Changing the Cycle: Understanding and Overcoming Period Poverty

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It's time to stop period stigma and talk about something that affects half the world's population. Yes, that time of the month when we experience cramps, mood swings, and a whole lot of fun. 

But for many women and girls around the world, having a period means a struggle for basic necessities like sanitary products. Welcome to the world of period poverty. With 1 in 5 teens missing school due to lack of menstrual products, period poverty is a significant yet often ignored public health crisis. 

"Period poverty is the lack of access to sanitary products, menstrual hygiene education, toilets, handwashing facilities, and, or, waste management," in other words, sanitation.

Period poverty is the number one reason teens miss school in developing countries and the leading cause of absenteeism for teens in the US. And missing just two days of school a month means teens are more likely to be underemployed, have more children, and live in poverty. 

Federal Leglative History

The average prison job only pays between $0.14 and $1.41 per hour, and a single box of tampons can cost six to seven dollars resulting in women working upward of 21 hours to afford one box. Now, federal prisons only house a little more than meaning that 96% of the population is in state prisons, still without access even after 2018. 

At a legislative hearing in Arizona, one state prison nurse said she’s treated women because they would “take multiple maxi pads and they would twist them and make a tampon out of it.” As of 2020, thirteen states have passed a version of the Dignity Act.

Period poverty in schools, shelters, prisons and reservations.

Auditing federal prisons made it clear that they were not allocating enough supplies (capping the number of products available) and providing low-quality supplies.

Key Players

 According to the World Economic Forum, the key players affecting period poverty are:

  • Entertainment and Media: periods have been taboo for far too long, impacting research, innovation, and health outcomes.

  • Governments: responsible for free access, education, & taxation.

  • NGOs, NPOs, Advocates: worked together to ​​improve education, access to menstrual products, and water and sanitation facilities.

  • Corporations: with the growth of e-commerce, direct-to-consumer brands have sub-segmented the market with a focus on ingredient transparency and social and environmental impact.

Entertainment & Media

As people with periods, we are skilled in the art of concealment: how to avoid leaks, how to sneak a tampon into our sleeve on the way to the bathroom, and the utility of a strategically wrapped sweatshirt to hide a bloodstain. 

As young people, we were taught euphemisms for our periods and our body parts. The impact of this stigma is widespread, resulting in a gap in research, misdiagnosis for   women throughout history, and little to no innovation in menstrual hygiene in the last 80 years. 




Poet Rupi Kaur


State Governments


The Curse of the Tampon Tax:

In the US, state tax is levied state by state. Each state decides whether it will have a sales tax and what items will be exempt. Necessities are exempt from taxes, and this includes essentials like food, medication, and toilet paper. 

All other products are subject to a luxury tax. Because there’s no exemption, pads and tampons are taxed in the majority of states.

  • Cowboy boots in Texas

  • Bar-B-Q sunflower seeds in Illinois

  • Gun Club memberships in Wisconsin

  • Mardi Gras beads in Louisiana

  • Rogaine

  • Viagra

  • Erectile dysfunction pills

Pads and tampons are then, by default, luxury goods. There is a $120 MM yearly profit for the tampon tax, which is 20 times the cost to provide free menstrual products in the entire country of Scotland, the first country to offer free menstrual products in public buildings (the size of South Carolina). 

Free Period Products

Today, 27 states still tax tampons as a luxury item. A mere 11 states provide free menstrual products in public schools.  

In 2018, New York became the first state to make menstrual products free in public schools. So how much do “free” period products cost? About $24 per year per student, or, for menstrual cups, $3.27 per year per student. And the cost of solving period poverty is likely far less than the public health costs and costs to individuals, social safety nets, and the economy. 

As mentioned previously, missing school makes teens more likely to be underemployed, have more children, and live in poverty. Aside from missing class and school, students are often forced to use menstrual items for longer than is safe and make DIY period products, which puts them at higher risk for cervical cancer, toxic shock syndrome, and other health issues. 

To quickly address a common objection. I’d like to remind everyone that we’re talking about communities that often shop at bodegas, convenience stores, and gas stations.

As one Huffington post interviewee noted, a box of pads at her local gas station was $7.39 on the Lakota reservation, where the average per capita income is $9,150, and the local Walmart was an hour away. We are discussing real people in the US, in urban and rural areas, who struggle to come up with $3 and often don’t own cars. 


Menstrual hygiene management (MHM) has become a globally recognized public health topic. NGOs, NPOs, activists, social entrepreneurs, and corporations have mobilized to advocate for improved education, access to menstrual products, and water and sanitation facilities.

Globally, At least 500 million women and girls lack adequate facilities for menstrual hygiene management, causing them to miss school and workdays. In Kenya, 40% of adolescents miss school because of their period. Investing in menstrual hygiene management (MHM) can help get girls back in school and keep more women employed. 


In 1975, Rely tampons hit the shelves. They were ultra-absorbent, made of polyester and carboxymethyl cellulose. Unfortunately, these materials also breed bacteria more easily than cotton, and with the recall of Rely tampons in 1980, knowledge of Toxic Shock Syndrome became mainstream.

In recent years the global consumption of tampons has been in steady decline from 70% before Rely to 7%. A new wave of brands has emerged, selling themselves as more ethical and more environmentally friendly. The driving force for the decision to move away from brands like Tampax (the same maker as Rely) included concerns over safety, transparency, and environmental impact.

And eCommerce made direct-to-consumer sales possible. In the wake of social enterprises that touted transparency, ethical business, and sustainability, major brands started to donate products and invest in sustainable technologies. 


Period underwear

Thinx is one of those brands that disrupted the industry. The period underwear is effective and reusable, lasting approximately 6 months. They are more expensive, on average $15-40.

Reusable pads

Reusable pads are a popular option in developing nations lasting up to 3 years. They are inexpensive and can be washed and reused. Days for Girls is a non-profit where volunteers sew reusable pads for donation in developing nations. 


Menstrual discs are a trending option for their comfort and convenience. They are single-use, disposable discs that can be worn for up to 12 hours. At 12 discs for $15, the disk is a better option for those with disposable income. 

Menstrual Cup 

Since 2001, when the first medical-grade silicone cup was made, menstrual cups have increased in popularity. Menstrual cups last up to 10 years, can be worn up to 12 hours, and are, on average, one-tenth the cost of traditional products.

Menstrual cups are sanitized by boiling, making them a good option for those who have access to potable water, but it can be difficult for homeless women to boil. One study found when paired with education on their use, 91% of women said they would continue to use a menstrual cup and recommend it to others.

With the introduction of reusable products comes the need to regularly sanitize them and the privacy to change them, which has posed a problem for some. 

Periods are a fact of life for half the world's population, and it's time we start treating them as such. Period poverty is a serious issue that affects the health, education, and economic opportunities of millions of women and girls. But together, we can break the cycle and ensure that every woman and girl has access to the menstrual products they need.

So let's break the taboo, shatter the period stigma, and take action to end period poverty. Because periods are not a curse, they're a celebration of our bodies and our femininity.

About Us

Did you know the average incarcerated person works an average of 21 hours to afford one box of tampons? Courtesy Cups is on a mission to give back by donating one cup for every cup purchased locally. We not only invented the first portable menstrual cup sanitizer, but we’re committed to Changing the Cycle of period poverty through education and advocacy. Here's how you can get involved.

Further Reading: 

Periods Gone Public: Taking a Stand for Menstrual Equity


  1. State of the Period The widespread impact of period poverty on US students. (n.d.).

  2. Rodriguez, L. (2022, September 12). Period Poverty: Everything You Need to Know. Global Citizen.

  3. What is chronic absence. (n.d.). - Connecticut’s Official State Website.

  4. Chronic Absenteeism in the Nation’s Schools. (n.d.).

  5. The Basic Facts About Women in Poverty. (2021, December 3). Center for American Progress.

  6. Meng: FEMA to Permit Homeless Assistance Providers to Purchase Feminine Hygiene Products-Such as Tampons and Pads-with Federal Grant Funds. (2016, March 1). Congresswoman Grace Meng.

  7. Meng Introduces Bold Plan to Improve Access to Menstrual Products. (2021, June 2). Congresswoman Grace Meng.

  8. ‘Pads And Tampons And The Problems With Periods:’ All-Male Committee Hears Arizona Bill On Feminine Hygiene Products In Prison. (2020, April 8). KJZZ.

  9. Polka, B. E. (2018, September 5). The Monthly Shaming of Women in State Prisons. Public Health Post.

  10.  There are 3 barriers blocking good menstrual hygiene for all women. Here’s how we overcome them. (2020, February 9). World Economic Forum.

  11.  Davidson, A. (2012). Narratives of menstrual product consumption: convenience, culture, or commoditization?

  12.  H.R.972 - 115th Congress (2017-2018): Menstrual Equity For All Act of 2017. (2017, March 2).

  13.  Text - S.1524 - 115th Congress (2017-2018): Dignity Act. (2017, July 11).

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  15.  Redactie. (2022, August 7). The origin of the word ‘taboo.’ Period!

  16.  Period Equity’s legal campaign to remove the tampon tax and fight for free, safe menstrual products continues as Period Law. (n.d.). Period Equity.

  17.  Babagoli, M. A., Benshaul-Tolonen, A., Zulaika, G., Nyothach, E., Oduor, C., Obor, D., Mason, L., Kerubo, E., Ngere, I., Laserson, K. F., Edwards, R. T., & Phillips-Howard, P. A. (2022). Cost-Effectiveness and Cost-Benefit analyses of providing menstrual cups and sanitary pads to schoolgirls in rural Kenya. Women’s Health Reports, 3(1), 773–784.

  18.  Goldberg, E. (2017, August 29). Why Many Native American Girls Skip School When They Have Their Periods. HuffPost.

  19.  World Bank Group. (2018). Menstrual hygiene management enables women and girls to reach their full potential. World Bank.

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  21.  Statista. (2022, February 2). Global feminine hygiene market share by segment 2018.

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  23.  Feminine Hygiene: Room for More. (2020, November 1). Nonwovens Industry.

  24.  The DFG Pad - Days for Girls International. (2021, June 29). Days for Girls International.

  25.  Weir, C.S. (2015). In The Red: A private economic cost and qualitative analysis of environmental and health implications for five menstrual products.

  26.  Salisbury, J. (2020, October 6). Eco Pulse® 2019 Special Report: A Period of Change. Shelton Group :: Experts in Sustainability and Energy Marketing.

  27.  Elmhirst, S. (2021, December 21). Tampon wars: the battle to overthrow the Tampax empire. The Guardian.

  28. Howard, C., Rose, C. L., Trouton, K., Stamm, H., Marentette, D., Kirkpatrick, N., Karalic, S., Fernandez, R., & Paget, J. (2011). FLOW (finding lasting options for women): multicentre randomized controlled trial comparing tampons with menstrual cups. Canadian family physician Medecin de famille canadien, 57(6), e208–e215.