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After starting at Hampton University, Amber Wynne quickly realized that many of her fellow students had trouble acquiring basic menstrual products. But she didn’t know just how profound the issue was until the coronavirus hit.

Wynne, a 21-year-old studying health-science policy administration at the historically Black university in Virginia, had been spearheading a proposal to increase access to menstrual products at the school, where she said availability was limited. But as widespread stay-at-home orders depleted supplies of basic necessities from store shelves when the coronavirus hit, Wynne’s peers began reaching out to her for help.

Wynne began distributing menstrual products through an emergency reproductive health hotline, a student-driven initiative which offers free emergency contraception and aid to students. As long as students were able to provide $5 for shipping, Wynne would typically send them $60 worth of products funded by a donor.

“I knew there was a need, but I didn’t realize how bad it was,” Wynne said. She says she received calls at 2 a.m. from people saying they needed to decide whether to buy food or buy pads. “I had a student who said that her mother wasn’t able to buy them menstrual products for that month because they were afraid that the lights were going to go out.”

A study from George Mason University’s College of Health and Human Services sheds light on the ways this kind of period poverty is impacting college students, who have been on the front lines of a broader movement to de-stigmatize menstrual health and expand access to care.

The study found that 1 in 10 female college students reported experiencing chronic period poverty, meaning that each month they struggled to pay for basic menstrual products; another 14 percent of the group reported struggling to pay for period products within the last year.

Published in BMC Women’s Health, the study analyzed data from 471 female students enrolled in undergraduate programs who participated in an online survey on menstrual health. Researchers looked at the frequency at which these women were experiencing period poverty and who was most affected, as well as its broader health implications. The findings reveal how stratified the experience of having a period can be for millions of Americans.

There were clear divides when it came to race and background: Nearly a quarter of Latina college students reported experiencing period poverty in the past year, while 1 in 5 Black women said they had trouble affording menstrual products. Rates of period poverty were also higher among college students from immigrant backgrounds and first-generation college students.

Researchers also found a strong correlation between period poverty and depression, with women who experienced any frequency of period poverty reporting similarly high rates of moderate and severe depression (between 61 and 68 percent) over the past year. In comparison, 43 percent of college women who could afford the products they needed reported having moderate or severe depression.

The study is believed to be the first of its kind to find such a link between period poverty and depression among college students.

Jhumka Gupta, the study’s senior author and a social epidemiologist, said it was important to explore the findings to better understand the broader implications of period poverty. Despite menstrual hygiene also being a basic need for millions of people, there isn’t much research exploring how a lack of access to menstrual products can impact someone’s mental health.

“When people struggle with other types of difficulties with meeting basic needs, whether it’s food insecurity or housing insecurity, we know from the research that impacts mental health,” said Gupta. “What we wanted to say is that we should also be explicitly looking at period poverty as well, because that’s something that definitely explicitly impacts women and girls and other menstruators, and that just hadn’t been researched yet.”

Part of the problem is the stigma associated with talking about periods and other menstrual issues, like endometriosis and fibroids, she explained. But there are also institutional barriers.

“I think you have to look at who is making these decisions on what to research and, more broadly, who makes these policies. And if those people are not necessarily impacted by having period, it’s just not going to be on their radar right now,” Gupta said.

The study noted that the “overwhelming majority” of the work on period poverty focused on women and girls in low- and middle-income countries, despite emerging research showing that unmet menstrual hygiene needs are an issue in high-income countries. One 2019 study found nearly 2 out of every 3 low-income U.S. women struggled to pay for basic period products; in another survey, 25 percent of teenagers say they have missed class because they could not afford pads or tampons. Unlike other basic hygiene products, tampons and pads are not covered by the federal Supplemental Nutrition Assistance Program or Medicaid. In fact, in most U.S. states, they are subject to sales tax.

Notably, the data from the study was collected before the coronavirus, which has disproportionately impacted women of color.

Gupta said the pandemic has probably exacerbated many of the issues that the study touches on, including racial divides. This is something Wynne has noticed as well.

While there has been a nationwide movement to increase access to menstrual products, particularly on college campuses, Wynne says HBCUs and religious institutions are frequently left out of those conversations — and overlooked by national donors. This is significant because the stigma around talking about menstrual health is particularly strong on these campuses, she explained.

“A lot of the time people will look to predominantly White institutions to assess the need of menstrual equity and period poverty,” she said. But, Wynne continued, these schools also seem to have greater access to these products when compared to campuses that serve minority students.

College students like Wynne have been leading the charge to expand menstrual equity. Cash-strapped students have limited employment options, so they are more reliant on their institutions to help bridge the gap in menstrual care. For decades, the stigma around menstruation meant students would rely on whatever was available in restrooms or health centers, tap informal networks (that one classmate who always seemed to have an extra tampon), use paper products or discarded clothing as alternatives, or forgo products altogether.

Before the pandemic, Wynne drafted a “period project” resolution for Hampton’s Student Government Association. In it, she included results of a survey, which found 83.9 percent of students reporting some form of menstrual product insecurity. In her proposal, she also pointed out that menstrual hygiene didn’t only affect women at the university, but nonbinary and trans students as well: In total, 68 percent of the school’s student body menstruated, she noted, making addressing the lack of menstrual products all the more urgent. The project was approved, and starting in the fall semester, Hampton University will have a “period pantry” available for students to get the menstrual products they need, free of cost. Wynne is now working with the Pennsylvania-based nonprofit No More Secrets to expand access to menstrual products at other HBCUs.

Gupta hopes the period poverty research is a step in drawing more attention to menstrual health access in the United States, and she sees plenty of opportunity to build on the study’s findings. Nationwide, there is a growing legislative push to recognize and center menstrual needs, but much of the direct aid still comes from grass-roots efforts led by young people like Wynne. She wants to see menstruation become more normalized and for more schools to take on these initiatives without being prodded by students.

“The conversation needs to change,” she said. “And we shouldn’t be looking to those who have been oppressed by the system to fix the issue.”

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