It’s shocking to think that, today in 2024, something as natural and routine as getting your period could end up posing a risk to your health. But that’s the reality for many women around the world who lack the means to manage their periods in a safe and sanitary way, whether it's as a result of living in poverty or financial precarity, or being caught up in a conflict or emergency.
An astonishing 500 million people are estimated to be affected by period poverty around the world, according to The World Bank, and in the UK, the number of those impacted is rising year on year.
Period poverty can be hugely disruptive and stop women and girls from reaching their potential, with those unable to afford or access period products often ending up missing out on school, work or sports activities, or experiencing bullying or feelings or shame.
But another consequence – one that is less commonly discussed – is the health complications that can come from reusing disposable period products, or resorting to using unsuitable alternatives.
These are common coping strategies relied upon by millions of women and girls around the world who can't get the period products they need.
Last year a poll by ActionAid found that 41% of UK women experiencing period poverty said they had resorted to keeping pads or tampons in for longer than they should do, while 8% said they had reused disposable pads.
The same poll revealed that women and girls in the UK were relying on items such as cotton wool (37%), socks or other clothing (13%) or paper or newspaper (9%) as substitutes for period products.
Anecdotally, ActionAid has heard of people in the countries it works in using everything from dried leaves and feathers to cow dung as home-made alternatives.
As well as being extremely uncomfortable, these methods can lead to health issues ranging from skin irritation and rashes to urinary tract infections (UTIs), thrush and pelvic inflammatory disease.
Using repurposed items poses a particular risk, because of the likely presence of bacteria. Meanwhile keeping a tampon in longer for the recommended four to eight hours can result in toxic shock syndrome (TSS) -- a rare condition, but one which can be life-threatening.
Sadly, the stigma around menstruation that still exists to this day may mean that women and girls who do develop health issues are less likely to seek medical help, or less likely to receive it when they do.
It isn’t just a lack of period products that prevents people from managing their period safely: the absence of clean water, soap, a suitable toilet or private and safe space are also huge barriers.
People may be more likely to use period products or substitutes for longer than is safe if they have nowhere private to change them, yet according to UN Women, 1.25million women and girls around the world have no access to a safe, private toilet.
Meanwhile those without access to clean water will struggle to use reusable pads, period pants or menstrual cups safely, and may face increased risk of infection.
In Uganda’s Imvepi refugee settlement, for example, where a lack of employment opportunities has pushed many into period poverty, women have started projects teaching others how to make reusable sanitary pads, but using them is made difficult by the fact that water is not always available due to drought.
Women and girls caught up in humanitarian crises around the world – from war and conflict, to earthquakes and floods – are among those most likely to lack access to period products as well as clean water, soap and private toilets, sometimes for a prolonged period of time.
For example, in Gaza right now, period products are so scarce that women are having to cut out bits of tent to use instead, while finding privacy is near impossible, with one toilet for every 850 people in some areas.
And in the immediate aftermath of earthquakes which devastated areas of Turkey and Syria in February 2023, and later Morrocco in September 2023, thousands of women and girls relied on organisations like ActionAid and its partners to provide them with emergency period products after homes, shops and roads were completely destroyed.
Everyone deserves the materials and resources to be able to manage their periods safely and in a healthy way. So how do we make this a reality?
For starters, it's crucial that we keep raising our voices on these issues, challenging the all-too-stubborn stigma around periods and dismantling unhelpful or harmful period myths. When they don’t feel embarrassed about talking about topic, women and girls are more likely to advocate for their needs around periods and demand that these needs are met.
With cost and access two of the biggest issues, people can call on that their governments to guarantee that period products are made free and easy to access -- just as Scotland did when it passed a landmark bill in 2020.
In times of emergency, it’s important that periods are not overlooked, and that humanitarian aid packages include period products as well as other essentials. When women are involved in and lead humanitarian efforts, women’s needs are more likely to be taken into account.
Ensuring women and girls around the world can manage their periods effectively is not just vital for their dignity. It could well be crucial for their health, too.
- Donate to ActionAid’s Share a Better Period campaign here
Dr Nighat Arif is a GP specialising in women’s health and a regular guest doctor on BBC Breakfast and ITV’s This Morning.
