Sage Journals: Discover world-class research

Abstract

Background:

Two in five menstruators struggle to afford period products at some point in their lives. Menstruators experiencing period poverty are often dictated which and how many period products they receive. Products received by menstruators experiencing period poverty may not be the right type or absorbency and are discarded without use. To address period poverty in Dayton, Ohio, USA the Free Flo Box (FFB) organization created period product pantries, which allow menstruators to choose which and how many products they need. FFB operates two-period product pantries, which are free-standing cabinets. Pads, tampons, and menstrual cups are available anonymously, 24 h a day, and 7 days a week.

Objective:

This article aims to: (1) determine if FFB pantries are an effective model for period product distribution (2) analyze pantry utilization trends, and (3) compare the pantry model of distribution to existing methods of period product distribution.

Design:

This is a longitudinal observational study of period product pantry utilization.

Methods:

Descriptive statistics and zero-inflated binomial regressions were conducted to analyze FFB utilization.

Results:

FFB pantries have provided over 30,000 products in less than 2 years, with a monthly average of 1736. Utilization of the pantries continues to grow. As gas prices increased, significantly more reusable and significantly less single-use products were taken. Pantries were more likely to be utilized on days when it rained but utilization was not affected by temperature. The pantry model overcomes barriers of fixed hours, perquisites for use, regular and reliable supply, and predetermined amounts and types of products provided.

Conclusion:

Period product pantries are an effective model of period product distribution and highlight the need for greater access to period products. While period product pantries will not solve period product poverty, they can help menstruators in need on a local level.

Keywords

menstruation period poverty menstrual hygiene management period product pantry

Introduction

Two in five menstruators struggle to afford period products at some point in their lives, with Black and Hispanic menstruators being disproportionately affected.¹ The negative consequences of period poverty extend beyond simply bleeding through clothing due to absent or inadequate menstrual products. Period poverty can profoundly impact menstruators’ lives, putting them at greater risk for psychological symptoms of depression, and anxiety²; infections such as urinary tract infections, yeast infections, and vulvar contact dermatitis from using unsanitary items to manage menstruation^3,4; and missing school, work and social events due to shame or fear of leaking blood on clothing.^5,6 The negative physical and mental toll that period product insecurity exacts on menstruators is further aggravated by deeply entrenched stigmatization surrounding menstruation,^1,7
–9 despite the recent positive representations of menstruation in the mainstream media.¹⁰ This negative stigma is exemplified by 58% of menstruators feeling ashamed of having a period, few menstruators being able to say something positive about menstruation,¹¹ and 51% of men believing it is improper to discuss periods in the workplace.⁷ Period poverty remains a major barrier to schooling among teens and college students, with 84% of teens missing class time or knowing someone who missed class time⁷ and 24% of college-age students missing school⁵ because they could not afford menstrual products.

On May 28, 2013, WASH United (Water, Sanitation, And Hygiene), held the first annual Menstrual Hygiene Day to raise awareness about the global lack of access to menstrual products, education, and sanitation facilities.¹² Until 2020, research and aid initiatives surrounding period poverty had largely focused on the Global South.⁹ The modest amount of research on period poverty in the United States has primarily been conducted by period product companies^7,13
–15 and nonprofits.^16
–18 Recently there has been a red wave of activists on social media challenging menstruation stigmatization and raising awareness of period poverty.^19
–21 This enthusiasm has been coupled with emerging peer-reviewed research focused primarily on the experience of students and the unhoused.^{4
–6,22
–28} The COVID-19 pandemic highlighted and punctuated period poverty as people struggled to access essential needs such as toilet paper.^29,30 People who previously had secure access to personal hygiene products experienced insecurity for the first time, thus allowing them to understand the hardships many menstruators in the United States face each month.³⁰ This burgeoning awareness helped increase access to period products in schools^31
–34 and prisons, remove the sales tax on period products in some states, and make period products available through social service providers, and food and diaper banks.^17,35 However, much of the general public who face period insecurity benefited little from these policies, and only a modicum of peer-reviewed research has been conducted on the development of interventions to address period poverty within the United States.³⁶

To end long-term period insecurity there needs to be a range of interventions that provide regular and reliable period products. Traditional methods of period product poverty alleviation are period product banks, food banks, diaper banks, and social service providers. Banks may be open as little as 1 h per month and/or provide little information about which products they provide or how many products a menstruator can take at one time.³⁷ Social services that provide period products may utilize predetermined kits,³⁸ ration amounts with as few as two pads per month,⁴ or require menstruators to publicly ask social service staff for products.⁴ While these services provide desperately needed products to menstruators in need, these methods of distribution may create barriers such as limited hours; inefficiencies of product availability that may not match the menstruators’ chosen method of menstruation management, and inequities of having to ask for products from a person in charge. There is a need for interventions that provide information about what products are available, stock a full range of products, and are available 24 h a day 7 days a week. Interventions should support menstruators’ ability to choose what and how many products they need, upholding menstruators’ dignity and autonomy without stigmatization, while also helping to end their cycle of insecurity long-term.

To help address period poverty in their neighborhood, authors JG, EG, and AL created Free Flo Box (FFB) period product pantries in Dayton, OH, USA. FFB is an innovative grassroots nonprofit that provides free period products through unmonitored, free-standing pantries (shown in Figure 1) that are available 24 h a day, 7 days a week. FFB pantries operate on a “take what you need, leave what you can” model of resource distribution, similar to little free libraries or free food pantries. FFB was created around the idea that all menstruators should have access to the products they need to manage their periods and that they should be able to choose what type, absorbency, and size of products they receive since they know which products are best for them.

Figure 1.

Free Flo Box pantries.

This paper serves as an introduction to period product pantries and provides resources for those who are interested in creating one. The purpose of this paper is to (1) determine if FFB pantries are an effective model for period product distribution, (2) analyze pantry utilization trends over time, (3) determine how and what factors impact utilization, and (4) compare the utilization of single-use/disposable period products to reusable products. These analyses are needed to describe the demand for access to free period products, menstruators’ preferences, use of reusable products by menstruators facing period poverty, and identify factors that may impact pantry utilization to help overcome barriers. This paper also seeks to compare the pantry model of distribution to existing methods that directly provide period products to menstruators in the United States and highlights the need for further research on the topic.

Methods

Pantry design

FFB pantries are located in the South Park (SP) and St. Anne’s Hill (SAH) neighborhoods of Dayton, Ohio, USA. The SP pantry was the first pantry opened in March 2022 and the second opened in SAH in November 2022. The SP pantry and SAH pantry are located a 20-min walk or a 5-min car ride from each other. Both the SP and SAH neighborhoods have social service providers in the surrounding area; however, the SP pantry is located along busy walking routes between social service providers, whereas SAH does not. SP and SAH are located in a low socioeconomic status area where 25% of residents experience poverty.³⁹ The specific sites of the pantries were selected because of the need in their respective neighborhoods, based on local knowledge of where unhoused informal communities were located, interactions with unhoused menstruators, proximity to social services, and proximity to pantry managers. These sites make daily tasks such as stocking products, recording usage, and fulfilling requests possible. Managers were members of these local communities, affording them unique knowledge of the problems faced by local menstruators who were period product insecure. The FFB is not associated with any social service, business, or healthcare facility.

The pantries are stocked daily by the pantry managers. Pantry managers count how many products remain in the pantry, document usage based on the number of products taken, and refill pantries with necessary products. Utilization is recorded on a Google Sheet document (Alphabet, Mountain View, CA, USA). When the pantry manager is unavailable to stock the pantry, a substitute stocker is used. Pantries are stocked with at least 20 of each product absorbency or size, with tampons absorbencies ranging from light to ultra and pad sizes ranging from size 1 to 5. The SP pantry only stocks a combined total of 20 size 4 and 5 pads due to a lack of space, whereas the SAH pantry stocks 20 size 4 and 20 size 5 pads. SP and SAH each stock 100 tampons, 110 pads, and 2 menstrual cups at a time. Menstruators are permitted to take any or all of the products available. Generally, Tampax^® (Proctor & Gamble, Cincinnati, OH, USA), Playtex^® (Playtex, Dover, DE, USA), and Always^® (Proctor & Gamble, Cincinnati, OH, USA) brand tampons are used as they are nationally recognized brands. Two menstrual cups are stocked in the pantry at a time, size 1/small and size 2/regular in the Diva Cup^® (Diva, Kitchener, Ontario, Canada) or Saalt^® (Saalt, Boise, ID, USA) brands. These brands are used because they are nationally recognized and are donated to the FFB. A full pantry inventory is described in Table 1. Period underwear is available via request cards found in the pantries and occasionally stocked when FFB receives period underwear donations. Period underwear was donated or purchased at a discounted rate from Goat Union (Atlanta, GA, USA). Goat Union was chosen due to its size inclusivity, model diversity in marketing materials, lack of per- and polyfluoroalkyl substances (PFAs), and positive reviews online and from local testers. Every attempt was made to stock FFBs with products that are unscented, free of PFAs, and from brands that have inclusive sizing practices. FFB offers paper lunch bags for menstruators to carry their supplies. Menstruators can take products from pantries at any time anonymously, pantries are never locked making them freely accessible (Table 2).

Table 1.

Average pantry utilization and cost.

	Pads			Overnight (size 4 and 5)	Total	Tampons					Total	Menstrual cups		Total	Period underwear	Grand
	Light (size 1)	Regular (size 2)	Super (size 3)	Overnight (size 4 and 5)	Total	Light	Regular	Super	Super+	Ultra	Total	Size 1	Size 2	Total	Period underwear	Grand
Period Product Information
Stock	50	20	20	20^a	105	20	20	20	20	20	100	1	1	2		207
Item cost	$0.20	$0.20	$0.20	$0.20		$0.21	$0.21	$0.21	$0.22	$0.23		$30	$30		$20
Cost per cycle	20 pads/cycle				$4	20 tampons/cycle					$4	1 cup/10 years		$30	$80^b
South Park
Monthly use	163	127	141	173	604	75	96	80	56	72	380	8	7	15	14	1019
Total use	3447	2673	2980	3644	12,688	1579	2051	1698	1176	1510	8014	166	153	319	287	21,308
St. Anne’s Hill
Monthly use	82	61	70	189	403	45	91	61	46	43	286	8	9	17	11	717
Total use	987	785	887	2380	5039	534	1132	772	599	531	3568	101	104	205	126	8938
Combined
Monthly use	245	188	212	362	1007	120	188	142	102	115	666	16	16	32	24	1736
Total use	4434	3458	3867	6024	17,727	2113	3183	2470	1775	2041	11,582	267	257	524	413	30,246
Total cost	$887	$692	$773	$1204	$3545	$423	$637	$494	$355	$408	$2316	$8010	$7710	$15,720	$8260	$29,841
Number of cycles provided for	20 pads/cycle				887	20 tampons/cycle					579	1 cup/cycle		524	103	2093^c

South Park Pantry had 20 size 4 and 5 combined due to space constraints. St. Anne’s Hill Pantry 20 size 4 and 20 size 5.

Four pairs of period underwear are enough for one cycle and can be reused for many years.

Number of cycles provided for is if each reusable product is only used once.

Table 2.

Zero-inflated negative binomial regression models based on daily pantry use.

Significance: p values less than or greater to 0.001.

Requests for specific items can be submitted via request cards within pantries. Cloth pads, period underwear, and teen-sized menstrual cups are listed on request cards as they are frequently requested. Menstruators can opt to communicate with FFB managers via text, email, or written notes on request cards. Completed requests are placed in labeled bags and left on the manager’s porch near the pantry and out of street view, to prevent theft. Managers also offer to deliver requests if menstruators are not able to pick them up; however, this has happened less than five times since opening. Managers have delivered requests to menstruators residing in SP and driven once to a surrounding suburb. The request process remains anonymous unless users choose to reveal their identity.

Pantries are advertised on social media via the FFB social media accounts (@Freeflobox), on the FFB website (https://freeflobox.wixsite.com/freeflobox), at local festivals, occasionally in the local news, and by word of mouth. FFB social media account provides details of where the pantries are located, what products are provided, and how to place a request in addition to information for those who would like to donate. Further advertisement has not occurred because of fear that the FFB does not have the resources needed to support further demand. There have been numerous requests for FFB to open additional pantries. However, FFBs resources and high product demand have limited their ability to expand. FFB is willing to open an additional pantry if there is also a manager willing to take on the responsibility of raising funds and having the necessary time to construct, maintain, and stock the new pantry. Our pantries operate on a one-to-one manager-to-pantry model.

FFB is supported by monetary and product donations from the local community, businesses, menstrual nonprofits, and period product companies. Members of the community in which FFB pantries are located support the pantries via donations on cash apps, purchasing products via registries, and dropping off unopened period products at the residence of the pantry managers. Local businesses support the pantries via holding fund-raising events, donating items to be raffled off, and holding period product collection drives. Period product nonprofits donated period products when FFB was first getting started and were especially important before a regular stream of monetary donations was established. However, FFB found it difficult to receive regular and reliable amounts of products from larger-period product nonprofits. A nonprofit called Equal Period (Equal Period Inc., Glendale, CA, USA) continues to support the FFB by supplying all the menstrual cups for the FFB pantries. Goat Union has been a huge supporter, selling period underwear to FFB at a discounted rate, and has donated over 400 pairs of underwear.

For more information about pantry locations, physical construction of the pantries, and managing the pantries, please see Fighting for Menstrual Equity Through Period Product Pantries published in Women’s Health.⁴⁰

Statistical analysis

This study is a longitudinal observation study of period product pantry usage from March 2022 to December 2023. The reporting of this study conforms to the STROBE statement.⁴¹ Daily pantry utilization was recorded by pantry managers in Google Sheets and exported to Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) for cleaning. Live daily pantry utilization can be seen on the FFB website. Data were then exported to Stata 18 (Stata Corp LLC, College Station, TX, USA) for further analysis.

Data were analyzed at the day level: for a total of 1009 days, 640 days for the SP pantry, and 369 days for the SAH pantry. Zero-inflated negative binomial regression models were used to determine if daily utilization was affected by various factors: the number of days a pantry had been open, pantry location, average daily temperature,⁴² average weekly gas prices,⁴³ whether or not it rained,⁴² and week of the month. The week of the month was determined by breaking the month into 7-day increments, starting with the first day of the month, and numbering the weeks sequentially. Average daily temperature and average weekly gas prices (applied to each day of that week) were both standardized for analysis. Zero-inflated negative binomial regression was used to account for the 35% of total days for which 0 products were taken and overdispersion of the number of products across days on which products were taken; a histogram of total products taken per day is shown in Figure 2.

Figure 2.

Histogram of total products taken per day.

Results

FFB was unable to determine how many menstruators were using products since use is anonymous and it is not known how many times menstruators returned to the pantries for subsequent cycles (Figure 3 shows monthly utilization by pantry). For similar reasons, and since no personal health information was collected from menstruators; the demographics of those accessing the pantries cannot be analyzed. FFB pantries have provided 30,246 period products that would retail for $27,479. This averages to 1736 period products monthly or $1554 worth of products. This equates to 2093 cycles based on 20 tampons (579 cycles), 20 pads (887 cycles), 1 cup (524 cycles), or 4 pairs of period underwear (103 cycles) per menstrual cycle. Total daily pantry utilization increased significantly the longer the pantries were open (β = 0.0005, p < 0.001). On average, the SP pantry provided an average of 1019 total products per month; or 604 pads, 380 tampons, 15 menstrual cups, and 14 pairs of period underwear. The SAH pantry provided an average of 717 products per month; or 403 pads, 286 tampons, 17 menstrual cups, and 11 pairs of period underwear. Daily, the SP pantry provided significantly more total products daily than the SAH pantry (β = −0.148, p < 0.001); for every one product provided by the SP pantry, 0.86 products were provided by the SAH pantry.

Figure 3.

Monthly pantry utilization for 2022–2023.

Daily single-use product (tampons and pads) pantry utilization increased significantly the longer the pantries were open (β = 0.0004, p < 0.001). The SP pantry provided significantly more single-use products than the SAH pantry (β = −0.229, p < 0.001). For every single-use product provided by SP pantry, SAH pantry provided 0.795. Daily reusable product (menstrual cups and period underwear) pantry utilization did not increase significantly the longer pantries were open (β = −0.0003, p = 0.556). There was not a significant difference in reusable product utilization between the pantries (β = 0.205, p = 0.098). Significantly more reusable products were utilized at the beginning of the month compared to the end of the month (β = −0.048, p = 0.03); for every week that passed in a month 0.950 less reusable period products were taken per week. For example, in the last week of the month 3–4 fewer reusable products were taken than in the first week of the month.

Daily product utilization was not affected by average daily temperature but was affected by precipitation and average weekly gas price. Total and single-use products were significantly more likely to be utilized on days when there was precipitation (total: β = 0.232, p < 0.001; single-use β = 0.104, p < 0.001). As gas prices went up, daily single-use product utilization significantly decreased (β = −0.065, p < 0.001) and reusable product utilization significantly increased (β = 0.062, p < 0.001). For every $0.40 per gallon (1 standard deviation) increase in gas price, 0.93 less single-use products and 1.06 more reusable products were utilized daily.

Discussion

Pantry utilization

Total utilization of the pantries continued to increase the longer they were open. The SP pantry averaged significantly higher monthly utilization and provided more products in its first year than the SAH pantry. The SP pantry may have had higher utilization because it is located along walking paths between social services such as free meal services and shelters for those experiencing homelessness. The SP pantry provided significantly more single-use products than SAH pantry. There was not a significant difference in the number of reusable products utilized from each pantry. However, the operating costs for the SAH pantry were higher than SP pantry because SAH pantry provided more reusable products (but not significantly more) than the SP pantry. Single-use products, such as pads and tampons, cost about $0.25 per product, whereas menstrual cups cost about $30 each and period underwear costs about $20 per pair. More reusable products were taken at the beginning of the month compared to the end, but we are unsure why. We hope to explore this in future research that will include surveys from menstruators who use the pantry.

Reusable product utilization did not significantly increase over time. This could be because reusable products can last up to 10 years, decreasing or eliminating the need to return to the pantry saving time and money. On average FFB provides 32 menstrual cups per month and period underwear are often taken within days of being placed in the pantry. This suggests that when menstruators are given the option of utilizing reusable products, they are interested in using them. Unhoused menstruators who use FFB have reported period underwear are their favorite method for period management. Research on the preference of menstruators using food/diaper/period product banks has reported preference for reusable products is low.⁴⁴ However, this could be underreported because those using reusable products are no longer in need and therefore not captured. Research surveying menstruators about preferred methods may not accurately capture the acceptability of reusable products if menstruators are not familiar with the existence of reusable products or how they are used.⁴⁵ More research needs to be done exploring the acceptability and adoption of reusable products by menstruators experiencing period poverty.

Unfortunately, reusable products do not work for all people or in all situations. There is little research on the utilization of reusable products among the unhoused, who may have lower rates of reusable product utilization, possibly due to their high cost and scarcity among social service providers. Even though unhoused FFB pantry users report liking period underwear there are barriers to utilization including a lack of running water, laundry, or sterilization methods required for menstrual cups and period underwear.^45,46 Menstruators who are unhoused and oscillate between friends’ houses and housing shelters report not wanting to clean or let reusable products dry in shared spaces.⁴⁵ Menstruators who use FFB pantries have also reported period underwear being stolen with other possessions. To help alleviate barriers to washing period underwear, FFB has provided detergent to those who are unhoused.

Reusable products are a valuable tool in the fight against period poverty and are especially well suited to help those who face period poverty and are housed. It is important for social service providers to offer reusable period products to menstruators since reusable products can break the cycle of period product insecurity. Through conversations, other menstrual nonprofits have expressed reluctance toward providing reusable products out of fear that menstruators will not be able to adequately clean them. This assumes those facing period poverty are predominantly unhoused. Furthermore, when provided information about reusable products menstruators are able to decide whether they have access to the necessary facilities to adequately clean and reuse products and should be able to choose if reusable products are right for them. Period poverty is multi-faceted with a myriad of problems that may affect each menstruator differently, highlighting the importance of including menstruators in the decision-making process.

Some evidence suggests that a significant number of pantry users were traveling further than walking distance to utilize the valuable resources the pantries provide. For example, higher gas prices had a significant effect on product choice. When gas prices were higher, more reusable products were utilized and less single-use products were utilized, possibly so that product-insecure drivers did not have to use gas to return for subsequent menstrual cycles. On one occasion when pantry managers drove to deliver a request, it was a 26-min drive.

Whether or not the pantries were utilized on a given day was significantly impacted by precipitation with pantries more likely to be utilized on days when there was precipitation. Anecdotally, managers had expected pantries to be more frequently utilized on days when there was precipitation based on their previous stocking experience. Pantry utilization may not have been affected by temperature for the following reasons. One, menstruators who were driving to the pantries may not have been affected by the temperature because they were in their cars. Two, menstruators who were walking may have been less financially secure, for example, unable to afford a car, and therefore so reliant on the pantry for period products that they were willing to walk to it in extreme temperatures.

Pantry model of distribution

Traditional methods of distributing period products include social service providers and food/diaper/period product banks. There is a relative paucity of research on these distribution methods. However, research on the distribution of food via food banks is more robust and parallels some of the current models of period product distribution. Existing data on providing period products combined with data from food banks reveals rigidity in the receipt of products from some social service providers, such as lack of choice for product type,^38,47 predetermined allotments,⁴ fixed hours of operation,^37,47 requirements for identification,^37,48 documentation,^37,48 qualifications for services,^37,48 having to publicly ask for products from social service providers,^6,47,49 and/or having to make an appointment or waiting periods before benefits begin.^48,50

Distribution via predetermined kits perpetuates the exclusion of those who receive aid from the decision-making process and can result in waste from menstruators receiving products that do not work for them.^4,47,49 Fixed period product quantities that are too low can cause menstruators to reuse soiled single-use pads. Limited hours of operation, as few as 1 h a month³⁷ act as barriers to accessing period products. This rigidity can prevent those who are on the edge of insecurity and do not qualify for state and federal social assistance programs from immediately accessing desperately needed products, if at all.⁴⁹ Some menstruators using social services have reported not even being aware that period products were available for free and, even when aware, felt uncomfortable requesting them from staff due to sociocultural power imbalances between themselves and staff.⁴⁵ Information about what products are available and how to obtain them needs to be more readily available for those suffering from period poverty to provide security.

While there is no research on the use of period product pantries, free little food pantries that also use the pantry method for distribution, have found this model successful at increasing access to food and with decrease stigma compared to food banks.^51
–54 The pantry model: (1) includes those they serve in the decision-making processes, (2) more efficiently uses resources by reducing the mismatch between items provided and those receiving items, (3) offers regular and reliable access to items, and (4) reduces administrative and bureaucratic barriers.^8,10,52,53 FFB includes menstruators in the decision-making process by offering a full range of products to choose from, having request cards for specific items that are not stocked, and adding to regularly stocked items based on recurrent recommendations from request cards, for example, including both pads with and without wings, based on specific requests. Inclusion in decision-making reduces waste and most importantly respects menstruators’ autonomy and dignity, empowering them to choose what’s best for them. FFB pantries are stocked at least daily and sometimes more frequently, when a lot of items are taken at once, making the pantries a regular and reliable source for period products month after month. FFBs social media and website lists what and how many period products are available. FFB pantries have no requirements or documentation needed for use. The lack of requirements helps menstruators access period products immediately, especially for those who may not qualify for social services or are not able to wait as applications are processed. Products are also available for those who may be able to afford period products but are insecure due to an unexpected period. The lack of fixed hours allows for flexible access to accommodate menstruators’ availability. From a research standpoint, the FFB model of distribution allows researchers the ability to track local needs, usage, and preferences in unprecedented detail over previous models of distribution.⁴⁰ This information can be used to inform local policy and period poverty initiatives as well as predict usage trends for efficient use of resources.

The small grassroots nature of FFB allows managers to respond to their community’s needs and provide a regular and reliable source of products. The period product pantry model demonstrates that there is a demand for greater access to period products and that menstruators will utilize products from this type of intervention. FFB has been possible because of the strong community in which it exists and shows how grassroots movements can make a difference within their community. Support from larger nonprofits or federal grants would be needed to grow and test this program in different environments. FFB plans to conduct additional research that includes surveys and/or interviews of menstruators who use the pantry to gain greater insights regarding how the pantry has impacted them, factors that affect their access to period products, which products they prefer, if there were other items they would like to see included in the pantries, and how to improve the pantry model. Surveys will also help show us how menstruators heard about and accessed the pantry.

The high demand for period products from FFB as well as requests for additional pantries exemplifies the severity of period poverty. To truly address period poverty there needs to be systemic changes. These changes may include free period products in public buildings, the elimination of sales taxes on period products in all states, and the inclusion of period products in government assistance programs. More interventions are needed that provide regular and reliable access to period products that include menstruators in the decision-making process to enable them to choose which and how many products they need. Further, information should be more readily available about where to access period products and what products are available. Without adequate access, menstruators will continue to miss school and work, face stigmatization, and use items to manage their periods that could have adverse health effects.

Limitations

FFB is a small nonprofit that is currently unable to grow due to the inability to sustain further demand, without additional support both monetarily and administratively. FFB would like to stock period underwear consistently but is currently unable to do so financially. In addition to there being a lack of space, it would require stocking a full range of sizes (XXS-6XL). Without stocking period underwear at all times, we were unable to fully analyze or determine menstruators’ interest in period underwear. Anecdotally, period underwear is almost always taken within 2 days of being put in the pantry, suggesting there is a high demand. Advertising primarily by social media and word of mouth undoubtedly affected who utilized the pantries, acting as a barrier to those who do not have access to a smartphone or computer. Advertising at social service centers would be beneficial; however, FFB is unsure it can sustain the additional demand. We hope to have a greater and more nuanced understanding of those FFB serves by conducting surveys and possibly interviews in the future.

Conclusion

Period product pantries are an effective tool to provide reusable and disposable period products to menstruators. The pantry model of distribution addresses barriers that menstruators may face when obtaining period products from social service providers. The small nature of the FFB allows pantry managers to respond to their communities through adjusting what they stock and fulfilling requests. Menstruators facing period poverty are interested in using reusable period products and should be given the opportunity to do so. Unhoused menstruators may face greater barriers when using reusable products, but when provided with education on how to use and clean reusable products, unhoused menstruators are able to decide if reusable products are right for them.

FFB is not a solution to period poverty. Social reform addressing the injustices and inequities of period poverty is needed and can only be done by raising awareness and electing government officials who believe access to period products is an essential need and a right. The period product model works as a stopgap to address urgent local needs through community involvement and can be replicated in other locations. People can support menstruators facing period poverty by creating a period product pantry in their neighborhood, supporting local period product nonprofits, and supporting government officials and legislation surrounding increased access to period products. Research on period poverty interventions, including their efficacy and efficiency is needed. Most importantly menstruators facing period poverty need to be included in developing interventions and decision-making processes.

Supplemental Material

sj-docx-1-whe-10.1177_17455057241306666 – Supplemental material for Enhancing menstrual equity: An observational study assessing the impact of free little period product pantries

Supplemental material, sj-docx-1-whe-10.1177_17455057241306666 for Enhancing menstrual equity: An observational study assessing the impact of free little period product pantries by Jennifer E Glayzer, Edward J Glayzer, Claire T Jennings, Judith M Schlaeger, Adriene Lee and Bethany C Bray in Women’s Health

Footnotes

Acknowledgements

None.

Declarations

ORCID iDs

Jennifer E Glayzer

Edward J Glayzer

Supplemental material

Supplemental material for this article is available online.

References

Michel

Mettler

Schönenberger

, et al. Period poverty: why it should be everybody’s business. J Glob Health Rep 2022; 6: e2022009.

Gouvernet

Sebbe

Chapillon

, et al. Period poverty and mental health in times of COVID-19 in France. Health Care Women Int 2023; 44(5): 657–669.

Wenzel

Andersen

Gifford

, et al. Homeless women’s gynecological symptoms and use of medical care. J Health Care Poor Underserved 2001; 12(3): 323–341.

Parrillo

Edward Feller

Menstrual hygiene plight of homeless women, a public health disgrace. Rhode Island Med J 2017; 100(12): 14–15.

Cardoso

Scolese

Hamidaddin

, et al. Period poverty and mental health implications among college-aged women in the United States. BMC Womens Health 2021; 21(1): 14.

Sommer

Gruer

Smith

, et al. Menstruation and homelessness: challenges faced living in shelters and on the street in New York City. Health Place 2020; 66: 102431.

Thinx

Period.

State of the Period: The widespread impact of period poverty on US students, https://cdn.shopify.com/s/files/1/0795/1599/files/State-of-the-Period-white-paper_Thinx_PERIOD.pdf?455788 (2021, accessed 12 April 2024).

Johnston-Robledo

Chrisler

JC.

The menstrual mark: menstruation as social stigma. Sex Roles 2013; 68(1): 9–18.

Bobel

. The managed body: developing girls and menstrual health in the global South. Cham Switzerland: Springer International Publishing, 2018.

10.

Koskenniemi

Say no to shame, waste, inequality—and leaks! Menstrual activism in the market for alternative period products. Fem Media Stud 2023; 23(1): 19–36.

11.

Fahs

There will be blood: women’s positive and negative experiences with menstruation. Womens Reprod Health 2020; 7(1): 1–16.

12.

Water, Sanitation, and Hygiene United. Menstrual Hygiene Day, https://menstrualhygieneday.org/about/about-mhday/ (2023, accessed 30 July 2024).

13.

U by Kotex. U by Kotex Period Poverty Awareness Week—Survey Results, https://allianceforperiodsupplies.org/wp-content/uploads/2022/05/U_by_Kotex_Period_Poverty_-_PPAW_Data_Set.pdf (2021, accessed 31 July 2024).

14.

Thinx. Give Rise, https://www.shethinx.com/pages/thinx-giverise (2020, accessed 12 April 2024).

15.

Intimina. Period Proverty, https://w98nxv5v9ct.typeform.com/report/SjF9Ss82/dNyK8902bdW8r7Y7? (2020, accessed 12 April 2024).

16.

The World Bank. Menstrual hygience management enables women and girls to reach their full potential. Who we are, https://www.worldbank.org/en/news/feature/2018/05/25/menstrual-hygiene-management (2018, accessed 10 December 2024).

17.

Alliance For Period Supplies. Tampon Tax, https://allianceforperiodsupplies.org/tampon-tax/#:~:text=Currently%2C%2021%20states%20charge%20sales,have%20a%20statewide%20sales%20tax (2023, accessed 30 July 2024).

18.

Zehtabchi

Monga

Berton

, et al. Period. End of Sentence. In: Zehtabchi

(ed). Directed by: The Pad Project, 2018.

19.

Hodge

#Menstruation: Instagram users challenging social stigma. Ottawa, ON, Canada: Université d’Ottawa/University of Ottawa, 2019.

20.

Urban

Holtzman

Menstrual stigma and Twitter. Sociol Focus 2023; 56(4): 483–496.

21.

Gaybor

Everyday (online) body politics of menstruation. Fem Media Stud 2022; 22(4): 898–913.

22.

Cotropia

CA.

Menstruation management in United States schools and implications for attendance, academic performance, and health. Womens Reprod Health 2019; 6(4): 289–305.

23.

Houston

Abraham

Huang

, et al. Knowledge, attitudes, and consequences of menstrual health in urban adolescent females. J Pediatr Adolesc Gynecol 2006; 19(4): 271–275.

24.

Kuhlmann

Key

Billingsley

, et al. Students’ menstrual hygiene needs and school attendance in an urban St. Louis, Missouri, district. J Adolesc Health 2020; 67(3): 444–446.

25.

Maroko

Hopper

Gruer

, et al. Public restrooms, periods, and people experiencing homelessness: An assessment of public toilets in high needs areas of Manhattan, New York. PLoS One 2021; 16(6): e0252946.

26.

Munro

Hunter

Hossain

, et al. A systematic review of the menstrual experiences of university students and the impacts on their education: a global perspective. PLoS One 2021; 16(9): e0257333.

27.

Schmitt

Booth

Sommer

A policy for addressing menstrual equity in schools: a case study from New York City, USA. Front Reprod Health 2022; 3: 725805.

28.

Secor-Turner

Huseth-Zosel

Ostlund

Menstruation experiences of middle and high school students in the Midwest: a pilot study. J Sch Nurs 2022; 38(6): 504–510.

29.

Otsuki

GJ.

Shit’s getting real: a cultural analysis of toilet paper. Anthropol Now 2021; 12(3): 15–23.

30.

Crawford

Waldman

EG.

Period poverty in a pandemic: harnessing law to achieve menstrual equity. Wash UL Rev 2020; 98: 1569.

31.

New York State. GreenNY specification: menstrual products, https://ogs.ny.gov/menstrual-products-approved-specification#:~:text=In%20July%20of%202018%2C%20Public,including%20SUNY%20and%20CUNY%20schools (2022, accessed 12 April 2024).

32.

Williams

California public schools will provide free menstrual products under new law. CNN. 2021.

33.

State of Ohio. Ohio Revised Code: Section 3313.6413. Free feminine hygiene products in schools, https://codes.ohio.gov/assets/laws/revised-code/authenticated/33/3313/3313.6413/10-3-2023/3313.6413-10-3-2023.pdf (2023, accessed 10 December 2024).

34.

Francis

Meraj

Konduru

, et al. An update on state legislation supporting menstrual hygiene products in US Schools: a legislative review, policy report, and recommendations for school nurse leadership. J Sch Nurs 2023; 39(6): 536–541.

35.

Ohio House of Representatives. Representative Kelly’s provision to repeal the Pink Tax takes effect, https://ohiohouse.gov/news/democrat/rep-kellys-provision-to-repeal-the-pink-tax-takes-effect-102332#:~:text=COLUMBUS%2D%20State%20Rep.,on%20April%201st%2C%202020 (2020, accessed 10 December 2024).

36.

Miller

Farley

Reji

, et al. Understanding period poverty and stigma: highlighting the need for improved public health initiatives and provider awareness. J Am Pharm Assoc (2023) 2024; 64(1): 218–221.

37.

San Diego Food Bank, Bank NCF. Diaper Bank Program-Diaper Distribution Sites. San Diego Food Bank, 2024.

38.

Periodkitsohio. Our Mission, Available from:https://periodkitsohio.org/ (2024, accessed 8 August 2024).

39.

United States Census Bureau. Dayton city, Montogomery County, Ohio: United State Government, https://data.census.gov/profile/Dayton_city,_Montgomery_County,_Ohio?g=060XX00US3911321000#income-and-poverty (2022, accessed 8 August 2024).

40.

Glayzer

Jennings

Schlaeger

, et al. Fighting for menstrual equity through period product pantries. Womens Health (Lond) 2024; 20: 17455057241281459.

41.

Cuschieri

The STROBE guidelines. Saudi J Anaesth 2019; 13(Suppl 1): S31–S34.

42.

National Weather Service. NOWData, https://www.weather.gov/wrh/Climate?wfo=iln (2024, accessed 30 July 2024).

43.

US Energy Information Administration. Ohio Regular Convential Retail Gasoline Price, https://www.eia.gov/dnav/pet/hist/LeafHandler.ashx?n=pet&s=emm_epmru_pte_soh_dpg&f=w (2024, accessed 30 July 2024).

44.

Massengale

Bowman

Comer

, et al. Breaking the period product insecurity cycle: an observational study of outcomes experienced by recipients of free period products in the United States. Womens Health (Lond) 2024; 20: 17455057241267104.

45.

Vora

. The realities of period poverty: how homelessness shapes women’s lived experiences of menstruation. In: The Palgrave handbook of critical menstruation studies. Singapore: Palgrave Macmillan, 2020, pp. 31–47.

46.

Orsini

Tarabay

Hardy-Johnson

, et al. The homeless period: a qualitative evidence synthesis. Women Health 2024; 64(3): 250–260.

47.

Kuhlmann

Bergquist

Danjoint

, et al. Unmet menstrual hygiene needs among low-income women. Obstet Gynecol 2019; 133(2): 238–244.

48.

United States Department of Agriculture. The special supplemental nutrition program for women, fns.usda.gov/wic/factsheet (2022, accessed 10 December 2024).

49.

Gruer

Hopper

Smith

, et al. Seeking menstrual products: a qualitative exploration of the unmet menstrual needs of individuals experiencing homelessness in New York City. Reprod Health 2021; 18(1): 1–11.

50.

United States Department of Agriculture. SNAP Application Processing Timelines, https://www.fns.usda.gov/snap/qc/timeliness (2024, accessed 30 July 2024).

51.

Rivera

Smith

Ruiz

A systematic literature review of food banks’ supply chain operations with a focus on optimization models. J Humanit Logist Supply Chain Manag 2023; 13(1): 10–25.

52.

Tsang

Holt

Azevedo

An assessment of the barriers to accessing food among food-insecure people in Cobourg, Ontario. Chronic Dis Inj Canada. 2011; 31(3): 121–128.

53.

Shieh

Leddy

Whittle

, et al. Perceived neighborhood-level drivers of food insecurity among aging women in the United States: a qualitative study. J Acad Nutr Diet 2021; 121(5): 844–853.

54.

Peterson

Freidus

Tereshenko

Why college students don’t access resources for food insecurity: stigma and perceptions of need. Ann Anthropol Pract 2022; 46(2): 140–154.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.03 MB