United Nations, New York — Every month, nearly 2 billion people menstruate, but gender inequality, poverty and other forms of marginalization mean the world has still not adapted to become period-friendly. In a humanitarian crisis, these inequities are greatly exacerbated.
When forced to flee their homes because of violence, conflict or climate disasters, people leave most of their possessions behind - including, usually, sanitary items. While on the run, most cannot earn an income, and even for those with money, menstrual hygiene products seldom top the list of critical needs. If they do have pads, tampons or cups, many lack the clean, safe washing facilities they need to attend to their personal hygiene.
It is the responsibility of leaders, policymakers and humanitarian actors to meet these needs. Yet even today, when an emergency erupts, sexual and reproductive health and rights are among the most neglected of basic needs. Below, we explore five key reasons why menstrual hygiene support is essential for women's and girls' well-being, even - or especially - during a crisis.
1. Because no setting is less period-friendly than a humanitarian crisis
"I only have one pair of underwear, and I have to wash them with dirty water and then use them again," Aisha*, from Gaza, told UNFPA, the United Nations sexual and reproductive health agency earlier this year. Amid the chaos and destruction of the conflict in Gaza, women and girls have struggled to manage their periods - a stark reminder of the urgent need for accessible, adequate menstrual hygiene supplies. Bakiza Nasrallah, 47, from Rafah, said, "I ended up tearing pieces of fabric to manage, and my daughter told me, 'Mama, we can't do this!' But what can I do?"
The lack of clean water in an emergency setting makes bathing of any kind nearly impossible and raises the risk of multiple health risks, such as urinary tract infections and bacterial vaginosis. UNFPA has so far distributed over 500,000 disposable sanitary pads and 300 dignity and menstrual hygiene management kits to women and girls in Gaza. The kits contain essentials for women and girls to protect themselves and maintain their hygiene in the face of natural disasters and crises; each has washable and disposable sanitary pads, underwear, toiletries such as soap and a reusable cloth, a whistle, and a solar-powered flashlight.
Research has shown that UNFPA's kits fill critical sanitation and hygiene gaps in catastrophic settings, and can improve women's and girls' mobility and ability to access other essential services.
2. Because lack of menstrual hygiene support can heighten other risks - like violence
At age 14, Gebeyanesh Getinet experienced her first period. In her village of Aipapo in Ethiopia's Benishangul-Gumuz region, her mother made her traditional gumuz sanitary pads from tree bark and cloth and taught her about personal hygiene. The family hosted a party celebrating her first menstruation - many men expressed an interest in marrying Ms. Getinet, believing she had come of age, but her mother sent them away. In a number of countries, the onset of menstruation is believed to indicate a girl is ready for sexual activity, raising the risk of abuses like child marriage and sexual violence.
When conflict erupted in their village, Ms. Getinet and her family were forced to flee into the forest. Behind them, their home and everything in it was burned to the ground. Without access to sanitary materials, either traditional or modern, the women of the community relied on the river to wash up, cutting off strips of clothing to layer inside their underwear. Then they would arrange leaves at the base of a tree and sit there until their periods passed. Not only was this unsanitary and uncomfortable, it exposed them to the threat of gender-based violence and extreme weather conditions.
UNFPA's dignity kits are designed to address these other risks, too. "The pads are easy to maintain and we were provided with soap to wash them with," Ms. Getinet said. The kit bag can be used to carry other belongings, and the torch helps increase safety in unlit spaces. Many women in rural areas had been making torches from grass so they could go into the forest at night to change their pads, Ms. Getinet explained; now with the flashlight, it was easier to make their way in the dark and look out for potential attackers.
3. Because not being able to manage menstruation can undermine health and well-being in other areas of life
"I dropped out of school the first time I saw my period," recalled Samrawit, who was 12 at the time and displaced by conflict in Ethiopia. "As I didn't have sanitary pads, I didn't feel confident going out. I didn't want to feel embarrassed."
Lack of menstrual health supplies can restrict mobility, with long-lasting impacts when it comes to school, work and community. It can also hamper access to critical support during a crisis, as menstruating people may avoid going out in public even for urgent care or aid distributions.
In this way, dignity kits not only meet the demand for menstrual hygiene products, they also build confidence and independence, particularly among adolescents. Dignity kits also include referral information to critical services, and the distribution itself offers an opportunity for humanitarian workers to provide sexual and reproductive health assistance. Ceylan Güzey, a nurse and health trainer with the UNFPA-supported Youth Approaches to Health Association in Türkiye, explained that while distributing kits to people displaced by the country's earthquake disaster, she often discovers other underlying issues, such as untreated sexually transmitted infections, unintended pregnancies, or violence or coercion.
4. Because millions suffer stigma due to myths and taboos
"I was afraid to tell my mother, thinking it was a crime to menstruate," said Suzan, 14, who lives in the Gbogoro cattle camp in Terekeka, South Sudan. Suzan got her first period at age 11, and like her elder sister before her, was compelled to leave home until her cycle passed. "I was afraid to die because of the flow, but isolation was a normal practice," she said.
Customs like isolation can expose women and girls to risks ranging from extreme weather conditions to animal attacks and sexual violence. Yet menstruation myths and misconceptions are widespread. Many believe periods are dirty and dangerous, that menstruating women cause food to turn bad and plants to wither. When these stigmas are coupled with crisis conditions, the challenges are only amplified. Research shows that, while women in humanitarian settings place a high priority on menstrual health and supplies, they face cultural barriers to raising this issue with male aid providers, and are often deeply frustrated when access to supplies is limited. UNFPA works with whole communities to make menstruation a safer, healthier experience for women and girls, including by dispelling myths. In Suzan's cattle camp, for example, community members were encouraged to discuss the use of sanitary pads, which some believed could cause infertility. Women and girls were taught how to make reusable pads using local materials. Suzan's sister, Akuol, said, "I learned how to make pads out of clothes, which will help me during my menstruation. I will not be isolated again."
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5. Because bodily autonomy unlocks benefits for everyone, not just women and girls.
Across the world, UNFPA supports information and awareness sessions to break the silence on menstruation - other and sexual and reproductive health issues - to make this natural process safe and healthy for everyone, everywhere. But bodily autonomy, nondiscrimination and gender equality are beneficial to everyone, not just women and girls.
There are the economic gains: Effective treatment of premenstrual syndrome could potentially contribute $115 billion to the global economy, for example, while failing to meet the menstruation needs of girls can lead to school discontinuation, limited employment opportunities, and a cycle of intergenerational poverty.
But supporting bodily autonomy and inclusive values brings other benefits, as well. When Mamouni's community in Gaibandha District, Bangladesh, flooded, she was forced to evacuate. "I had to sleep on a train line as I had nowhere to go and no support," Mamouni told UNFPA. As a transgender woman - or hijra - she faced not only displacement but also discrimination and exclusion from relief. Support for Mamouni came in the form of inclusive dignity kits, so she could manage her hygiene needs, as well as financial support and assistance finding a safe place to shelter. "LGBTQIA+ people deserve full enjoyment of their equal rights just like all others," UNFPA Executive Director Dr. Natalia Kanem said. "During conflicts and crises, their rights may be overlooked and their unique needs for protection and health care can go unmet."
This is part of a series of stories illustrating progress made since the 1994 International Conference on Population and Development, which committed to ensure gender equality and the right to sexual and reproductive health for all. Find out more.
