"A Culture of Silence Around the Issues of Menstruation Needs To Be Broken"

With evidence estimating that nearly one-fourth of the world’s women and girls face challenges related to menstrual management—including stigma, privacy, and access to affordable materials—a commentary in JAMA reinforces the need to engage the public in understanding the importance of menstrual health and equity. This includes sufficient funding and more research to educate young people, their parents, and communities about the process of menstruation, along with the clinicians who serve them.

“A culture of silence around the issues of menstruation needs to be broken,” said Marni Sommer, DrPH, MSN, RN, associate professor of sociomedical sciences at Columbia University Mailman School of Public Health and commentary co-author.

“Menstrual equity is a human rights and public health issue, with racial, socioeconomic, and sex disparities intertwined,” added co-author Diana J. Mason, PhD, RN, senior policy service professor at the Center for Health Policy and Media Engagement, George Washington University School of Nursing.

Evidence from low -as well as high-resource countries shows that significant menstruation-related challenges are faced by schoolgirls, displaced adolescent girls and women, as well as women in the workplace, and many of these disparities intensified during the pandemic. Additional data highlight how those affected by homelessness face issues that go beyond access to products, and how they encounter barriers to manage their periods with dignity.

“At a minimum, access to free menstrual products in all public spaces is needed, as Scotland has done. In addition, attention is essential to assure all people with periods have access to safe, private spaces with water and soap for changing their menstrual products in comfort,” noted Sommer.

To promote menstrual equity Sommer and Mason make the following points:

    •    Policymakers in the U.S. should eliminate state sales taxes on menstrual products. 
    •    High-quality menstrual products should be available for free in schools, prisons, homeless shelters, and health care facilities.
    •    Health professionals should advocate for free access to menstrual products.
    •    The U.S. should open the door for coverage of menstrual products under Medicaid and propose increasing the monthly benefit for adolescent girls and women of childbearing age under The Temporary Assistance for Needy Families.
    •    We need to underscore the relevance of menstrual health and hygiene to all UN 17 Sustainable Development Goals.

“Women, adolescent girls, and all people with periods in the U.S. and around the world must be able to manage their periods with dignity and comfort, without stigma or shame,” said Mason.