Women’s menstrual health becoming public policy

The average woman has her period for 2,535 days of her life. That’s nearly seven years’ time of making sure she has a pad or tampon, finding a makeshift solution if not, and managing pain and discomfort.

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. 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. 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 also are 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 — such as 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.

Here is an overview of the issues that women’s health advocates are talking about.

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. The Justice Department directed federal prisons to provide inmates with free menstrual products last year.

In the House, Rep. Grace Meng, D-N.Y., 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,” Meng said. “It’s really about accessibility and equity.”

That’s the same argument that Rep. Sean Patrick Maloney, D-N.Y., made after he was ordered to reimburse the Committee on House Administration for menstrual products.

The committee rebutted Maloney’s account. But that didn’t stop him and 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 past 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.

Ohio is considering legislation that would exempt tampons, panty liners, sanitary napkins and other feminine-hygiene products from the sales tax. Supporters argue that the products are medical necessities that should not be subject to taxation.

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, 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, and Zimbabwe subsidizes local manufacturers. The Kenyan government also provides funding for pads in schools.

But Onabanjo cautioned that More people than ever are discussing menstrual periods in public, including at events such as a Period Party. The items shown here came from a Period Party in New York. There are plenty of new ways for women to take control of their period, including with apps to track it and medicinal cannabis for pain.

access to products is only one factor. Clean water and sanitation facilities, information and medical treatment all are 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.

CAN TECHNICAL INNOVATION ‘SOLVE’ 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.

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.

In the coaching realm, there has 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, such as 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.