Menstrual Health and Dignity for Girls and Women

 

Menstrual Health and Dignity for Girls and Women

Menstrual health is a state of complete physical, mental, and social well-being related to the menstrual cycle. It means that people who menstruate can access accurate information, manage their periods with dignity, get proper care for discomfort, and live free from stigma or exclusion.

Menstrual health and dignity matter because roughly half of the world's population menstruates at some point in their life. An estimated 2.1 billion women and adolescent girls worldwide menstruate (WHO, 2026). Despite this, menstruation remains surrounded by misinformation, lack of education, insufficient resources, stigma, and harmful myths — including practices like menstrual confinement in some cultures.

UNESCO estimates that one in ten girls in sub-Saharan Africa misses school during menstruation. Over the course of a year, this amounts to nearly 30% of school days lost, solely due to menstrual poverty.

There's a lot of shame and stigma around periods, and this largely comes down to one root cause: a lack of proper information — about hygiene, biology, and health — combined with a lack of resources, such as access to pads and other period products.

This affects people in general, but it affects women and girls in particular, since they are the ones menstruating. Many grow up without adequate education, internalizing the belief that menstruation is something shameful. Communities and environments are often not open or supportive enough to change this.

Dignity, in this context, is tied to several things:

• Access to accurate information
• Access to adequate resources (pads, clean water, painkillers)
• Privacy to manage menstruation (e.g., a private place to change products)

Physical Health During Menstruation

The menstrual cycle is the body's monthly process of preparing for a potential pregnancy. It typically lasts around 28 days, though anywhere from 21 to 35 days is considered normal, and it's driven by a shifting balance of hormones — mainly estrogen and progesterone. The cycle has a few key phases: the follicular phase, when the body prepares an egg and the uterine lining begins to thicken; ovulation, when the egg is released; and the luteal phase, when the body either supports a possible pregnancy or, if that doesn't happen, prepares to shed the uterine lining. Menstruation is that last step — it falls at the very end of the cycle, when the lining of the uterus breaks down and leaves the body as the period.

In the days leading up to menstruation, many people experience premenstrual symptoms, commonly called PMS, as hormone levels drop. And once the period itself begins, the body is doing a lot of physical work, which shows up in some very real, very physical ways.

Breast pain and tenderness is one of the most common premenstrual symptoms. As estrogen and progesterone shift, breast tissue can swell slightly, leading to soreness or sensitivity that often eases once the period starts.

Skin changes, especially breakouts, are another familiar sign. Hormonal shifts increase oil production in the skin, which can clog pores and trigger acne in the days before a period.

Menstrual cramps, medically known as dysmenorrhea, happen because the uterus contracts to help shed its lining. These contractions can restrict blood flow temporarily, causing pain that ranges from mild to genuinely debilitating. Research, including data referenced by the WHO, suggests a large majority of menstruating people experience these cramps to some degree, even if severity varies widely from person to person.

Digestive changes are common too, and they can be confusing because they go in opposite directions. Some people experience bloating and constipation, as hormonal shifts slow digestion and cause the body to retain water. Others experience diarrhea, as the same prostaglandins that trigger uterine contractions can also stimulate the intestines. It's not unusual to deal with both bloating and looser stools in the same cycle.

Appetite changes are another physical reality — many people notice an increased appetite or specific cravings in the days before their period, again tied to hormonal shifts.

Body weakness and fatigue round out the physical picture. Even without doing anything differently, many people feel drained — as though they've been carrying something heavy — during their period. This isn't imagined; it's tied to blood loss, hormonal drops, and the energy the body spends on the physical process of menstruating.

Alongside all this, many people also experience mood-related symptoms — low mood, anxiety, or irritability — as part of PMS or during the period itself, adding an emotional layer on top of the physical one.

Taken together, these symptoms mean that menstruation is rarely "just" a few days of bleeding — it's a physical event with real, sometimes significant effects on the body. Yet the expectation in most workplaces is that people menstruating will show up and perform exactly as their non-menstruating colleagues do, with no accommodation for what their bodies are actually going through that week.

Access to Menstrual Hygiene Products

Women and girls need access to quality menstrual hygiene products to manage their menstruation safely, hygienically, and with dignity. Lack of access to hygiene products can limit their participation in school, work, and social activities.

The World Bank reports that over 500 million people globally experience period poverty, leading to lost opportunities and unsafe practices.

This shows that a large percentage of people lack access to menstrual products and proper menstrual hygiene. When we talk about these products, we mean pads (both disposable and reusable/washable), tampons, menstrual cups, period underwear, and a growing range of other options.

In the Western world, this level of access is often taken for granted, since the average person can afford these products without much difficulty. But that's not the global reality. In many developing countries — across parts of Africa, Asia, and elsewhere with high poverty rates — these products, which should be accessible to every girl and woman, simply aren't. Because of this gap, many girls and women resort to using items that were never meant for menstrual use, putting their health at risk.

This is the heart of the issue: it's not just about access, but affordability. For many people, basic menstrual products remain out of financial reach.

To their credit, a number of campaigns are being run around Nigeria to address this. Many focus on helping young girls and teenagers in secondary school get access to pads, with volunteers and organizations going into communities and schools to distribute them directly. It's encouraging to see this kind of progress.

Still, the problem persists. Period poverty is a real and ongoing public health concern — millions of people lack access to the products they need during menstruation, and that gap has real consequences for health, dignity, and daily life.

Access to Clean Water, Sanitation, and Private Toilets

Despite being an education and gender-equality issue, millions of women and girls in Nigeria still lack access to basic water, sanitation, and hygiene (WASH) services, as well as accurate information and safe spaces to manage their periods. This reality contributes to keeping girls out of school and preventing women from participating fully in daily life (Mukhtar, 2025).

Access to clean water, sanitation, and hygiene remains a significant global challenge: over 2 billion people lack clean drinking water at home, 1.5 billion lack basic sanitation facilities, and a 2025 SDG report showed that 2 billion still lack basic hygiene services (WHO, 2023).

Water is supposed to be one of the most basic natural resources. It's not that people are lacking water entirely — it's that they're lacking access to clean, safe water. Water that's safe not just for drinking, but for bathing and for taking care of your body and your skin.

And when you're on your period, this matters even more. You need water to bathe regularly, and you need to wash up before and after changing your pad — to wash your private areas properly each time.

Then there's sanitation. Sanitation means having a clean environment and proper waste disposal. But many people don't have this, even when it comes to menstrual hygiene specifically — they don't have the means to properly wrap and dispose of used pads. This is one of the real challenges affecting people's ability to maintain good menstrual hygiene. It's often why you can tell when someone nearby is on their period — because they simply don't have the basic resources to wash up and change properly.

Now, private facilities. There are households where people don't even have a toilet. It sounds unbelievable, but it's true. Without one, people are forced to go outside and find somewhere to relieve themselves — often in unsafe, unsanitary conditions.

This affects everyone, including men, since sanitation and access to clean toilets and water are basic needs for all of us. But the impact is especially severe for women during menstruation. When women don't have access to proper sanitation, they're forced to make do with whatever they have — sometimes discarding used pads improperly because there's no safe way to wrap and dispose of them. That's a real problem, and a public health issue we need to take seriously.

Cultural Myths and Stigma Surrounding Menstruation

There are so many myths surrounding menstruation. A lot of cultures treat a girl or woman who is menstruating as if she's unclean. In some religions, like Islam, women are forbidden from entering mosques or from fasting while on their period, because they're considered impure during that time. There are many examples like this.

In churches, too, women are often not allowed near the altar while menstruating — the belief being that the church wouldn't allow a woman near the altar during her period.

There's just a lot of stigma around periods. For example, many people, growing up in a Nigerian home, are told that during your period you shouldn't let any man — even casually — touch you, or something bad will happen. Conversations like that subconsciously make girls feel like they're unclean, like they're somehow forbidden or restricted while menstruating — as if it's not a natural biological process created by God himself.

According to UNICEF Australia, there are eight common myths surrounding menstruation:

1. "You can't eat certain foods on your period." There's nothing you can't eat during your period; food doesn't decide your flow.
2. "You shouldn't touch plants while menstruating." Plants don't discriminate; they thrive on good care regardless of who provides it.
3. "Periods are dirty, so buying pads or products is shameful." Getting your period is completely natural, and buying sanitary products is no different from buying soap or toothpaste — they're all personal hygiene items.
4. "Menstruating girls are impure and shouldn't go certain places or touch certain things." This is the one closest to what I described above. Periods are simply nature's way of signaling growth, and there's nothing impure about them — bleeding doesn't affect where a girl can go or what she can touch.
5. "Girls have to miss school while on their period." This happens to girls worldwide, but it shouldn't — which is why UNICEF works with partners to provide sanitation facilities and education so girls can stay in school and feel good about their bodies.
6. "You can't exercise or play sports on your period." Exercise and sport can actually help relieve period pain.
7. "You shouldn't talk about periods openly." Menstruation education in schools, for both boys and girls, gives girls the confidence to talk about it and helps reduce stigma.
8. "Period shame is just a normal part of growing up." This myth ties back to the psychological cost of all this: period shame can have real negative psychological effects, disempowering girls and making them feel embarrassed about something that's just a normal biological process.

Access to Healthcare for Menstrual Disorders

The global prevalence of menstrual disorders ranges from 3% to 87%, depending on the region, with dysmenorrhea and PMS being the most common (Das & Jugari, 2024).

Global data indicates that up to 90% of adolescent girls experience menstruation-related problems, yet only about 30–33% of those who experience these issues actually seek medical care or treatment. The remaining majority largely resort to self-medication, traditional remedies, or suffer in silence.

Many women and girls suffer from menstrual disorders and related mental health struggles, yet most lack the basic information to recognize when something is wrong. Severe dysmenorrhea, abnormally heavy bleeding, and other irregularities are often treated as "normal" simply because no one has taught girls and women what warrants medical attention.

This problem is compounded by limited access to education and healthcare. Many women, especially in underserved communities across Africa, don't have access to proper health education, and even when they suspect something is wrong, they often don't feel comfortable or safe enough to seek help.

One might assume that stigma comes only from outside the medical field — that healthcare providers, being trained professionals, would understand these issues and avoid judgment. But this isn't always true. Even some healthcare providers stigmatize menstrual health issues, which makes women and girls feel unsafe discussing symptoms or concerns. When the very people meant to offer care contribute to the silence, the cycle of shame and misinformation only deepens.

There's also a widespread lack of awareness that conditions like PMS, PCOS, and other menstruation-related health issues are real, treatable medical concerns rather than something to simply endure.

Finally, affordability remains a major barrier. Access to a qualified gynecologist — someone who can properly examine, test, and treat menstrual health issues — is simply out of reach for many women in Nigeria and across Africa. This raises an important question for the conversation around menstrual dignity: how many girls and women can actually afford the healthcare they need?

These are the circumstances shaping menstrual dignity today: a lack of awareness, persistent stigma even within healthcare spaces, and financial barriers that keep proper care out of reach.

Why Advancing Menstrual Health Is Important

Improves Girls' Education

According to the World Bank, menstrual health directly improves girls' education by reducing absenteeism and preventing dropouts. When girls have access to proper hygiene resources, private facilities, and accurate puberty education, they miss fewer classes, overcome period-related anxiety, and achieve better academic concentration and grade progression.

Here's why dignity around menstruation leads directly to absenteeism:

First, a girl who doesn't have access to proper period products won't want to go to school because she's afraid of being stained. Without pads, many girls resort to rags or cloth that aren't absorbent enough, so they're constantly aware that within ten or twenty minutes, they could leak through. If she's wearing a light-colored uniform — something that shows stains easily — that fear is even worse. Without money to buy proper products, she'd rather stay home than sit in school afraid and ashamed of being exposed.

Second, a girl who knows her school doesn't have a decent toilet system — no private place to change or clean herself — lives with constant anxiety. What if she leaks? Where would she go? Many schools simply don't provide that basic privacy or washing facilities. The fear of stepping out of a school toilet while on her period, with boys around and people who might notice, is real and overwhelming. Staying home feels safer.

Third, there's the stigma and misinformation around periods. Girls grow up not understanding their own bodies, so when their period comes, many rush home to hide rather than understanding it as something normal they can manage.

Fourth, a lack of basic information about managing cramps makes things worse. Many girls don't know that period pain can be eased with something as simple as a painkiller or a warm compress. Without that knowledge, they go to school struggling with cramps, unable to concentrate, feeling fatigued — all because no one taught them these basic, manageable solutions.

For all these reasons — access to products, access to clean and private facilities, freedom from stigma, and access to basic health information — dignity around menstruation is essential to improving the education of the girl child.

Protects Health and Prevents Infections

Using unclean sanitary products, or not changing them frequently enough, can increase the risk of infections such as urinary tract infections (UTIs), yeast infections, or bacterial vaginosis — causing discomfort, itching, and odor. Following the right menstrual hygiene practices, women can significantly reduce these risks and promote better intimate health.

Menstrual health education is essential because it protects women's physical health and prevents infection. Many girls and women are never taught the basics: how long a pad can safely be worn before it needs to be changed, how to maintain proper hygiene during their period, or how to care for their reproductive health more broadly. Without this knowledge, something as routine as a menstrual cycle can lead to avoidable health problems, including UTIs and other reproductive infections.

When girls are given accurate, accessible information, they're able to take care of their bodies with confidence. They know how to clean themselves properly, how often to change their products, and how to recognize signs that something isn't right. This knowledge doesn't just prevent infection — it gives them a sense of control over their own health, reducing discomfort and protecting their long-term wellbeing.

In this way, menstrual health education isn't just about managing a monthly cycle. It's a matter of basic healthcare — one that determines whether girls grow up informed and protected, or left vulnerable to complications that are entirely preventable.

Increases Confidence and Self-Esteem

According to UNICEF, menstrual health improves confidence and self-esteem by shifting periods from a source of shame or fear into a manageable, understood bodily function. When individuals have access to the right resources, education, and support, it directly enhances their psychological wellbeing.

Menstrual health and self-esteem are deeply connected, and for good reason. When someone is educated about their menstrual cycle — when they understand the biological process behind it, why it happens, and everything involved — it becomes easier for them to make informed decisions. They stop seeing themselves as a problem, a burden, or something dirty that needs to be hidden.

They no longer treat menstruation as a topic that should be avoided or concealed, because they understand it's simple biology — a natural occurrence, just like eating, sleeping, or using the toilet. Menstruation is no different.

When people aren't informed about their menstrual cycle — why it happens and how to manage it, including proper hygiene — they're left without the tools to feel in control. But education changes that. It empowers them. It enlightens them.

With that knowledge, they stop feeling ashamed or like they need to hide. They don't develop low self-esteem, and they don't feel inferior to their male counterparts who don't experience menstruation. They don't see menstruating as a curse.

This also means they can go about their daily lives — school, work, business — without carrying an inferiority complex over something so natural. They don't have to whisper or feel embarrassed asking a friend for a pad, or saying "I have cramps" out loud. Many women were raised to be ashamed of these moments, to treat them as abnormal, simply because no one ever explained that this is normal biology. But an informed, empowered person doesn't carry that shame. They can speak about it plainly, without flinching, because they understand exactly what's happening in their body and why.

This shift happens because they now understand the process: why the uterine wall sheds, why cramps happen, and how to take care of themselves through it — including how to manage their hygiene and present themselves with confidence. There's no shame in it. Understanding the menstrual cycle also empowers people to practice effective self-care, including "cycle syncing" — planning around the days they tend to feel most energetic and confident.

Boosts Productivity at Work

Managing symptoms like dysmenorrhea (severe cramps) or heavy bleeding impairs focus and energy. Providing access to pain management and comfortable rest areas helps employees recover and refocus quickly.

Just as menstrual health education helps girls show up more confidently and comfortably in school, it does the same for women in the workplace.

When a woman understands her own body — when she can track her cycle, communicate with a healthcare provider about any challenges, and knows what to expect — she's able to plan around her period instead of being blindsided by it. She knows which products suit her flow, how often to change them, and why that matters for preventing infection. She has access to the right products, to clean and private facilities to change in, and to accurate information generally.

That combination removes the anxiety that otherwise follows women through the day: the fear of not having supplies, not knowing when her period will start, not having anywhere to change, or not understanding what's happening with her own body. Without that anxiety, she's free to focus and perform — at work, in school, anywhere. In short: good menstrual health information and hygiene access don't just protect health, they directly remove the barriers that hold women and girls back from being fully present and productive.

Causes of Poor Menstrual Health

Poverty

Poverty is a leading driver of poor menstrual health, forcing millions to choose between food and basic menstrual supplies. This lack of access restricts education, harms mental health, and introduces severe physical infection risks. Globally, an estimated 500 million people who menstruate lack access to menstrual products and hygiene facilities. Due to financial constraints, women frequently resort to unsafe substitutes — studies in Nigeria show up to 62.8% of adolescents sometimes rely on rags or old cloths to manage blood flow.

When people lack the finances, they simply cannot do much. A lack of money hinders access to basic menstrual products — tampons, pads, period cups, or even safe disposal materials. It also prevents people from affording basic healthcare, let alone specialized care for menstrual health.

Poverty also affects housing — people may not have access to a private bedroom or proper facilities where they can change and manage their period with dignity. And then there's WASH — Water, Sanitation, and Hygiene — which also requires funding to be properly implemented.

All of this requires financial investment to address. And while this is a challenge even in the Western world, it is even more pronounced in developing countries. That's why poverty stands out as one of the leading factors affecting menstrual health.

Gender Inequality

Gender inequality and poor menstrual health are mutually reinforcing. Cultural taboos and a lack of resources — often referred to as period poverty — force millions, particularly in low-income regions like Nigeria, to miss school or work, compromising their bodily autonomy, economic opportunities, and health.

For years, decades even, Nigerian society has pushed back against prioritizing women's health issues. It's only with the rise of the feminist movement that women have had to fight for their voices to be heard, even within healthcare. Women's issues are often dismissed as something normal and natural that they should simply deal with on their own — "What's the big deal about menstrual cramps? Why can't you go to work?" That kind of dismissiveness ignores the fact that women are actually dealing with serious issues — fibroids, PCOS, and much more.

It's not that people consider women's health unimportant outright — it's that resources for it simply aren't distributed equally. As a result, women often end up managing on their own, in spaces where men are in positions of leadership, making decisions about women's menstrual health without truly understanding what it feels like, because they've never experienced it themselves.

Lack of Government Support

Lack of government support for menstrual health causes "period poverty," where millions of girls and women cannot afford basic sanitary products, lack access to private WASH facilities, and face severe stigma. This directly leads to missed school days, increased risk of infection, and lost economic opportunities.

In contrast to countries like Kenya, Scotland, or South Africa, which have successfully scrapped taxes on menstrual products and distributed free items in schools, support in Nigeria is highly localized. Notable interventions are limited to state-level initiatives — such as the Pad the Girl Initiative in Kaduna — and the work of international organizations. There is ongoing advocacy, led by groups like WaterAid and other civil society organizations, pushing the Ministry of Women Affairs to implement a formalized menstrual health and hygiene policy.

What are governments actually doing to make sure menstrual products become subsidized, or even free of charge? What initiatives are in place to ensure women and girls are educated about their reproductive, sexual, and menstrual health? What is being done to make sure they can access and afford proper healthcare for their reproductive needs?

What about schools? Are they being funded to have adequate sanitation — clean, functional toilets — and are communities being supported to build proper WASH systems?

These are the questions we should be asking our governments. Do they actually treat women's health as a priority? There is still so much work to be done, especially in developing countries, and still so many conversations that need to be had.

And here's one that often gets overlooked: what are governments doing to help women remain productive at work? The challenges that come with menstruating affect women's productivity in the workplace, whether we like to admit it or not. Is this being factored into workplace policy at all?

Inadequate Healthcare Systems

Inadequate healthcare systems severely worsen menstrual health by failing to provide accessible products, sanitation facilities, and specialized care. This neglect forces many to rely on unsafe hygiene alternatives, exposes them to reproductive infections, and allows serious gynecological conditions to go undiagnosed.

When we talk about an inadequate healthcare system, what we're really asking is: does the system have the resources and facilities to handle menstruation-related health conditions? Do we have enough specialists who can properly diagnose and treat these conditions? How accessible is it for young girls and women to have one-on-one consultations with doctors when they need information about menstruation?

Do we even have the resources to support women and girls through their periods at school, especially when complications arise? For the most part, the honest answer is no. Our healthcare system isn't equipped enough.

People are developing infections and carrying a disease burden caused by poor menstrual hygiene management, simply because they have no access to healthcare providers or facilities that can support them. They're left to handle it entirely on their own.

That's the real question we should be asking when it comes to supporting girls and women: how adequate is our standard of care? And it doesn't stop at menstruation — women who no longer menstruate go on to experience menopause, with symptoms like hot flashes and other changes. What are we doing to support treatment for that? How are we educating people about it? When women walk into our healthcare facilities, are we making it easier for them to get real solutions, or are we leaving them to figure it out alone?

Religious or Cultural Misconceptions

Religious beliefs heavily influence menstrual health worldwide, shaping hygiene practices, access to medical care, and community participation. While these traditions provide deep cultural and spiritual frameworks, they often intersect with stigma that affects physical and mental wellbeing.

In some communities, taboos result in the isolation of women in separate structures — such as Chhaupadi in parts of South Asia — which increases the risk of unsafe sanitary conditions and exposure to the elements. In certain traditional practices, menstruating women are considered ritually impure and may be restricted from entering temples, participating in communal cooking, or interacting with religious icons. In Islam, this is known as Niddah; Jewish law similarly dictates specific separations between husbands and wives during menstruation, followed by a ritual immersion in a mikvah (ritual bath).

When it comes to belief systems, it's worth acknowledging how deeply religion shapes people's values, including how they see themselves. Unfortunately, many religious traditions around the world portray menstruation as something unclean or impure. People who menstruate are often barred from certain spaces, activities, or interactions during their period, because they're considered "impure" at that time.

If religion is the foundation of someone's values and self-perception, it's only natural that these teachings shape how a woman or girl sees herself while menstruating. If her religion has taught her that she's unclean, or that she should be restricted from certain interactions or even from worship during her period, she's likely to internalize that same view of herself. That internalization breeds shame and stigma.

This isn't a debate about whether religion is "right" or "wrong." It's simply pointing out a consequence: when religious belief frames menstruation as something dirty, people absorb that message and learn to hide it, even when something feels genuinely wrong or painful. Instead of seeking help or talking openly about their experience, they conceal it, because they've been taught that menstruation is something shameful that should be kept quiet rather than discussed. This is ultimately why religious belief matters so much in conversations about menstrual health — it doesn't just shape practice, it shapes silence.

Solutions

Free or Affordable Sanitary Products

Even in high-income nations, 1 in 4 teens and 1 in 3 adults struggle to afford period products. Across Nigeria, Africa, and the world, many NGOs and government organizations have pushed period-poverty initiatives, and real progress has been made — but much more still needs to happen. Menstruation is a natural occurrence that women don't choose and can't control, so access to pads should not be a struggle or a hassle.

One of the biggest solutions to improving menstrual hygiene and dignity is developing free, reusable, washable, and absorbent period products that are truly accessible — even to girls and women in the most underserved and underdeveloped areas — without cost being a barrier. This would go a long way toward improving menstrual health outcomes and restoring dignity for millions of women and girls.

Menstrual Health Education in Schools

According to the World Bank, only 39% of schools globally provide menstrual health education, leaving millions unprepared for their first cycle. Inadequate education often leads to anxiety, poor hygiene, and school absenteeism, with studies in Nigeria showing over 82% of adolescents initially had poor menstruation knowledge and negative attitudes toward it.

Menstrual health education is the process of teaching people, accurately and without shame, about menstruation: what it is, why it happens, and how to manage it hygienically and safely, while understanding its effects on physical, emotional, and social wellbeing. For girls and women, this kind of education builds confidence and dignity. It helps them understand their own bodies, manage their periods with the right knowledge, and let go of the fear or anxiety that so often comes from silence around the topic.

But menstrual health education isn't just for girls and women. Boys don't experience menstruation themselves, but that doesn't mean they should be left out of the conversation. When boys are taught what menstruation is and why it happens, they grow up to understand rather than laugh, and to support rather than shame. They become the kind of brothers, sons, and classmates who stand by the girls in their lives instead of mocking them or making them feel small for something completely natural.

This is really the heart of the matter: education empowers. It eradicates stigma. It reduces the anxiety that so often surrounds menstruation simply because no one talks about it openly. It equips young people, girls and boys alike, with the knowledge to take care of themselves and to support one another, building communities that are more respectful and more progressive.

Menstrual health is not a topic to hide away. It deserves open, respectful conversation in our schools and homes. No girl should be made to feel that her body is something to be embarrassed about — and this is where the work of dedicated facilitators and health educators matters most: not only teaching the facts, but restoring dignity and nurturing good mental health around something that is, at its core, simply a natural part of life.

Better Sanitation Facilities

Modelling of WASH data collected between 2000 and 2019 estimates that 500 million people who menstruate globally lack access to the full range of materials, facilities, and services that support menstrual health and allow them to menstruate with dignity.

To be considered menstruation-friendly, public and private washrooms must meet several critical standards:

• Privacy and security: Cubicles must have sturdy, lockable doors from the inside and be fully enclosed to prevent visibility from the outside.
• Clean water supply: Access to running water and soap inside or immediately adjacent to the cubicle is essential for washing hands and cleaning reusable menstrual products (like menstrual cups or cloth pads).
• Disposal mechanisms: Cubicles should feature individual hygiene bins with hinged lids or contactless sensors for discreet, odor-free disposal of single-use products.
• Waste management systems: Proper infrastructure must exist to empty hygiene bins regularly through safe incineration or municipal waste collection.
• Product accessibility: Public and institutional washrooms should ideally offer sanitary pad or tampon dispensers.

Public Awareness Campaigns

Public awareness campaigns for menstrual health tackle period poverty and stigma through education, resource distribution, and policy advocacy. They promote menstrual hygiene, provide sanitary products to marginalized groups, and push for menstrual dignity in schools and workplaces.

Public health campaigns are about going out and educating people so they can make better-informed decisions and adjust their way of life. When it comes to menstrual health, these campaigns should transform lives — they should bring about solutions.

Where can these conversations happen? In schools, talking to the girl child about menstrual health. In markets, interacting with market women. In churches, mosques, and offices — basically any public space where women and men come together.

The priority should be teaching about menstrual hygiene and the things people can do in their day-to-day lives to improve their menstrual health; teaching men how to support women in this conversation; and teaching women not to shame other women — or themselves — around menstrual health topics.

Teaching people about the products themselves — pads, tampons, washable pads, menstrual cups — how they work, how to properly dispose of them, and how to maintain good hygiene and privacy, would go a long way toward improving the menstrual health of society and equipping people with real knowledge.

Government Policies and Funding

Governments can waive VAT and tariffs on sanitary pads to lower costs, or provide free products in public institutions, schools, and displacement camps. Integrating age-appropriate menstrual and reproductive health into the national curriculum helps dispel taboos and educates both girls and boys. Policies can mandate that schools and public places provide clean, running water, soap, and private changing and waste-disposal facilities. Tax exemptions and grants can also be offered to local enterprises producing affordable, reusable, and eco-friendly products — creating jobs while increasing supply.

Community Involvement

Community involvement is the foundation of effective menstrual health. It transforms periods from a source of shame or secrecy into a normalized, openly discussed, and supported biological function. Without grassroots buy-in, even well-funded policies fail to sustainably address period poverty.

Local stakeholders play a crucial role in advocating for and maintaining safe WASH facilities in community hubs and local schools. A fully engaged community guarantees that menstruators can participate in daily life — school, work, and community events — without restrictions or exclusion.

Community involvement in menstrual health starts with women and girls supporting one another rather than pushing these issues to the background. Too often, concerns about menstrual health are treated as secondary — but listening to women's experiences, especially around the mental health toll of stigma and lack of resources, has to be part of the conversation.

This support looks like women educating each other, sharing resources, and even offering financial support where needed. Older women can take the lead in mentoring younger girls — normalizing conversations about menstruation instead of stigmatizing girls based on where they are in their maturity. No girl should be made to feel ashamed or mistreated by other women simply because she is younger or less experienced. The goal is to create a space where women feel safe approaching each other to talk openly about menstruation and the challenges they face.

The role of local leadership

Community involvement also has to include policymakers — local government chairmen and community leaders — who have real influence over whether menstrual health is taken seriously. Their advocacy matters: pushing for environments where women and girls feel comfortable seeking help, and where a woman's dignity isn't stripped away simply because she is menstruating.

Concretely, this means leaders advocating for funding and infrastructure — WASH systems, more conducive school and public facilities, and basic resources that make menstrual health manageable rather than a source of shame. When local leadership treats this as a priority worth fighting for, it sends a message that women's dignity and wellbeing are a communal responsibility, not an individual burden.

Engaging Men and Boys in Menstrual Education

Engaging men and boys in menstrual education is essential for dismantling period stigma, ending period poverty, and fostering supportive environments. Inclusive education equips them to respect menstruators, support family members, and understand physiological changes.

When it comes to conversations about women's health, men need to be part of the discussion — and this works both ways: when the topic is men's health, women should be involved too. We are all connected to one another, whether as mothers, sisters, colleagues, classmates, or friends. There is no one in society who isn't connected to a woman in some capacity, and there's no solving these issues by keeping the sexes separate from the conversation.

This starts with how we raise our children. Don't teach a boy that he shouldn't talk about menstruation, or that he should look away whenever the topic comes up. Boys need to be educated too — much of the shame surrounding menstruation has, whether we like it or not, been perpetuated by men and boys who were never taught otherwise. Too often, we see young boys laughing at a girl who has been stained, treating her distress as a joke rather than understanding it as a normal biological process she may be anxious or embarrassed about. That reaction isn't malice so much as ignorance — boys who were never taught simply don't know what a period is, or why it matters, because the subject has been treated as taboo rather than as ordinary biology.

This is why men's involvement matters. A husband should be someone his wife feels comfortable asking to pick up pads. A brother should be someone his sister can turn to for help. A father shouldn't be someone his daughter feels she has to hide her period from out of shame. There is no part of this that men should be excluded from. Whether it's a wife, a sister, or a girlfriend experiencing cramps or discomfort, men should know how to offer support and comfort, not distance or embarrassment. Having people around you who can support you through these moments — whether men or women — matters enormously.

Encouraging Reusable and Environmentally Friendly Menstrual Products

Conventional period products — pads and tampons — often come with a hidden environmental cost. Most contain plastic, and tampons frequently include plastic applicators, both of which contribute to plastic pollution. Many conventional products also contain harmful chemicals, which has led more people to seek out sustainable alternatives.

Reusable pads made from fabric are one popular alternative. Instead of throwing them away after a single use, you wash them in the washing machine and reuse them. This not only reduces environmental impact but is also more affordable over time, since you're not constantly buying and discarding disposable products.

Menstrual cups are another widely recommended option. While cultural acceptance varies from place to place, menstrual cups offer real advantages: they're made of medical-grade silicone, can last up to ten years, and only require regular sterilizing between uses rather than being replaced each cycle.

Other sustainable options include:

• Applicator-free tampons, which reduce waste by eliminating the single-use plastic applicator entirely.
• Reusable tampon applicators, for those who prefer using an applicator that can be washed and stored for repeated use.
• Organic products, such as organic cotton tampons and pads, grown without synthetic pesticides — a safer choice for both users and the environment.

Overall, sustainable period products offer a range of benefits: they reduce environmental harm, lower the risk of exposure to harmful chemicals, and — since many are reusable — save users money in the long run.

The Role of Other Stakeholders

Parents

Discussing periods can help a child feel comfortable with her body and enable her to look after her health.

Parents are among the most important stakeholders when it comes to menstrual health. This is because parents are our first point of contact in life — they're the ones who introduce us to everything, and whatever they teach us follows us throughout our lives, shaping our health journey, including our menstrual health. This isn't to say the burden should fall solely on mothers, but mothers are often the ones who have already lived through this experience, which puts them in a strong position to be among the best teachers for their daughters.

Parents can explain what menstruation is in simple terms children can understand, framing it as a normal occurrence rather than something shameful or frightening. They can teach proper menstrual hygiene — for instance, how to dispose of pads correctly, making sure children know not to flush them down the toilet but to wrap them properly and dispose of them in a waste bin. Parents can also involve their sons in these conversations, teaching boys how to support their sisters, so the responsibility doesn't rest on girls alone and everyone plays a part in creating a supportive environment.

Just as important, parents should create a safe space where children feel comfortable coming to them as a first point of contact — a space where they feel supported, understood, and heard when they raise concerns. Children should also be taught the warning signs that something might be abnormal, so they know when to speak up instead of staying silent. If the pain is severe, they shouldn't feel they have to endure it quietly. If their cycle is irregular, that's something to talk about, not hide.

Parents shouldn't wait until their child actually starts menstruating to begin these conversations. Since periods can start around age twelve or thirteen, it's best to start introducing the topic earlier — somewhere between ages ten and twelve — so the child already has some understanding before it happens. Starting the conversation early helps normalize the process, so that when it does happen, the child understands it as a natural part of life rather than something confusing or frightening.

Healthcare Providers

Healthcare providers play a critical role in menstrual health by treating cycle disorders, providing education on hygiene, and validating menstruation as a key vital sign. They empower individuals to manage symptoms safely, address taboos, and screen for broader sexual and reproductive health issues. Nurses, doctors, and community health workers educate adolescents and adults on tracking cycles, understanding hormonal changes, and selecting appropriate menstrual products. They also assess and treat conditions like endometriosis, PCOS, and abnormal bleeding using exams, ultrasounds, and hormone panels, and manage severe dysmenorrhea and PMS.

First, providers themselves must be well-equipped with accurate, up-to-date knowledge about menstruation and menstrual disorders. This knowledge base allows them to educate the public effectively, both inside and outside the hospital. When young girls and women come in confused or uncertain about their bodies, providers should act as guides and advocates, walking them through what's happening and what steps to take. This is knowledge that people without medical training often cannot reliably provide, which makes the healthcare provider's role especially important.

Beyond the clinic, providers can take this knowledge into the community through health outreach programs, school visits, and awareness campaigns. These efforts can cover:

• Menstrual hygiene practices — teaching safe, healthy ways to manage periods.
• Menstrual disorders — helping people recognize conditions such as dysmenorrhea, menorrhagia (heavy bleeding), amenorrhea (absent periods), irregular cycles, PCOS, and endometriosis.
• Warning signs and symptoms — educating people on signals that may indicate an underlying problem, such as severe pain, unusually heavy or prolonged bleeding, missed periods, or symptoms that disrupt daily life, so they know when to seek medical attention rather than dismiss these as normal.

Within the clinic itself, providers also have a responsibility to create a comfortable, non-judgmental environment during consultations. Making patients feel at ease helps them open up and speak honestly about their symptoms and concerns, leading to better diagnosis and care.

Ultimately, healthcare providers are key stakeholders in the broader effort to improve menstrual health and reduce stigma and misinformation. Their combined role — as educators, advocates, and clinicians — makes them central to any meaningful progress in this area.

NGOs

Non-governmental organizations are essential in tackling period poverty and promoting menstrual dignity. They work to dismantle cultural stigmas, distribute hygiene products, provide reproductive education, and advocate for safe sanitation facilities so that women and girls can manage their periods safely and with respect.

NGOs and non-profits deserve real commendation for the work they've done in advancing menstrual health, often driven by small teams or even individuals pushing this initiative forward on their own. These organizations go into schools and communities to educate young girls and women about menstruation and menstrual hygiene. Their approaches include distributing branded merchandise to raise awareness and spark conversation, running campaigns that reach students directly, sharing informational cards and bulletins that break down menstrual health topics in accessible ways, and distributing free sanitary products to those who need them.

Beyond providing information and products, many of these organizations also create safe spaces where young girls and women can openly express themselves and share the challenges they face around menstruation — challenges that are often kept silent due to stigma. By listening to these experiences, NGOs are better positioned to develop practical, community-informed solutions.

Despite this commendable progress, there is still so much more to be done. While many people have been reached, countless young girls and women remain uninformed or underserved when it comes to menstrual health education and hygiene support. The gap between those who have access to this knowledge and those who don't remains significant, and closing it will require continued and expanded effort. Some areas where NGOs and stakeholders could deepen their impact include:

• Reaching rural and underserved communities where access to menstrual health education and products is often more limited.
• Running long-term, sustained programs rather than one-off campaigns, so that education and support continue as girls grow older.
• Partnering with schools and government bodies to embed menstrual health education into formal curricula, rather than relying solely on outreach visits.
• Addressing stigma at a community level, involving parents, teachers, and boys and men, so menstruation is normalized rather than treated as taboo.
• Improving access to affordable menstrual products through subsidies, local production initiatives, or distribution networks in low-resource areas.

NGOs and non-profits have laid important groundwork, but sustained collaboration between these organizations, healthcare providers, and government stakeholders will be key to closing the remaining gaps in menstrual health and dignity for all.

Media

The media serves as a powerful catalyst for normalizing menstruation, eradicating long-standing taboos, and advocating for period dignity. By shaping public perception, driving educational campaigns, and pushing for policy reform, it transforms menstrual health from a silenced, private struggle into a visible, rights-based public health priority.

Media initiatives also hold governments and institutions accountable. Campaigns — such as the African Union's drives for gender-responsive WASH facilities and Nigeria's push for pad banks in schools — are amplified by media tracking and storytelling, keeping these commitments in public view and pressuring stakeholders to follow through.

Through documentaries, news coverage, social media campaigns, and personal storytelling, the media gives menstrual health a public language it has historically been denied. When journalists and content creators cover period poverty as a health and human-rights issue rather than a taboo topic, they help normalize conversations that were once confined to whispers. This visibility matters — it reaches parents who may never attend a workshop, policymakers who respond to public pressure, and young people who are shaping their understanding of their own bodies through what they see online and on screen.

A Global Perspective

Menstrual health is no longer viewed merely as a personal or reproductive health issue; it has become a global public health, human rights, education, gender equality, and sustainable development priority. Across the world, governments, international organizations, researchers, healthcare professionals, and civil society increasingly recognize that the inability to manage menstruation safely and with dignity limits the social, educational, and economic potential of millions of girls and women.

Despite remarkable progress, significant inequalities persist. In many high-income countries, access to menstrual products, comprehensive menstrual education, and quality healthcare is generally more available. However, even these nations continue to struggle with period poverty, workplace discrimination, misinformation, and inadequate support for menstrual disorders such as endometriosis, PCOS, adenomyosis, and severe dysmenorrhea. Menstrual poverty is not limited to developing countries — it affects vulnerable populations across every region of the world.

The situation is considerably more challenging in many low- and middle-income countries, where poverty, weak healthcare systems, inadequate sanitation, armed conflict, displacement, and deeply rooted cultural taboos combine to create multiple barriers to menstrual dignity. Millions of girls continue to miss school because they lack sanitary products, private toilets, or clean water. Women in refugee camps, conflict zones, and humanitarian emergencies often face even greater challenges, with menstrual hygiene supplies becoming secondary to food, shelter, and security, despite being equally essential for health and dignity.

Recognizing these realities, international organizations such as the WHO, UNICEF, UNESCO, UN Women, UNFPA, and the World Bank have increasingly integrated menstrual health into broader development agendas. Menstrual health is now closely linked with several Sustainable Development Goals, particularly:

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 5: Gender Equality
• SDG 6: Clean Water and Sanitation
• SDG 8: Decent Work and Economic Growth
• SDG 10: Reduced Inequalities

Progress has also come through innovative policies worldwide. Scotland became the first country to guarantee free access to menstrual products nationwide. Kenya removed taxes on menstrual products and has implemented school-based distribution programs. Several countries — including New Zealand, France, India, Canada, South Africa, and Australia — have introduced varying forms of menstrual product subsidies, educational reforms, workplace accommodations, or public awareness campaigns. These initiatives demonstrate that meaningful policy interventions can significantly reduce period poverty while improving health, educational attainment, and workforce participation.

Technological innovation is also transforming menstrual health globally. Digital menstrual tracking applications, telemedicine consultations, reusable menstrual products, biodegradable sanitary materials, and locally manufactured affordable pads are making menstrual management more accessible and environmentally sustainable. Researchers continue to expand scientific understanding of menstrual disorders, while advocacy organizations use social media and digital campaigns to challenge harmful myths and normalize conversations surrounding menstruation.

Nevertheless, considerable work remains. Cultural stigma continues to silence discussions in many communities. Healthcare providers in numerous countries still receive limited training in diagnosing menstrual disorders, leading to delayed treatment and unnecessary suffering. Millions of girls still experience their first menstruation without adequate preparation or education, and many governments have yet to fully integrate menstrual health into national health, education, and social protection policies.

Achieving menstrual dignity worldwide will therefore require sustained global collaboration. Governments must invest in comprehensive menstrual health policies and infrastructure. Healthcare systems must prioritize menstrual disorders as legitimate medical concerns. Educational institutions should provide evidence-based menstrual education for both girls and boys. Communities must reject harmful myths and embrace open, respectful dialogue. The private sector should continue developing affordable and sustainable menstrual products, while international organizations must maintain financial and technical support for countries with limited resources.

Ultimately, menstrual health is not simply a women's issue; it is a measure of how societies value health, equality, education, and human dignity. A world that enables every girl and woman to manage menstruation safely and confidently is a world that invests in stronger families, healthier communities, more productive economies, and more equitable societies.

Conclusion

Menstruation is one of the most natural biological processes experienced by humanity, yet it continues to be surrounded by silence, misinformation, stigma, and inequality. For millions of girls and women around the world, a normal physiological process becomes a source of educational disruption, social exclusion, economic hardship, physical illness, and emotional distress — not because menstruation itself is inherently problematic, but because societies have failed to provide the knowledge, resources, healthcare, and supportive environments necessary to manage it with dignity.

Advancing menstrual health requires far more than distributing sanitary pads. It demands a comprehensive, multisectoral approach that combines accurate education, accessible healthcare, affordable menstrual products, clean water and sanitation facilities, supportive workplace and school environments, gender-responsive government policies, community engagement, and the active participation of parents, educators, healthcare professionals, men, boys, civil society organizations, and the media. Every stakeholder has a role to play in dismantling the barriers that continue to prevent girls and women from living healthy, productive, and dignified lives.

The benefits of investing in menstrual health extend far beyond individual wellbeing. Girls remain in school, women participate more fully in the workforce, families become healthier, healthcare costs are reduced, and communities become more inclusive. When menstrual health is prioritized, societies move closer to achieving gender equality, reducing poverty, improving public health, and promoting sustainable development.

Nigeria has made encouraging progress through the efforts of healthcare workers, educators, non-governmental organizations, community leaders, and advocacy groups. Nevertheless, significant gaps remain in access to menstrual products, healthcare services, sanitation infrastructure, public awareness, and policy implementation. Addressing these challenges requires stronger political commitment, increased investment, and sustained collaboration across every level of society.

Above all, advancing menstrual health is fundamentally about protecting human dignity. No girl should miss school because she cannot afford a sanitary pad. No woman should endure debilitating menstrual pain in silence because she fears stigma or cannot access medical care. No individual should be made to feel ashamed of a biological process that is essential to human life.

Creating a future where every girl and woman can menstruate safely, confidently, and with dignity is both an achievable goal and a collective responsibility. By replacing silence with education, stigma with understanding, and inequality with opportunity, we can build societies where menstruation is recognized not as a barrier to participation, but simply as a normal part of life — managed with the respect, compassion, and dignity that every human being deserves.

References

African Union. (2026, May 28). AU drives continental action on menstrual dignity and gender-responsive WASH. https://au.int/en/pressreleases/20260528/au-drives-continental-action-menstrual-dignity-and-gender-responsive-wash 

Afripads. (n.d.). Why boys and men need to be included in menstrual health and hygiene discussions. https://www.afripads.com/blog/why-boys-and-men-need-to-be-included-in-menstrual-health-and-hygiene-discussions/ 

Center for Health Education, Development and Leadership. (n.d.). Menstrual hygiene management in Nigeria: Towards a period-friendly world. https://cheld.org/menstrual-hygiene-management-nigeria-period-friendly-world/ 

Centers for Disease Control and Prevention. (n.d.). Global water, sanitation, and hygiene (WASH). https://www.cdc.gov/global-water-sanitation-hygiene/about/index.html 

CWS. (n.d.). Menstrual hygiene in public spaces. https://www.cws.com/en/hygiene/news-knowledge/menstrual-hygiene-in-public-spaces 

Global Partnership for Education. (n.d.). A community approach to promote menstrual health and hygiene: Youth perspectives from Tanzania, Myanmar, and Pakistan. https://www.globalpartnership.org/blog/community-approach-promote-menstrual-health-hygiene-youth-perspectives-tanzania-myanmar-pakistan 

IGE-SRH. (n.d.). For every person who bleeds: The menstrual health and hygiene policy matters. https://www.ige-srh.org/for-every-person-who-bleeds-the-menstrual-health-and-hygiene-policy-matters/ 

Medical News Today. (n.d.). Period poverty. https://www.medicalnewstoday.com/articles/period-poverty 

National Center for Biotechnology Information. (2018). Menstrual hygiene management and the role of WASH facilities. https://pmc.ncbi.nlm.nih.gov/articles/PMC5838436/ 

National Center for Biotechnology Information. (2021). Community engagement and menstrual health. https://pmc.ncbi.nlm.nih.gov/articles/PMC8098749/ 

National Center for Biotechnology Information. (2021). Menstruation. In StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK565592/ 

National Center for Biotechnology Information. (2021). Healthcare providers and menstrual health education. https://pmc.ncbi.nlm.nih.gov/articles/PMC8541887/ 

National Center for Biotechnology Information. (2024). Government support and menstrual health policies. https://pmc.ncbi.nlm.nih.gov/articles/PMC12571764/ 

National Center for Biotechnology Information. (2024). Menstrual disorders among adolescents. https://pmc.ncbi.nlm.nih.gov/articles/PMC12663074/ 

National Center for Biotechnology Information. (2024). Healthcare systems and menstrual health. https://pmc.ncbi.nlm.nih.gov/articles/PMC12406439/ 

National Institutes of Health. (n.d.). Menstruation fact sheet. https://www.nichd.nih.gov/health/topics/factsheets/menstruation 

Nigeria Health Watch. (n.d.). Ending period poverty in Nigeria: The role men must now play. https://nigeriahealthwatch.com/articles/thought-leadership/ending-period-poverty-in-nigeria-the-role-men-must-now-play/ 

Nigeria Health Watch. (n.d.). Tackling period poverty is now a national policy—but can it become reality? https://nigeriahealthwatch.com/articles/thought-leadership/tackling-period-poverty-is-now-a-national-policy-but-can-it-become-reality/ 

Springer Nature. (2022). Community-based approaches to menstrual health and healthcare systems. https://link.springer.com/article/10.1186/s12913-022-07818-5 

Taylor & Francis. (2024). Global prevalence of menstrual disorders. https://www.tandfonline.com/doi/full/10.1080/16549716.2024.2433331 

Taylor & Francis. (2025). Understanding the menstrual cycle and adolescent self-care. https://www.tandfonline.com/doi/full/10.1080/02673843.2025.2467116 

UN Women Africa. (2024, May). Period poverty: Why millions of girls and women cannot afford their periods. https://africa.unwomen.org/en/stories/news/2024/05/period-poverty-why-millions-of-girls-and-women-cannot-afford-their-periods 

UN Women Africa. (2024). Period poverty costs too much: Take action to end it. https://africa.unwomen.org/en/stories/news/2024/05/period-poverty-costs-too-much-take-action-to-end-it 

United Nations. (n.d.). Menstrual health and dignity commitment. https://sdgs.un.org/partnerships/menstrual-health-and-dignity-commitment 

UNICEF. (n.d.). Menstrual hygiene. https://www.unicef.org/wash/menstrual-hygiene 

UNICEF. (n.d.). Menstrual hygiene products. https://www.unicef.org/supply/menstrual-hygiene-products 

UNICEF. (n.d.). Talking about periods at home. https://www.unicef.org/parenting/health/talking-about-periods-at-home 

UNICEF Australia. (n.d.). Busted: Eight myths about periods. https://www.unicef.org.au/stories/busted-eight-myths-about-periods 

Venkateshwar Hospital. (n.d.). Menstrual hygiene tips for women. https://www.venkateshwarhospitals.com/blog/menstrual-hygiene-tips-women/ 

WaterAid Nigeria. (n.d.). Breaking barriers: Menstrual health equity. https://www.wateraid.org/ng/media/breaking-barriers-menstrual-health-equity-wateraid-calls-urgent-action-menstrual-health 

WHO/UNICEF Joint Monitoring Programme. (n.d.). Menstrual health in schools. https://washdata.org/menstrual-health-schools 

WHO/UNICEF Joint Monitoring Programme. (n.d.). Menstrual health. https://washdata.org/topics/menstrual-health 

World Bank. (n.d.). Menstrual health and hygiene. https://www.worldbank.org/en/topic/water/brief/menstrual-health-and-hygiene 

World Health Organization. (n.d.). Menstrual health. https://www.who.int/news-room/fact-sheets/detail/menstrual-health 

World Wildlife Fund. (n.d.). Sustainable sanitary products. https://www.wwf.org.uk/challenges/sustainable-sanitary-products