Addressing menstrual stigma, period poverty, and inequities in women’s health
Joanne Armstrong, MD, MPH, is vice president and chief medical officer, Women’s Health and Genomics at CVS Health, and Joneigh Khaldun, MD, MPH, FACEP, is vice president and chief health equity officer at CVS Health. CVS Health is a sponsor of Fortune WELL.
Menstruation is a normal part of a woman’s life. In fact, it’s estimated that women menstruate 3,500 days during their lifetime, or about 10 years. And yet, the shame around this healthy biological function can have adverse clinical, educational, and economic impacts.
Today, on International Day of the Girl, we invite young women, and individuals of all ages and gender identities, to be a driving force for change in their communities by speaking up about the conditions that affect their everyday lives. Occasions such as these give us space to acknowledge how menstruation impacts people around the world. But it is often difficult to advocate for menstrual health when society views periods as taboo, and many states consider menstrual products, like tampons and pads, “non-essential” and thus add sales taxes that cause undue financial burdens on women.
Despite the normalcy of menstruation, this biological necessity remains highly stigmatized. A survey from OnePoll found that 58% of women in the U.S. felt embarrassed for even having a period. In another survey of 1,000 American teens, the majority reported feelings of shame, self-consciousness, and/or embarrassment about their periods.
This stigma affects multiple areas of women’s lives, preventing them from receiving proper care for menstrual problems, impacting their social, economic, physical, and mental well-being, and exacerbating barriers to affording and accessing period products.
Menstrual stigma can prevent people from speaking out about or obtaining timely care for their related medical problems. There are a myriad of diseases and conditions that can cause or manifest as heavy, painful, or irregular periods, including von Willebrand disease (a blood clotting disorder), endometriosis (abnormal endometrial tissue growth outside the uterus), and endometrial cancer (cancerous cells found in the uterus lining). When women are embarrassed to speak about their menstrual problems, they can receive delayed diagnoses. A delay in diagnosis and treatment raises the likelihood of more health problems later in life.
Period stigma also results in negative social and economic effects. Because it can seem socially unacceptable to discuss menstrual symptoms, many women keep their period a secret at work. Women with paid leave often use their PTO days due to extreme menstrual symptoms. Women who don’t receive paid leave (one in five civilian workers don’t have this benefit) will forfeit a day’s wages to take time off due to extreme menstrual symptoms. A Harris Insights and Analytics survey also showed that more than 4 in 5 students (84%) in the U.S. have either missed class time or know someone who has because they did not have access to period products, which can have lasting effects on their educational trajectory.
Period stigma is exacerbated for individuals who cannot afford basic menstrual products, a condition known as period poverty. While most of the evidence and advocacy on unmet menstrual hygiene needs center on the experiences of women and girls in low- and middle-income countries, new research suggests that the experience of period poverty is also a pressing concern for low-income women in developed countries.
In a study of low-income women in St. Louis, Missouri, 64% of participants reported being unable to afford menstrual products in the previous year. One in three women said they used other products as a result, including rags, toilet paper, and their children’s diapers. Other research shows that one in five teens in the U.S. have struggled to afford period products or were not able to purchase them at all. One study of U.S. college students found that 14.2% of women had experienced period poverty at some point in the last year, and an additional 10% experienced period poverty each month.
Being unable to afford menstrual products has an impact on a woman’s overall health. College students in the U.S. who experience monthly period poverty were more than twice as likely to report moderate/severe depression compared to students who never experienced period poverty. Individuals with poor access to the facilities and resources needed during menstruation have increased risk of infection and reduced health quality of life. For example, in a study of 602 women in Ethiopia, lack of access to menstrual hygiene products and good sanitation practices was associated with increased risk of bacterial vaginosis and other reproductive tract infections.
As part of our commitment to removing the barriers that women face in their health care journeys and making care as accessible, convenient, affordable, and equitable as possible, CVS Health is working to reduce the costs of period care as well as the stigma associated with menstruation and period poverty. We will be paying the tax on period products in 12 states, and we are lowering the price of menstrual products in our stores.
We are committed to ending gender-based price discrimination in our stores by eliminating the “pink tax”, an increased price for personal care products marketed specifically to women compared to similar products for men. These are just a few of the steps we are taking to ensure women’s health care needs are met. If we want to achieve health equity for all communities, we must work together to fight period stigma and eliminate the economic and mental well-being burden of menstruation.
Addressing period poverty and equity pricing for women’s health products are a few examples of CVS Health’s cross-enterprise efforts to advance health equity.
It’s time that we prioritize women’s holistic health by putting an end to menstrual stigma, putting a dent in period poverty, and addressing gendered product pricing inequities.
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