Period product insecurity in higher education: a call for change ================================================================ * Lydia Seed * Ashna Biju * Emma Johnson * Health Policy * Patient Advocacy * Reproductive Health Period product insecurity describes unreliable access to sufficient menstrual products. People experiencing period product insecurity are at risk of period poverty. Period poverty is defined as a lack of access to menstrual products or any other component of satisfactory menstrual hygiene management (MHM): “clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required and having access to facilities to dispose of used menstrual management materials”.1 A key contributing factor to period product insecurity is the cost of menstrual products, such that 1 in 10 girls in the UK are unable to afford period products.2 Period poverty can be detrimental to both physical and mental health. For example, in the UK, 38% of teenage girls wear period products for longer than recommended,3 behaviour that is associated with higher rates of reproductive tract infections,4 which can have significant long-term health consequences. Additionally, higher rates of moderate-severe depression have been reported among university students in the US who have experienced period poverty.5 Furthermore, period poverty can lead to adverse educational outcomes. In 2020–2021 in the UK, 11% of girls missed school because they could not afford period products – a dramatic rise from 2% in 2019.3 In order to ensure provision of products to all “who need them, when they need them, […] to access education”, the UK government launched a free period products scheme in 2020.6 However, only secondary schools and 16–19 education organisations in England can access the scheme.6 In the UK, 1 in 7 girls aged 14–21 years struggle to afford period products,2 indicating that period product insecurity is prevalent not only among school pupils, but also students in higher education (HE). A recent informal survey at the University of Cambridge revealed that 51.6% of menstruating students find purchasing period products to be a financial burden, with 12.5% experiencing this persistently, implying that over half experience a degree of period product insecurity.7 Moreover, with the increasing rate of progression to HE among children eligible for free school meals, and more female than male students entering HE, a growing proportion of the HE student body may be affected by period product insecurity.8 In Scotland, all educational institutions must ensure that period products are made freely available, as stipulated in the Period Products (Free Provision) (Scotland) Act 2021.9 However, HE institutions throughout the rest of the UK are not similarly mandated, hindering the uniform delivery of this service. For example, despite the demonstrated need among its students, the University of Cambridge does not have a free period product scheme.7 Indeed, the provision of free period products in a few HE institutions has only recently been reported in the media.10 Research into the prevalence of period product insecurity among HE students is needed, and a nationwide investigation into the provision of free period products within HE institutions in England, Wales and Northern Ireland is long overdue. Government-mandated provision in line with Scotland is warranted. An extension of the free period products scheme to include HE institutions should also be considered. The Department of Education declares that “having periods should not be a barrier to education for any learner”,6 yet period product insecurity persists in HE institutions and results in missed educational opportunities due to forced absences. A lack of free period product provision fails to provide barrier-free education. The provision of free period products in all HE institutions would allow all students throughout the UK to achieve their full potential, irrespective of whether they menstruate. ## Ethics statements ### Patient consent for publication Not applicable. ### Ethics approval Not applicable. ## Acknowledgments The Cambridge Period Project. ## Footnotes * Contributors LS devised the concept of the manuscript. LS, AB and EJ contributed to the writing of the manuscript and approved the final draft. * Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. * Competing interests None declared. * Provenance and peer review Not commissioned; externally peer reviewed. ## References 1. United Nations Children’s Fund (UNICEF). Guidance on menstrual health and hygiene (1st edn), 2019. Available: [https://www.unicef.org/media/91341/file/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf](https://www.unicef.org/media/91341/file/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf) [Accessed 24 Jan 2022]. 2. Plan International UK. 1 in 10 girls have been unable to afford sanitary wear, survey finds, 2017. Available: [https://plan-uk.org/media-centre/1-in-10-girls-have-been-unable-to-afford-sanitary-wear-survey-finds](https://plan-uk.org/media-centre/1-in-10-girls-have-been-unable-to-afford-sanitary-wear-survey-finds) [Accessed 5 Mar 2022]. 3. phs Group. Period equality: breaking down the barriers, 2021. Available: [https://www.phs.co.uk/media/2907/96671-phs-group-period-equality-whitepaper\_uk-v3.pdf](https://www.phs.co.uk/media/2907/96671-phs-group-period-equality-whitepaper_uk-v3.pdf) [Accessed 5 Mar 2022]. 4. Ademas A , Adane M , Sisay T , et al . Does menstrual hygiene management and water, sanitation, and hygiene predict reproductive tract infections among reproductive women in urban areas in Ethiopia? PLoS One 2020;15:e0237696.[doi:10.1371/journal.pone.0237696](http://dx.doi.org/10.1371/journal.pone.0237696) pmid:http://www.ncbi.nlm.nih.gov/pubmed/32822377 [PubMed](http://jfprhc.bmj.com/lookup/external-ref?access_num=http://www.n&link_type=MED&atom=%2Ffamilyplanning%2F48%2F4%2F313.atom) 5. Cardoso LF , Scolese AM , Hamidaddin A , et al . Period poverty and mental health implications among college-aged women in the United States. BMC Womens Health 2021;21:14.[doi:10.1186/s12905-020-01149-5](http://dx.doi.org/10.1186/s12905-020-01149-5) pmid:http://www.ncbi.nlm.nih.gov/pubmed/33407330 [PubMed](http://jfprhc.bmj.com/lookup/external-ref?access_num=http://www.n&link_type=MED&atom=%2Ffamilyplanning%2F48%2F4%2F313.atom) 6. Department for Education. Period product scheme for schools and colleges in England, 2021. Available: [https://www.gov.uk/government/publications/period-products-in-schools-and-colleges/period-product-scheme-for-schools-and-colleges-in-england](https://www.gov.uk/government/publications/period-products-in-schools-and-colleges/period-product-scheme-for-schools-and-colleges-in-england) [Accessed 5 Mar 2022]. 7. Vides G . Bloody poor access: open letter demands provision of free menstrual products across Collegiate University. Varsity, 2021. Available: [https://www.varsity.co.uk/news/20581](https://www.varsity.co.uk/news/20581) [Accessed 3 Feb 2022]. 8. Department for Education. Widening participation in higher education, academic year 2019/20, 2021. Available: [https://explore-education-statistics.service.gov.uk/find-statistics/widening-participation-in-higher-education/2019-20#releaseHeadlines-summary](https://explore-education-statistics.service.gov.uk/find-statistics/widening-participation-in-higher-education/2019-20#releaseHeadlines-summary) [Accessed 2 Feb 2022]. 9. legislation.gov.uk. Period products (free provision) (Scotland) act 2021, 2021. Available: [https://www.legislation.gov.uk/asp/2021/1/2021-03-18](https://www.legislation.gov.uk/asp/2021/1/2021-03-18) [Accessed 5 Mar 2022]. 10. Hammond A . University launches free sanitary products scheme. Nouse, 2022. Available: [https://nouse.co.uk/2022/01/12/university-launches-free-sanitary-products--scheme](https://nouse.co.uk/2022/01/12/university-launches-free-sanitary-products--scheme) [Accessed 5 Mar 2022].