period poverty.
Given her motivation in addressing an urgent matter such as period poverty, it shouldn’t be any surprise that Anaya Andre’s journey to found Promote Her, Period. was full of heart. The groundwork of Promote Her, Period. was laid when Andre was still attending high school. As a student at Pembroke Pines Charter High School, she had received a grant from America's Promise Alliance to start a service project. She consulted a mentor and the topic of period poverty arose through their discussion. Andre recounts not even having heard of period poverty at the time, but was intrigued. After educating herself on the subject, Andre knew that this was of significant importance and something she had to become involved with. She used her grant funding to plan a community event for International Day of the Girl, where she distributed hygiene packages assembled by her and her mother. These packages contained pads, tampons, panty liners, and wipes. The response to her efforts was heartwarming and Andre detailed how the girls in attendance at the event had the “biggest smiles on their faces” and how they and their parents expressed gratitude for the hygiene packages. Andre describes the feedback as having been the turning point for her: “I've seen the change that I'm making in other people's lives.”From there, she was inspired to form Promote Her, Period.
The organization has grown to have a positive impact on South Florida’s underserved groups, including girls in foster care and teen mothers. They have distributed over 5,000 feminine hygiene products and have held seminars educating people on period poverty as well as the importance of destigmatizing menstruation. Such hard work has earned them several accolades, including the Miami Herald Silver Knight Award. But these successes did not come without their challenges. Andre described how their initial campaign was to convince the administration at her high school that an organization such as Promote, Her Period. was worthwhile. As part of this campaign, they came up with the idea of creating Promote Her, Period. stickers. To their surprise, nearly the entire campus engaged with the campaign in support. Andre describes having multiple future goals for the organization: they hope to increase the number of Promote Her, Period. high school chapters, run more events, and expand their social media presence.
The sobering reality of period poverty is that it is connected to broader issues of oppression.10 Now there’s no ignoring the elephant in the room, especially since it’s barrelling towards us. The recent U.S. presidential election illuminated the country’s perspective on women’s bodily autonomy and, simultaneously, its ignominious literacy rates.17 To make matters worse, certain state laws have/are banning or severely limiting sex education.11 Until there is a severe change, women’s lives will continue to be harmed, the restriction of abortion access being the devastating example of this.12 Abortion bans are a human rights issue and it is paramount that the focus of discussion surrounding women’s bodies remain factual and seeks to uphold bodily autonomy.12, 13
Abortion bans prove that there is a long road ahead of us in dismantling systems of oppression against women.14 The same ideologies, in many ways, impede our ability to combat period poverty.14, 15 But amidst the distress, we can find a glimmer of optimism in knowing that there will always be people who fight relentlessly for reproductive justice. Organizations such as Promote Her, Period. are a beacon of hope that menstrual health will not be ignored. Anaya Andre’s recommendations for becoming involved with period poverty are to follow menstrual health organizations on social media, take the time to educate oneself about period poverty, have open discussions about menstruation, and actively contribute to period organizations. In the end, menstrual health is a fundamental human right and with the help of organizations such as Promote Her, Period., there will be a light at the end of this tunnel. Period.

Writer: Sirena D'Orazio
Researcher: Amogh Baranwal
Editor: Aadil Khan
Illustrator: Gloria Kim

1 Maharaj, Trisha, and Inga T. Winkler. “Transnational Engagements: Cultural and Religious Practices Related to Menstruation.” In The Palgrave Handbook of Critical Menstruation Studies, edited by Chris Bobel, Inga T. Winkler, Breanne Fahs, Katie Ann Hasson, Elizabeth Arveda Kissling, and Tomi-Ann Roberts, 163–74. Singapore: Springer Singapore, 2020. https://doi.org/10.1007/978-981-15-0614-7_15.

2 McHugh, Maureen C. “Menstrual Shame: Exploring the Role of ‘Menstrual Moaning.’” In The Palgrave Handbook of Critical Menstruation Studies, edited by Chris Bobel, Inga T. Winkler, Breanne Fahs, Katie Ann Hasson, Elizabeth Arveda Kissling, and Tomi-Ann Roberts, 409–22. Singapore: Springer Singapore, 2020. https://doi.org/10.1007/978-981-15-0614-7_32.

3 “Menstruation Stigma Must Stop. Period. | The Public Health Advocate,” June 5, 2018. https://pha.studentorg.berkeley.edu/2018/06/05/menstruation-stigma-must-stop-period/.

4 Jaafar, Hafiz, Suraya Yasmin Ismail, and Amirah Azzeri. “Period Poverty: A Neglected Public Health Issue.” Korean Journal of Family Medicine 44, no. 4 (July 20, 2023): 183–88. https://doi.org/10.4082/kjfm.22.0206.

5 Ramaiyer, Malini, Bethlehem Lulseged, Rachel Michel, Fiza Ali, Jinxiao Liang, and Mostafa A. Borahay. “Menstruation in the USA.” Current Epidemiology Reports 10, no. 4 (December 2023): 186–95. https://doi.org/10.1007/s40471-023-00333-z.

6 Michel, Janet, Annette Mettler, Silvia Schönenberger, and Daniela Gunz. “Period Poverty: Why It Should Be Everybody’s Business.” Journal of Global Health Reports 6 (February 22, 2022). https://doi.org/10.29392/001c.32436.

7 “‘Period Poverty:’ Why Many Girls and Women Miss School or Work - Pennlive.Com.” Accessed November 19, 2024. https://www.pennlive.com/news/2024/01/period-poverty-why-many-girls-and-women-miss-school-or-work.html#.

8 “Period Poverty Forcing Women to Leave Tampons in Longer and Risk Their Health | The Independent.” Accessed November 19, 2024. https://www.the-independent.com/news/uk/home-news/period-poverty-tampons-toxic-shock-syndrome-b2346455.html.

9 “Nearly 1 in 5 American Girls Have Missed School Due to Lack of Period Protection1: Always® Joins Forces with Gina Rodriguez & Feeding America® to Help #EndPeriodPoverty and Keep Girls in School.” Accessed November 20, 2024. https://news.pg.com/news-releases/news-details/2018/Nearly-1-in-5-American-Girls-Have-Missed-School-Due-to-Lack-of-Period-Protection1-Always-Joins-Forces-with-Gina-Rodriguez--Feeding-America-to-Help-EndPeriodPoverty-and-Keep-Girls-in-School/default.aspx.

10 “Period Stigma and the Unacknowledged System of Oppression | Digital Education.” Accessed November 23, 2024. https://digitaleducation.stanford.edu/period-stigma-and-unacknowledged-system-oppression.

11 “Sex Education Bills: States Restricting Abortion Access Have Been Targeted the Most | CNN Politics.” Accessed November 29, 2024. https://www.cnn.com/2024/05/16/politics/sex-education-bills-united-states-dg/index.html.

12 Fine, Johanna B., Katherine Mayall, and Lilian Sepúlveda. “The Role of International Human Rights Norms in the Liberalization of Abortion Laws Globally.” Health and Human Rights 19, no. 1 (June 2017): 69–80.

13 “Why Finding Accurate Facts about Abortion Has Become More Difficult in Post-Roe America | PBS News Weekend.” Accessed November 29, 2024. https://www.pbs.org/newshour/show/why-finding-accurate-facts-about-abortion-has-become-more-difficult-in-post-roe-america.

14 Hyatt, Erica Goldblatt, Judith L.M. McCoyd, and Mery F. Diaz. “From Abortion Rights to Reproductive Justice: A Call to Action.” Affilia 37, no. 2 (May 2022): 194–203. https://doi.org/10.1177/08861099221077153.

15 Eaton, Lynn. “A Woman’s Right to Choose: Five Minutes with . . . Stella Creasy.” BMJ, November 7, 2019, l6424. https://doi.org/10.1136/bmj.l6424.

16 Mann, Simranjot, and Sharon K. Byrne. “Period Poverty from a Public Health and Legislative Perspective.” International Journal of Environmental Research and Public Health 20, no. 23 (November 28, 2023): 7118. https://doi.org/10.3390/ijerph20237118.

17 Ritchie, Alyssa. “For Life or Choice: Abortion Views in America.” Student Publications, October 1, 2020. https://cupola.gettysburg.edu/student_scholarship/898.