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POLICY AND PRACTICE REVIEWS article

Front. Reprod. Health

Sec. Adolescent Reproductive Health and Well-being

Volume 7 - 2025 | doi: 10.3389/frph.2025.1589772

This article is part of the Research TopicThe Impact of US Health Policy on Women's Health and WellbeingView all 3 articles

Mapping menstrual health and hygiene progress in US schools: A systematic policy review and comparison across states

Provisionally accepted
  • 1Georgia State University, Atlanta, United States
  • 2Georgia Institute of Technology, Atlanta, Georgia, United States
  • 3Emory University, Atlanta, Georgia, United States

The final, formatted version of the article will be published soon.

Menstrual health and hygiene (MHH) policy initiatives have emerged as a key strategy to improve adolescent MHH, particularly through the expansion of state-level legislation aimed at increasing access to menstrual materials in K-12 schools in the United States (US). However, limited research has evaluated the implementation or effectiveness of these policies, and efforts to rigorously track and characterize existing policies remain limited. This study systematically reviewed and characterized state-level policies concerning menstrual material access in K-12 schools. We conducted a comprehensive search of all 50 US state government websites and legal databases to identify relevant legislation. Using MHH domains covered by the indicators recommended by the Global MHH Monitoring Group, we characterized policies. We also estimated policy reach by state and overall using National Center for Education Statistics enrollment data. We found that 32 (64%) US states have enacted policies since 2017, which have the potential to improve MHH for approximately nine million, or 34%, of K-12 students. Most policies lack comprehensive coverage of essential MHH domains, including only three of the seven MHH domains on average. These findings highlight the need for more rigorous research to evaluate the effectiveness of different policies and identify the best strategies for implementation.

Keywords: period poverty, menstrual policy, Adolescent Health, Menstrual Equity, School-Based Health

Received: 07 Mar 2025; Accepted: 31 Jul 2025.

Copyright: © 2025 M Ballard, Wallace, Kaza, Self-Brown, Freeman and Caruso. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor 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.

* Correspondence: April M M Ballard, Georgia State University, Atlanta, United States

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