By Steph, 27 August 2021

Period poverty is defined as the lack of access to menstrual products, menstrual health and hygiene education, washing facilities, waste management for individuals who menstruate, which often leads to missed school days, job opportunities and also compromised well-being. Globally, over 500 million women and girls are affected by period poverty each month. Period poverty in Malaysia, as a developing country, affects mostly lower-income and disadvantaged families.

Despite the fact that menstruation is a natural biological occurrence for most females once they reach puberty, period items like sanitary pads and tampons are very often overlooked and not being included as a basic necessity. Women and girls who are unable to afford the cost of sanitary and menstruation products turn towards using other options that are harmful to their well-being, for example, using coconut husks or newspapers to replace sanitary pads and tampons, which can cause infection and other health risks.


Period poverty during COVID-19



According to a survey conducted by WASH United and UNICEF, since the beginning of the epidemic, about one in every four women and girls between the ages of 13 and 35 has found it more difficult to manage their periods. It is also reported that 47% of women and girls had an even harder time getting access to menstrual supplies. For girls who menstruate, not having access to sanitary pads means not being able to go to school or even leaving the house. Even till this day and age, many cultures still prohibit women and girls who are on their periods to participate in activities, and are encouraged to be indoors. In worse cases, they are even forbidden to be within their homes as it is believed in some cultures that menstruating women and girls may contaminate the food. This usually results in girls missing out on schools, and not being able to go out to work, which in turns negatively influences their education and even mental health. Girls may be more prone to be coerced into child marriage as a result of insufficient of education. During this pandemic, families are forced into dire situations where most are struggling financially. The main priority for most families would be to put food on the table. Sanitary products would not even make it to the top of list. All in all, period poverty is definitely not a result of the pandemic but it certainly worsened the problem.





Period Stigma



Period stigma refers to the discrimination that women who menstruate experience. Period stigma has a direct negative impact on those who experience it, ranging from physical issues such as a lack of access to sanitary supplies to verbal shaming of menstruation individuals as “filthy” or “unclean.” As mentioned previously, menstruation is a part of most women and girls’ biological function, thus, the stigma that comes from it serves absolutely no useful purpose at all. For girls and women, the menstrual cycle should be viewed as an important indication that can reveal other physiological issues. Abnormally heavy bleeding or intense cramps are sometimes overlooked as “simply part of life,” however they could be signs of endometriosis or fibroid growth.




Period stigma manifests through many ways. One of the most common ways are through discrimination. Whether it be just a jovial joke, it is still harmful. Some examples of ‘light’ discrimination may come with accusations that a girl or women is PMSing or having their periods if their behavior is viewed as sensitive or aggressive. Claims that menstruating individuals are incapable of doing well at work have no basis in reality at all. In addition to the discrimination, there is even misinformation involving sanitary products, for instance, using a tampon can “take away” a person’s virginity.




Discussions of periods are also often a taboo. Instead of using the term ‘menstruation’ or ‘periods’, so-called code words such as ‘Aunt Flo’, ‘Time of the month’, ‘Code Red’, ‘Monthly visitor’ are often used. When someone needs a tampon or sanitary pad, they usually ask another individual in a hushed tone so others don’t hear. We foster the assumption that it isn’t acceptable to talk about menstruation simply, without using veiled terms. In Malaysia as well as other countries in the world, we tend to practice the culture of concealment, which means masking the idea or any topics relating to menstruation. Even in some parts of Malaysia, the idea of seeing a sanitary pad is still being considered a taboo. It is still expected that any form of sanitary products should be kept under wraps. For instance, buying sanitary pads or any other type of menstruation products must be done discreetly.




At this point, you might be thinking – “Are we unconsciously encouraging period stigma if we are practicing all of the above?” Stigma is internalized in our society – our actions, words, thoughts, as well as feelings are already embodied in us, henceforth, all of it continues to perpetuate in our daily lives and society. In order to break this toxic cycle of period stigma, we have to go against the current to change our thoughts and our behavior on anything related to period.





The Link between Menstruation and Mental Health



One of the many symptoms of menstruation is mood changes. The emotional roller coaster is caused by the changing amounts of hormones during the menstrual cycle, however at times, the intensity of mental problems can be worrying and may indicate a mental disorder. Premenstrual syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are the main mental disorders that are connected to periods. PMS is more common and has mild symptoms compared to PMDD. Symptoms of PMDD involve mood, behavioral, and physical symptoms. Mood swings, tearfulness, increased sensitivity, irritability, increased interpersonal conflicts, anxiety, lethargy, change in appetite, hypersomnia or insomnia are the major symptoms of PMDD. Both PMS and PMDD should be treated under medical supervision, and not just by a gynecologist, but also by a psychiatrist. The topic of menstruation, in itself, is already labelled “shameful”. As a result of the social stigma, young girls and women find it incredibly difficult to own their physiology and share their discomfort. Mood swings are linked to the menstrual cycle and can be extremely distressing for women. Hence, the lack of awareness of these changes in the family, friends, and society as a whole acts as a blockade, accumulating and taking a toll on mental well-being. Women and girls require an environment in which they can be free of mental pressures and receive the support they need. The support outsiders can give is to acknowledge menstruation is a natural process with mental health ramifications that are just as significant as any other. We can pave the path for improvements and abolish social barriers that should never have existed in the first place by removing the stigma around menstruation and mental health.





An Alternative to Sanitary Pads



Many girls and women have been using sanitary pads for a long time, maybe ever since they reached menarche. Are sanitary pads safe or sustainable enough? Organic sanitary pads are safe to use. However, there are some sanitary pads are made of plastic materials that contain certain chemicals such as BPA and BPS. Using pads as such may expose women to low levels of chemical contaminants which will amass inside bodies. This will result in a possible threat to reproductive health by complicating embryonic development and in worse cases, organ damage. Some absorbent pads contain fibers that can cause cervical cancer. As a matter of fact, not all sanitary pads are purely made of cotton, but rather, cellulose gel and rayon, which is frequently used in pads to absorb wetness. The dioxin present in both chemicals increases the risk of contracting ovarian cancer. In addition, cotton is not naturally white. Most sanitary pad companies use dioxin to bleach the cottons until it becomes white. The idea of white is associated with something that is new and clean; unfortunately, even low level of exposure to dioxin may result in the darkening of skin and also, liver damage. Cottons that are used to make pads are from cotton crops. These crops are sprayed with pesticides and herbicides, a known carcinogen, which can definitely threaten one’s health when the chemical contaminant reaches the bloodstream. These carcinogens can cause defect in thyroid function, fertility issues and other major health implications. It is completely comprehensible why some women opt for scented pads – to get rid of the period odor. Pads that are pleasant to the nose consist of deodorants or neutralizers cause yeast infections and complications to the development of the embryo. Besides that, prolonged usage of sanitary pads is linked to the overgrowth of staphylococcus aureus in the vagina, commonly known as toxic shock syndrome. The bacteria releases toxins that causes a sudden drop in blood pressure. It can be considered an extreme health risk as the brain would be unable to receive ample supply of blood. Sanitary napkins are costly for many women around the world.




Nowadays, more women are choosing to use menstrual cups rather than sanitary pads. A significant reason is due to the convenience and also inexpensive cost. Menstrual cups are eco-friendly, reusable and also safe to use as it is made from medical grade silicone. In a scientific review conducted for menstrual cups, it is reported that 70% of women continued using them after trying it for the first time. Even though tampons are like menstrual cups in which vaginal insertion is necessary per usage. Menstrual cup is much preferred because unlike tampons, it does not absorb natural vaginal moisture, leaving the pH balance of the vagina undisturbed. A study conducted to examine the vaginal canal and cervix showed that menstrual cups do not cause any sort of tissue damage. However, women using intrauterine devices (IUDs) may be confronted with certain risks.



It is not just about ensuring girls and women having access to menstrual pads when having their monthly period, it is also equally important to consider the reproductive health and sustainability of the sanitary products. It should be an acceptable and safe option for menstrual hygiene in countries with high-income, low-income, and middle-income. A durable alternative to disposable sanitary products should definitely be reviewed, especially where sanitation facilities and waste managements are poor.





Normalizing Menstruation




To ameliorate the situation in Malaysia with regard to period poverty, we must first understand the root causes of the problem. The government must conduct a number of rigorous research on period poverty. The government may then focus on developing and implementing solutions to eradicate period poverty for Malaysian girls and women with the use of considerable data and information. There are numerous ways to invoke change to end period stigma without the usage of a public platform. We can start by having open conversations about periods without feeling ashamed. That way, we are assisting in the removal of the societal prohibition on discussing it and those around you will become accustomed to hearing about menstruation as a regular and natural biological function. One major part of the reason why countries such as Zambia and Kenya provides free sanitary products to girls and women that are menstruating is to ensure that girls are able to attend school, and to prevent them from missing out on classes or even dropping out of school due to periods. These countries grasp the long-term implications and importance of girls receiving proper education, as they should. The gravity of educating women as well as providing them with basic resources they need is formidable as it is able to create a domino-like effect – women will help other women and they will help their community in many ways. Hence, empowering women can alleviate the community and economic status of the country. Furthermore, menstrual cycle and health education should be for everybody, beginning in primary school and also including boys, should be improved and made more comprehensive. As adolescents go through puberty and have changing needs, this education must continue throughout high school. Menstruation education for both boys and girls will help to eliminate stigmas and taboos associated with menstruation. It is vital for boys and men to be fully education on menstruation in healthy and safe settings. In many countries, men have more representation in spaces where they have the authority to make decisions. If they are completely oblivious to menstruation is, it is unlikely they will continue to make decisions that will be beneficial for crucial situations, such as period poverty.





Normalizing the idea of menstruation can significantly decrease the stigma around periods. Reducing period stigma will have a strong emotional impact on everyone who menstruates. People would be less disturbed about the subject, be less worried when mentioning it, and no longer feel ashamed. Shaming diminishes self-esteem, thus just eliminating that factor would result in a happier, healthier society. Normalizing periods benefits everyone, regardless of whether it is one of their biological function or not.


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