#MedTwitter #MedStudentTwitter #obgyntwitter let's talk about another public health crisis that has been exacerbated by the pandemic.

PERIOD POVERTY.

For a brief overview, see the thread below... https://www.ama-assn.org/delivering-care/population-care/why-stigma-prevents-treating-menstrual-hygiene-essential

I would like you to imagine a change in our current societal structure. What if you were required to bring toilet paper with you whenever you left your household for use in public restrooms? Hand soap? What about paper towels?

Period poverty also known as menstrual hygiene inequity is defined as the inadequate access to menstrual hygiene tools and education

However, there are many more cultural and social related norms and expectations that deepens the ramifications of this issue.

In many parts of the world and even in the United States, there are misconceptions surrounding menstruation that limits an individual from attaining education, advancements in careers, and even resulting in severe social stigmatization

Look at some of the ways we try to mask menstruation in “coded terminology” or myths that are told to people who menstruate to evoke fear

In certain cultures, during times of menstruation, persons are denied basic rights and dignity

Financial Impact:
Within the United States, the average lifetime cost, for around 10 years — or about 3,500 days — of the average woman's life that will be spent menstruating

This adds up to nearly 17,000 tampons and/or pads utilized, costing about $1,800 dollars

Without access to these menstrual hygiene products, make-shift sanitation products may be utilized which has the potential for dangerous physical health impacts such as vaginal and urinary tract infections, and rarely toxic shock syndrome and other reproductive health conditions

It is also critical to evaluate the mental health impacts that impaired menstrual hygiene has on an individual’s social, emotional, and mental well-being

Studies in school aged children show that those who are unprepared for menarche in terms of education and access to hygiene products had increased rates related to depression, anxiety, substance abuse, delinquency and school drop out

Period Poverty is a crisis that disproportionately impacts those who qualify as lower socioeconomic status

Menstrual hygiene products are taxed at the highest sales tax level known as “luxury tax” in 34 states, which is challenging as this contributes to state revenue

Lower SES individuals are particularly effected. These products are not defined as essential which means that they are not covered by federal food stamps programs and are NOT included as essential items that would potentially be tax exempt during a public health crisis

COVID-19 Changes:

The COVID-19 crisis has further exacerbated the severity and disproportionate impact of inequities surrounding menstrual hygiene

CARES Act allowed for menstrual hygiene products to be purchased with health savings accounts and FSAs for those with private insurance, but those on Medicaid were still left to fend for themselves as these products continued to be excluded from food assistance programs

In addition, lack of supply and transport led to areas without readily accessible grocery stores further restricting access to pads and tampons

Period poverty is an important, yet often ignored, public health crisis

We have clear examples of the social, emotional, physical, economic and structural impacts this has on individuals who menstruate. This is especially relevant in the #LGBTQIA community.

Without access to readily available products, menstruating individuals may feel that they lack agency over their own bodies.

We must reiterate that this is not a pathological abnormality, and you should not be punished for having your period.

Although this is long overdue, we now see five states that have implemented legislation to provide free menstrual products (i.e., tampons, sanitary napkins) in public school restrooms

In the most recent legislative term, even more states have considered similar legislation!!

There are also current proposed legislative efforts on a federal level, but unfortunately, these have not been considered as a priority

So how do we move forward? First... Let's talk about it. No.. seriously... let's talk about the issue.

Although, period poverty impacts many, there are still a large proportion of people who have not been educated about this issue

This type of education can be delivered simultaneously with hosting menstrual hygiene product drives to collect products for those who are most vulnerable in your community!

“The reason this public health crisis is yet to be addressed is largely due to stigma. Stigma associates menstruation with uncleanliness & disgust instead of recognizing it as biologically healthy & normal. The shame associated with periods prevents people from talking about it"

“Access to menstrual products is a right, and feeling clean, confident, and capable during one’s period is a necessity. We can all work toward menstrual equity, and the opportunities are boundless....

Whether it’s writing to representatives, advocating for free products in our schools, spreading period positivity on social media, or hosting donation drives for menstruators in need, every action has a ripple effect....

Coalitions of advocates each making even the smallest of ripples in their daily lives has the potential to give rise to seismic change. For the menstrual movement, this change is non-negotiable.

...We believe that menstrual equity can only be achieved when period products are accessible, safe, and destigmatized. We also believe that this is attainable. Together, we will change the cycle.”

@AmerMedicalAssn @cclareMDMPH @meganranney @marklewismd @choo_ek @arghavan_salles @DrJenGunter @ACOGAction @acog @SaraTheIceBerg @rohankhaz @RyanMarino @DoctorYasmin #PeriodPoverty @DrAlethaMaybank @DraytonCHarvey

@kari_jerge @darakass @WFKARS @drjessigold @DrOniBee @uche_blackstock @RheaBoydMD @RepGraceMeng @Grace4NY @EnergyCommerce @obgyn_delivered #publichealth