From the classroom to the workplace, the menstruation-related challenges women face are inescapable. In a study based in Italy, researchers found that menstruation-related absenteeism explained at least 14% of the gender gap in earnings (Ichino and Moretti 2009). An earlier study based in the U.S found that women lose wages of around USD 2,700 (CAD 3,400) annually as a result of heavy or abnormal menstrual bleeding (Côté, Jacobs, and Cumming 2002). These losses in productivity can, in part, also be attributed to the physical discomfort caused by excessive cramping and premenstrual syndrome. According to a study in the U.S, these symptoms affect at least 19% of women (Strine, Chapman, and Ahluwalia 2005). Such losses, however, may also have to do with the challenges women experience accessing menstrual hygiene products (MHPs) in the workplace.
Rural villages in Kenya, urban shantytowns in Bangladesh, and thriving metropolitans in the U.S all suffer from a common issue: an absence of universal access to MHPs. Although most would assume that this issue only hinders the opportunities of women in developing countries, it obstructs the capabilities of those in developed nations as well. In fact, such lack of access poses a barrier everywhere except Scotland, which recently became the first country to make MHPs free. In a study on women who attended U.S high schools, 24% reported leaving school early due to lack of access to MHPs (Cotropia 2019). This problem disproportionately affects low-income women, who do not have as many means of accessing MHPs even outside of school. One study on low-income women in St. Louis, for instance, found that 64% were unable to afford MHPs, with 46% reporting being unable to afford food and MHPs simultaneously (Kuhlmann 2019). Not only does lack of access to MHPs pose a unique challenge to women, it also further limits marginalized women from enjoying equal opportunities. Where lack of access to MHPs is left unaddressed, local collective action is necessary to ensuring social equity.
In my junior year at UC Berkeley, I established the Coalition for the Institutionalization of Free Menstrual Products (CIFMP), a student-led organization providing free access to MHPs across campus. Prior to CIFMP’s establishment, there was virtually nowhere on campus you could find pads or tampons by piece. I personally never once found the 25¢ dispensers in the restrooms stocked. To better understand the experiences of menstruating students on campus, CIFMP conducted a survey prior to launching. The results were shocking: from leaving campus early to turning toilet paper into makeshift absorbents, lack of access to MHPs was unfairly impacting women across campus.
At the time CIFMP began taking form, only a few universities in the U.S had made attempts at institutionalizing universal access to MHPs. The model by which they delivered MHPs depended largely on student population, administrative support, and funding. Consequently, we needed to come up with a model that best fit Berkeley, where our operations would be entirely student-run and serving a population of at least 20,000. We were fortunate, nevertheless, to have received a generous grant aimed at supporting student wellness initiatives, which made logistics a lot easier. CIFMP began its operation in the spring of 2019 as a pilot program based in two restrooms in Berkeley’s bustling undergrad library. What started with a handful of students restocking two storage containers with pads and tampons has since expanded into a multi-location initiative serving students and staff across campus.
The reactions to CIFMP have been overwhelmingly positive. In the early days, I spent a lot of time restocking the library restrooms myself and was pleasantly surprised by how fast supplies were being depleted. In the past school year alone (prior to the pandemic, of course), CIFMP distributed over 27,000 MHPs and expanded operations to 8 locations across campus. Given the amount of progress we’d made in short time, a private donor even offered to match our funding! Above all, I was most moved by those who reached out to express their gratitude – those who were overjoyed to remain on schedule having avoided an inconvenient situation.
One of CIFMP’s most wonderful outcomes is the impact the organization has had beyond Berkeley. From high school students to national activist groups, I’ve had the pleasure to speak with a wide range of individuals who are passionate about improving access to MHPs in their communities. To anyone interested in getting started in this space, it’s important to keep in mind that context is key. There is no one model to addressing access to MHPs. Instead, before they can even brainstorm a model, advocates need to firmly grasp the challenges faced by women at the local level. For example, through CIFMP’s pre-launch survey, not only did we learn about the multifaceted challenges facing students, but we also discovered that there was a slightly greater demand for pads than tampons. These insights enabled us to design a more suitable program, one that effectively serves the needs of Berkeley. Again, communicating with the people you aim to serve is key.
Failing to keep the needs of those you serve at the center of your plans is an inefficient use of time and resources. CIFMP was more a working group before it was an organization, taking over a year and a half to plan before the organization even distributed its first MHP. Much of the early days consisted of grant writing and coalition building, which involved discussions with leadership from various student organizations focused on women’s health and menstrual equity advocacy. Our discussions solidified our shared vision for the organization CIFMP would ultimately become. In addition to the quantitative insights provided by our later survey, the diverse perspectives offered by the Coalition were invaluable to establishing the foundations of an organization that is now over 2 years strong.
It goes without saying, effective collaboration is essential to the success of MHP initiatives. Given the traction universal access to MHPs has gained in recent years, I look forward to watching grassroots organizations like CIFMP take the world by storm. I’m proud of the work I’ve accomplished at Berkeley and the change it has inspired, but I’m most excited for the work that has yet to be accomplished everywhere else. For when women are given the opportunity to succeed in the classroom and workplace, we are all, collectively, much better off.
Côté, I., Jacobs, P., & Cumming, D. (2002). Work Loss Associated With Increased Menstrual Loss in the United States. Obstetrics & Gynecology, 100(4), 683-687.
Cotropia, C. A. (2019). Menstruation Management in United States Schools and Implications for Attendance, Academic Performance, and Health. Women's Reproductive Health, 6(4), 289-305.
Ichino, A., & Moretti, E. (2009). Biological Gender Differences, Absenteeism, and the Earnings Gap. American Economic Journal: Applied Economics, 1(1), 183-218.
Kuhlmann, A. S., Bergquist, E. P., Danjoint, D., & Wall, L. L. (2019). Unmet Menstrual Hygiene Needs Among Low-Income Women. Obstetrics & Gynecology, 133(2), 238-244.
Strine, T. W., Chapman, D. P., & Ahluwalia, I. B. (2005). Menstrual-Related Problems and Psychological Distress among Women in the United States. Journal of Women’s Health, 14(4), 316-323.