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<article article-type="editorial" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xml:lang="EN">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Reprod. Health</journal-id>
<journal-title>Frontiers in Reproductive Health</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Reprod. Health</abbrev-journal-title>
<issn pub-type="epub">2673-3153</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/frph.2023.1140981</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Reproductive Health</subject>
<subj-group>
<subject>Editorial</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Editorial: Period poverty</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes"><name><surname>Sacca</surname><given-names>Lea</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="cor1">&#x002A;</xref><uri xlink:href="https://loop.frontiersin.org/people/722824/overview"/></contrib>
<contrib contrib-type="author"><name><surname>Markham</surname><given-names>Christine Margaret</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref><uri xlink:href="https://loop.frontiersin.org/people/386215/overview" /></contrib>
<contrib contrib-type="author"><name><surname>Gupta</surname><given-names>Jhumka</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref><uri xlink:href="https://loop.frontiersin.org/people/1776677/overview" /></contrib>
<contrib contrib-type="author"><name><surname>Peskin</surname><given-names>Melissa</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref><uri xlink:href="https://loop.frontiersin.org/people/410556/overview" /></contrib>
</contrib-group>
<aff id="aff1"><label><sup>1</sup></label><addr-line>Charles E. Schmidt College of Medicine</addr-line>, <institution>Florida Atlantic University</institution>, <addr-line>Boca Raton, FL</addr-line>, <country>United States</country></aff>
<aff id="aff2"><label><sup>2</sup></label><addr-line>Center for Health Promotion and Prevention Research, School of Public Health</addr-line>, <institution>University of Texas Health Science Center Houston</institution>, <addr-line>Houston, TX</addr-line>, <country>United States</country></aff>
<aff id="aff3"><label><sup>3</sup></label><addr-line>Department of Global and Community Health, College of Health and Human Services</addr-line>, <institution>George Mason University</institution>, <addr-line>Fairfax, VA</addr-line>, <country>United States</country></aff>
<author-notes>
<fn fn-type="edited-by"><p><bold>Edited and Reviewed by:</bold> Pamela Stratton, National Institutes of Health (NIH), United States</p></fn>
<corresp id="cor1"><label>&#x002A;</label><bold>Correspondence:</bold> Lea Sacca <email>lsacca@health.fau.edu</email></corresp>
<fn fn-type="other" id="fn001"><p><bold>Specialty Section:</bold> This article was submitted to Gynecology, a section of the journal Frontiers in Reproductive Health</p></fn>
</author-notes>
<pub-date pub-type="epub"><day>07</day><month>02</month><year>2023</year></pub-date>
<pub-date pub-type="collection"><year>2023</year></pub-date>
<volume>5</volume><elocation-id>1140981</elocation-id>
<history>
<date date-type="received"><day>09</day><month>01</month><year>2023</year></date>
<date date-type="accepted"><day>19</day><month>01</month><year>2023</year></date>
</history>
<permissions>
<copyright-statement>&#x00A9; 2023 Sacca, Markham, Gupta and Peskin.</copyright-statement>
<copyright-year>2023</copyright-year><copyright-holder>Sacca, Markham, Gupta and Peskin</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<kwd-group>
<kwd>period poverty</kwd>
<kwd>menstrual equity</kwd>
<kwd>women&#x0027;s rights</kwd>
<kwd>sanitary facilities</kwd>
<kwd>menstrual hygiene</kwd>
<kwd>menstrual health</kwd>
<kwd>human rights</kwd>
</kwd-group>
<counts>
<fig-count count="0"/>
<table-count count="0"/><equation-count count="0"/><ref-count count="12"/><page-count count="0"/><word-count count="0"/></counts>
</article-meta>
</front>
<body>
<sec><title/>
<p><bold>Editorial on the Research Topic</bold> <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/research-topics/35620/period-poverty">Period poverty</ext-link></p>
<p>Each month, half of the world&#x0027;s female population, estimated at 1.9 billion individuals, experience menstruation (<xref ref-type="bibr" rid="B1">1</xref>). Yet, as normal as it seems, menstruation is still stigmatized around the world, particularly in low-income countries with inadequate access to menstrual health and hygiene management resources (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>). Menstrual health is a critical global public health issue that has been impacting the physical, mental, and socioeconomic health of both women and girls (<xref ref-type="bibr" rid="B2">2</xref>). However, there still exists social, cultural, economic, and political barriers to accessing menstrual products, menstruation educational material, and sanitation facilities when needed (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>).</p>
<p>The American Medical Women&#x0027;s Association defines period poverty as the lack of accessibility or affordability of menstrual hygiene tools and educational material, such as sanitary products, washing facilities, and waste management (<xref ref-type="bibr" rid="B5">5</xref>). The term also refers to the increased economic vulnerability menstruating people face due to the financial burden posed by menstrual supplies, which are not only limited to menstrual pads and tampons, but also include costs accrued from pain medication and underwear used during the menstruation cycle (<xref ref-type="bibr" rid="B6">6</xref>&#x2013;<xref ref-type="bibr" rid="B8">8</xref>). Such resource-limited settings drive women and girls to improvise with unsanitary alternatives such as old blankets, chicken feathers, old rags, newspapers, and cow dung (<xref ref-type="bibr" rid="B4">4</xref>). Difficulty affording menstrual products can cause women and girls to stay home from school and work, with lasting consequences on their education and economic opportunities. It can also exacerbate existing vulnerabilities, pushing individuals closer toward dangerous coping mechanisms (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>).</p>
<p>Period poverty does not only affect menstruating people in lower income countries; it also affects them in higher income countries (<xref ref-type="bibr" rid="B11">11</xref>). It is estimated that 16.9 million menstruating women in the United States live in poverty, two-thirds of which are low-income and food-insecure women who cannot afford basic menstrual products such as pads, tampons, and menstrual products. One national survey among college students found that 14.2&#x0025; of respondents reported experiencing period poverty in the year preceding the survey, while an additional 10&#x0025; experienced it every month (<xref ref-type="bibr" rid="B12">12</xref>). The same study documented period poverty being associated with higher likelihood of symptoms consistent with moderate/severe depression (<xref ref-type="bibr" rid="B12">12</xref>), with those reporting monthly period poverty at greatest risk for reporting such symptoms. Period poverty has also been associated with mental health issues and urinary tract infections (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>).</p>
<p>The gap in the literature and the lack of data on period poverty is a continuous challenge to measure its deteriorating impact on women&#x0027;s health. The following special issue aimed to address this gap by including a diverse set of qualitative, cross-sectional, and review studies exploring the menstrual experiences of girls and women from different regions across the world. For instance, the menstrual health challenges reported by adolescent girls in Myanmar ranged from access to information and social support, to behavioral restrictions, stigma surrounding menstruation, and difficulties managing menstrual bleeding and pain (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/frph.2022.893266">Swe et al.</ext-link>). These findings were similar to those highlighted in the systematic review by <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpubh.2022.1018092">Patel et al.</ext-link> on period poverty in lower and middle income countries, which included three emerging themes:
<list list-type="simple">
<list-item><label>1.</label><p>Availability and affordability of menstrual products, and accessibility to water, sanitation and health (WASH) services,</p></list-item>
<list-item><label>2.</label><p>Availability of support system and coping with &#x201C;period poverty,&#x201D; and</p></list-item>
<list-item><label>3.</label><p>Gender dimensions of menstrual hygiene management.</p></list-item>
</list>Age appropriate education, using innovative approaches such as interpersonal practical guidance (IPG) as face-to-face communication and mediated practical guidance (MPG) as social and behavior change communication (SBCC), was successful in improving menstrual health and hygiene management (MHHM) knowledge, attitudes, and practices in India, while addressing the existing menstrual health challenges in similar settings (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/frph.2022.1025376">Block et al.</ext-link>). Another country that suffered drastically from the consequences of period poverty amidst an economic recession and political turmoil was Lebanon (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/frph.2022.920461">Elhage Hassan et al.</ext-link>, <xref ref-type="bibr" rid="B11">11</xref>). A qualitative study exploring stakeholders&#x2019; perspectives on the Lebanese public health policy regarding menstrual health emphasized the need to decrease the monetary burden by subsidizing menstrual products or by implementing a coupon system. The study also reported the need for proper education on multiple levels, cooperation between key players in the private and public sectors, and encouragement of local production to ensure future sustainability (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/frph.2022.920461">Elhage Hassan et al.</ext-link>).</p>
<p>When it comes to the United States, low-income menstruating adults were seen to be disproportionately affected by period poverty during the COVID-19 pandemic because the pandemic acted as a barrier to period supplies and an underlying factor for missing work due to the lack of such products (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/frph.2022.1003040">Hunter et al.</ext-link>). Similarly, adults working with U.S-based communities of color revealed tension between school responsibility and family authority in providing menstruation and puberty education in schools, school- and teacher-related delivery challenges, and inadequate and disengaging menstruation and puberty content (<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/frph.2022.1018217">Schmitt et al.</ext-link>).</p>
<p>Social, physical, and mental issues imposed by period poverty and encountered by females globally are inhumane and require immediate attention of policymakers and healthcare professionals to attain positive and sustainable menstruation outcomes. Findings from this issue will provide the readers with an overview about the current situation of period poverty in high-income and low-income countries. It will also guide research experts in the design and implementation of interventions seeking to address structural, social, and individual factors among populations impacted by such a phenomenon.</p>
</sec>
</body>
<back>
<sec id="s1"><title>Author contributions</title>
<p>LS and CM: development of the editorial. JG and MP: critical review of the editorial. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec id="s2" sec-type="COI-statement"><title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s3" sec-type="disclaimer"><title>Publisher&#x0027;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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