Research from the University of Southampton has identified common issues women face when experiencing periods while homeless.
A review of research published in Women and Health has found homeless women experienced practical challenges in managing menstruation alongside feelings of embarrassment and shame, with many 'making do' due to inadequate provision.
The researchers say it's high time to address the provision of menstrual health resources as a basic human right.
Dr Stephanie Barker, a teaching fellow at the University of Southampton who co-led the review said: "So-called 'period poverty' is a global concern. Our findings highlight the need to stop gatekeeping and limiting access to menstrual health products. This is both a public health issue and a human rights one."
The review of research evidence is the first to explore homeless women's experiences of menstruation. The University of Southampton team identified and analysed nine studies on the topic conducted in the United Kingdom, the United States, Canada and Nepal. Three key themes emerged from the research.
The first is challenges in the logistics of managing menstruation while homeless. Finding a clean, private space to use and change menstrual products was a common issue. The few options available, such as public toilets, were described as unsanitary and not fit for purpose. The stigma attached to homelessness means women are often turned away from public and privately owned bathroom facilities.
Dr Polly Hardy-Johnson, also a teaching fellow at the University of Southampton and co-lead author on the paper, added: "Even as paying customers, women were subject to stigma around assumed drug use, limiting their access to bathrooms. Being able to pass as 'not homeless' was more difficult when women were unable to maintain menstrual health.
"Limited access to facilities led to infections and increased the need for costly laundry services, due to leakages and blood-stained clothing. There is a need for private, safe and clean locations for managing menstruation, as well as access to laundry facilities."
Rough sleepers relied on service providers for menstrual products, but several studies noted that provision fell short and was sporadic. This meant women would sometimes forgo food to buy menstrual products or shoplift them.
The second theme was around feelings of embarrassment, shame and dignity linked to maintaining menstrual health. Women felt the need to hide that they were menstruating and felt judged when they could not maintain menstrual health, causing anxiety and discomfort.
Women reported services rationing free menstrual supplies, forcing them to have to ask staff (sometimes men) multiple times per day for tampons, sanitary pads, and other products.
The third theme was around women 'making do' to manage the challenges they were facing. Several women reported using sponges, clothes, and cut-up t-shirts as reusable ways of soaking up menstrual blood and avoiding leaks. Others used layered wads of toilet paper, and some reused soiled disposable menstrual products. To treat infections some women turned to cheap herbal remedies rather than more expensive treatments.
Studies also looked at what services the women found useful. The provision of menstrual health products and birth control products was useful, alongside sexual health services. Warm, welcoming cafes and day centres helped to soothe period pain and discomfort.
Shared information within the homeless community about the support available, showering facilities and the sharing of products helped to improve menstrual health management.
The research team found there is a lack of evidence on the experiences of homeless people who do not identify as women and who menstruate. To address this, the team has received £9.9K in funding from British Academy/Leverhulme Small Research Grants to better understand the menstruation needs of all people experiencing homelessness.
The project will conduct in-depth interviews and use creative ways to amplify marginalised voices, and co-create a policy brief with the homeless community and key stakeholders on improving access to menstrual healthcare.
The homeless period: a qualitative evidence synthesis is published in Women and Health and is available online.
