Australia's cost of living crunch has seen more than half the country's menstruating population forgo basic period products and manage with make-do solutions.
According to the 2024 Bloody Big Survey of more than 153,000 respondents — the world's largest study on menstruation — three in five people, or 64 per cent, struggled to afford period products, with many resorting to low-cost alternatives.
It found tampons and pads, of which the median spending is $15 a month, were the first to be ticked off the shopping list when household unaffordability rose, and expenses like food and rent were prioritised, resulting in "period poverty".
Share the Dignity, the charity behind the research, said that of the 153,000 people who took part in the survey, more than 98 per cent were female. But 1,735 respondents identified as gender fluid, non-binary or trans.
Researchers define period poverty as a lack of access to menstrual products, hygiene facilities, waste management, and education.
The problem disproportionately impacted people without secure employment, those from lower socio-economic backgrounds, residents of rural areas, Indigenous communities, people with disabilities, and those who identify as gender diverse.
Share the Dignity founder Rochelle Courtenay called on the government to take the issue more seriously.
"No one should have to go without these basic essentials, yet this issue is alarmingly prevalent," she told AAP.
"Some people used tea towels or tote bags to try and manage their period with dignity, which is unacceptable here in Australia."
In rural areas, 24.3 per cent of those who menstruate had to improvise on period products due to cost, and 18.7 per cent in urban areas. This included using items like toilet paper, socks, and pieces of spare cloth.
Ahead of the survey, Ms Courtney said low accessibility to menstrual products was a form of "unspoken poverty", which girls, women, and non-binary people often did not seek help for.
This reluctancy was found to be driven by barriers like societal shame and stigma and an early education gap around menstruation.
Enormous toll to workplaces
Period poverty has implications beyond individuals.
One in two, or 56 per cent, of respondents who are employed reported having skipped work due to their period, which cost Australia's economy $9.6 billion per year in missed days of work.
(This calculation was based off the median income of women from the Australian Bureau of Statistics and does not account for gender-diverse people.)
Ms Courtney said this could be counteracted to a degree through availability of sanitation products at work.
"We need businesses to provide free access to period products so we can improve productivity and negate this heavy cost to the economy," she said.
"You just provide period products in the bathroom, why wouldn't you? It is a very low-cost solution … (people) will be able to effectively work and we all want that."
Support workers, retail workers, cleaners and customer service representatives were the hardest hit.
The report said occupations suffering most from period poverty are lower paying than others, however they are also typically feminised carers jobs.
Women make up the greatest part of the paid and unpaid support workforce in Australia and operate in roles that are typically undervalued and insecure.
Victims of violence, Indigenous people over-represented
The Bloody Big Survey found more higher education students improvised on menstrual products this year compared to 2021, and 68 per cent missed playing sport due to their period.
Period poverty was the highest in Tasmania at about 10 per cent, and lowest in the ACT at 6 per cent. These respondents were unable to afford period products.
But respondents who said they found it difficult to afford products, but still purchased them, sat above 60 per cent across all states and territories.
Difficulty in access among Aboriginal and Torres Strait Islanders and the gender diverse community was dramatically higher than the national average at a rate of 83 per cent, while for those with a disability or a chronic condition it was 78 per cent.
About 21 per cent of Indigenous Australians could not afford period products compared to 6.9 per cent of non-Indigenous people in the past 12 months.
People experiencing some form of violence — domestic, family, or relationship — also reported higher rates of period poverty than those who do not.
"I had been in a violent controlling relationship where he had my bank card and would control the money," one participant said.
"I used to open packets of pads or tampons in the shop and steal individual products if I didn't think I could get away with taking a whole packet. I was so isolated that I didn't even have anyone to ask for help."
Eighty-two per cent of domestic violence victim-survivors found it difficult to buy products due to cost.
Access and education the key solutions
Free pads and tampons are already available in many public places across Australia, but the report stresses this access needs expanding.
In an improvement from the last survey in 2021, every state and territory now mandates free period products in public high schools.
However, universities, TAFEs, and hospitals have no such obligation.
"In public hospitals across Australia, there is access to band-aids, bandages, painkillers, and incontinence aids, but not period products. Respondents in every state and territory in Australia were not able to access period products in hospital," the report states.
The ACT became the first Australian jurisdiction to enshrine access to free period products in law with its Period Products and Facilities (Access) Act passed last year.
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Examples of places designated as access areas include public schools, tertiary training centres, public libraries, and other ACT Government outlets and designated community service providers.
Victoria has also committed to installing period product vending machines in up to 700 locations across the state, which will begin this year.
Share the Dignity says more actions needs to be taken on all government levels — federal, state, and local.
Additionally, the charity argues that addressing stigma around menstruation is key to reducing period poverty, to allow for people to seek help when they need it. This can be done beginning conversations about periods at a young age, and with all genders.
Share the Dignity has scores of digital vending machines for pads and tampons across the country. See their map here.
The Bloody Big Survey is run every three years and and aims to monitor the physical, social and financial impacts of menstruation and whether period poverty rates have improved over time.
ABC/AAP