Societal attitudes and policies relating to menstrual health have come a long way, but it’s not enough to ease the burden of ‘period poverty’. What still needs to be done?
By Suzanne Harrison
Each month, 14-year-old Charlotte endures heavy periods that can cause enough pain for her to miss school.
With her mother, Charlotte sought medical help and was lucky that her doctor made her feel supported and that her concerns were not being dismissed.
“I’m better at dealing with the pain now because I’ve had my period since I was nine and I’ve had to accept it. But the doctor says my normal is everyone else’s worst,” Charlotte told Medical Forum.
The good news is, she can’t fault the availability of free period products at her school.
“All I have to do is visit the nurse and they’re really good about handing them out.”
Charlotte’s cycle started off as light but over the years her periods became heavier and more physically depleting.
“There are times when I have had to miss school because it’s too heavy, tiring or painful.
“I’m not the only one. Other girls have to travel further to get to school and it’s stressful for them on the bus, so sometimes they just stay at home to avoid leaking.”
Charlotte’s experience with seeking medical help is a sign times are changing, because until noise was made by those seeking to alleviate the reality of period poverty and menstrual issues, many felt their concerns were dismissed.
While stigma and misconceptions still abound, now free period products in schools are the norm and conversations are being had in the media.
Share the Dignity founder Rochelle Courtenay said a doctor once told her daughter – who was in immense pain – “You know periods can be painful”.
It was soon discovered her daughter had a twisted ovarian cyst, which needed immediate operation.
“That kind of comment was ill-informed and wrong,” says Ms Courtenay.
Share the Dignity defines period poverty as a lack of access to menstrual products, hygiene facilities, waste management, and education.
When people hit hard times, they sometimes have to choose between purchasing period products, buying food for their families or paying their rent, according to the charity.
People without fulltime employment and those who come from lower socioeconomic backgrounds are disproportionately impacted by this problem.
Period poverty in WA
The charity released a groundbreaking report in 2024, The Bloody Big Survey. The results show period poverty well and truly exists in Australia.
Students at schools, TAFEs and universities are struggling with the cost-of-living and being able to afford period products.
In WA, Brookton council – 100km from the Perth metropolitan area – recorded high instances of period poverty, with 100% of respondents saying they had difficulty buying period products.
All respondents also said they had missed school due to periods.
More than 65% of WA respondents found it difficult to buy products, almost 8% were unable to afford them, and 20% had to improvise using materials like toilet paper due to the cost. The median spend was $50 per month on period products.
Some 55% of respondents have missed work due to their period, and one in three of these respondents said the reason was fear of leaking.
It’s costing the country economically too. Share the Dignity estimates $9.6 billion is attributed to missed working days per year due to periods.
“These figures are quite astonishing, and I hope will help shine a light on this issue in workplaces across the nation,” said Ms Courtenay.
Ending the stigma
Perth-based Dr Dani Barrington, senior lecturer in global health at UWA, said the concept of period poverty also encompasses issues surrounding societal expectations, cultural pressures and stigma.
It also relates to whether they can openly discuss, or feel comfortable, explaining their pain or be accepted within their community while menstruating.
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Dr Barrington, a founding member of Share the Dignity and a public health engineer, has worked to improve people’s experiences with toilets, menstrual health and hygiene.
“Period poverty is not just about products and financials, but also about stigma and mental health,” she said.
“In Australia we do have people who can’t afford period products. But we also have quite poor education around menstruation; there’s very little around the school curriculum and there’s not enough in the medical curriculum for GPs.”
Reducing the stigma and unnecessary embarrassment surrounding menstruation has long lagged behind other societal growth areas, she said.
And while there have been improvements when it comes to access, Dr Barrington is now working on finding a better understanding of where this stigma comes from and how different cultural groups approach periods. That also involves doing work with men and boys.
RACGP Vice President and WA chair Dr Ramya Raman adds that people’s experiences with periods and menstrual issues are often shaped by their cultural backgrounds. In some cultures it is not discussed, especially not outside the home.
Therefore, the role of the GPs can be crucial in breaking down that barrier.
“That is one component that has not been touched on much in the articles I have seen,” said Dr Raman.
“In some cultures, a period is not to be talked about publicly. It’s taboo. So, they may not see it – menstrual pain or heavy bleeding – as an issue. And this is when the GP plays a role.”
Building up that trust ensures women from diverse backgrounds have confidence in their doctor and also supports GPs to forge strong relationships over a patient’s lifetime.
“This is something patients should be empowered to talk about with their GP. It needs to be embraced and respected.”
Thankfully, Dr Raman added, there is a lot more information now available for girls and women, whether that’s through advertising, social media or even product placement in supermarkets. She hopes the more it is talked about the quicker the taboo will be broken.
Free period products
In 2023, all Australian States and Territories implemented policies to provide free period products in public schools.
In WA, the State Government launched a program to provide free period products in 225 public high schools. It was later extended in 2024 to include more than 570 public primary schools.
This is a positive step, but is only part of the story. As Ms Courtenay explained: “I think we are about a quarter of the way there.”
For example, she said, what happens when girls can’t access period products during school holidays?
“We want vending machines in libraries. There should be period products everywhere,” Ms Courtenay said.
To that end, Share the Dignity hopes to work with local councils to encourage them to be part of the conversation.
The Victorian Government has recently announced plans to expand the initiative to also provide period products via vending machines in selected public spaces.
Similarly, the ACT said it would make products available in some public health services, courts and child centres.
In June 2024, the Federal Government also announced it would provide free products to women and girls living in remote First Nations communities.
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This initiative aims to help around 12,500 women and girls each year to access period products – including pads, tampons, menstrual cups and period underwear.
Period products can be almost double the price in some remote communities, with people paying $15–$25 on average for a packet of pads, compared to an average of $10–$15 in metropolitan areas.
This inequity means women and girls in remote First Nations communities are often forced to miss out on school, work, community events and social activities when they have their period.
Access to period products in healthcare settings
Access to free or easily accessible period products in many Australian hospitals can be a challenge, both for patients and staff.
Unlike the move to provide vending machines and free products in State schools around the country, few hospitals have followed suit.
As part its Pad up Public Health campaign, Share the Dignity has called on the Federal Government to ensure free period products for all patients being cared for in public hospitals.
While some hospitals provide free products it is not mandatory for them to do so.
“In public hospitals across Australia, patients can get band-aids, bandages, painkillers, or incontinence aids, but not sanitary items when they need them,” the charity stated in an online petition.
“Some have been forced to bleed through their hospital gowns. Others have had to use unsuitable alternatives like dressings or adult nappies.
“When provision is managed at an individual hospital level, availability can be limited, and patients have relied on the kindness of doctors, nurses and staff who give pads of their own.”
The Federal Government has said responsibility for the provision of free period products in public health settings rests on State and Territory governments.
In Perth, a Dignity Vending Machine at Joondalup Health Campus has helped more than 6500 people each month since its installation. Some 12,000 period packs have been provided.
Goldfields Women’s Health Care Centre also has a vending machine. Currently, no other WA hospitals are listed as offering this service.
The question begs, in hospitals without this service, how do medical staff deal with their own periods, especially when so time constrained?
Jodie, a Perth-based registered nurse, says nurses – the majority of whom are female – are already used to holding on to full bladders for as long as possible. So, in her experience when it comes to their periods, they rely on each other if they are caught short.
“Generally, you can find what you need or ask a colleague, but I think hospitals could actually provide a small array of products,” she told Medical Forum.
“Hospitals should provide them to staff in the changing rooms. Even pads would be enough, or a vending machine. Then we don’t have to go fossicking for products.”
How can doctors do better?
In May last year the Medical Journal of Australia cited a report from Dr Lauren Cameron and colleagues at Deakin University, that 90% of adolescents who menstruate experience period pain and that for 21% this pain is severe (dysmenorrhoea).
They found that adolescents with dysmenorrhoea were “up to five times as likely to miss school and three times as likely to miss sporting or exercise for reasons related to their periods as female participants without dysmenorrhoea”.
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The study makes clear that period and pelvic pain must be recognised, and evidence‐based interventions provided to adolescents with persistent dysmenorrhoea.
“Understanding the trajectories of menstrual health throughout life is critical for developing effective public health interventions for optimising women’s health,” the study found.
Ms Courtenay would like to see more training for health practitioners and the availability of products in healthcare settings.
“There’s no provision for period products in general practice or hospitals. We’ve got stories on our website of people being in hospital, getting their period and having to use such things as incontinence pads,” she explained.
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