When Anisha Abraham’s aunt passed away from uterine cancer in April, the news came as a wakeup call.
“She always knew that something was wrong,” Abraham said. But the stigma around gynecological care pushed her aunt to postpone a checkup. And having experienced gynecological pain herself, Abraham decided to see a doctor.
The passing of a loved one was “the little push I needed to seek help,” said Abraham, a 17-year-old Palm Harbor High School senior. “If there wasn’t such a stigma, I really feel like less women would postpone treatment.”
Since then, Abraham has started to write biweekly blog posts about women’s health. She also kick-started the Pink Power Project, aimed at breaking down stigmas and organizing donation drives for menstrual hygiene products across Pinellas County.
Her efforts are focused on tackling period poverty, the inability to access feminine hygiene products and supplies, particularly among low-income people. Similar to food access and homelessness, the inequities surrounding access to period products have been exacerbated by the COVID-19 pandemic.
Some women, girls, transgender and nonbinary individuals may have been able to access these supplies in schools, public facilities or workplaces prior to the pandemic. For some, job loss, work from home, and virtual schooling have limited access to period products. And although access has dwindled, the need persists.
Prior to the pandemic, one in four women said they have struggled to afford feminine hygiene products in the past year due to lack of income, according to a survey conducted by YouGov on behalf of U by Kotex, a brand of feminine hygiene products. And in 2019, one in four teens across the country said they have missed school due to lack of period supplies, according to the Alliance for Period Supplies.
In Florida, one in six women and girls between the ages of 12 and 44 live below the federal poverty line, data from the alliance shows.
But those fighting to close the access gap say the need is not exclusive to low-income individuals.
“It’s your colleague, it’s the person next to you, it’s everyone,” said Lyndsey Siara, chair of the Junior League of Tampa’s Diaper Bank, which recently started focusing on period product initiatives.
Some states employ a “tampon tax,” increasing the cost of feminine hygiene products and further perpetuating inequities. In 2017, then-Governor Rick Scott signed a law exempting such products from taxation — a step that lessened the cost burden but did not end the problem.
A 2019 survey of 2,000 women aged 18 to 55 revealed the average woman spends over $6,300 on menstrual products in her lifetime. The survey was conducted by OnePoll for INTIMINA, another feminine hygiene brand that sells menstrual cups, a reusable alternative for pads and tampons.
Other estimates of just tampons alone — not including products like panty liners, the need to buy clean underwear, and period cramp pain management methods — estimate a lifetime total of just under $2,000 over an individual’s reproductive age.
For women with endometriosis, a disorder characterized by extremely heavy and painful periods, the cost rises significantly. One study published in the Human Reproduction Update in 2007 estimated that these individuals may pay upwards of $2,800 per year in medical expenses, which does not account for lost wages due to days off work.
Those receiving nutrition assistance through federal and state programs are not allowed to use those benefits for period products, Siara said.
Since the pandemic started, one in three parents report being worried about the ability to afford period products, according to Always, another feminine hygiene brand.
The Junior League of Tampa has seen an increase in demand for basic need supplies, including diapers and period products. From August to early October, the group donated just over 11,000 period products.
And those donations are having the largest impact on elementary schools.
“This is a child welfare issue,” said Caroline Foss, the basic needs strategic advisor for the Junior League. “This isn’t a high school or college problem.”
In schools with younger students, supply for feminine hygiene products may be low as the average age for a girl’s first period is 12 years old. Yet, girls as young as age 9 are beginning to menstruate, underscoring the need for accessible period products and women’s health education for youth and adults alike.
However, working with schools has proven difficult, according to Foss. Often period education gets conflated with sex education, she said, limiting opportunities to increase awareness around feminine hygiene.
“We’re not able to have open conversations and open distribution,” Foss said.
Teens like Abraham have been chipping away at education gaps and limited period product access. Abraham hosts drives where people can donate used clothing, then sells those items and uses the proceeds to purchase period products. The products are donated to local food banks or shelters.
When she got the idea, Abraham was looking to mobilize teenagers like her who may not have money, but had clothes they no longer use.
Hillsborough High School sophomore Aanya Patel has been pursuing a similar mission.
During a virtual global forum this summer, Patel learned about period poverty and was inspired to start her nonprofit, Global Girls Initiative. On Oct. 10, National Period Day, she launched a project called “Periods in the Pandemic: No Girl Left Behind,” which helps provide pads to low-income and homeless families as well as domestic violence shelters in Tampa.
Her goal started with collecting 10,000 pads and has since expanded to 50,000 as support poured in. In addition, Patel has started a GoFundMe to raise $4,000 for the project, which she says she’s close to reaching.
“People are losing their jobs in this pandemic and they can’t afford food much less menstrual products,” Patel said.
Since its launch, the project has expanded to include partnerships with Hillsborough County Public Schools to distribute supplies and the University of Tampa, where she held a period product drive on campus.
For Patel, 15, donations are one piece of the puzzle. She started a social media campaign aimed at debunking menstrual hygiene myths and menstrual health stigma. Now she’s promoting the use of environmentally sustainable products, such as menstrual cups or biodegradable pads.
“I can buy (period supplies), and I can afford it,” Patel said. “Why not take it one step further with sustainability?”
Her local success has pushed her to think globally. Now working with six villages in India, she hopes to donate a 6-month supply of period products to 100 girls. She chose India because of her heritage. Her mom is from Gujarat, a state on the west coast of India.
“I think it’s important that we give back to our roots.”
Times staff writer Gabrielle Calise contributed to this report. The Foundation for a Healthy St. Petersburg provides partial funding for Times stories on equity. It does not select story topics and is not involved in the reporting or editing.