How Much Are Those Tampons?: My Research Experience in the Period Aisle
During my first year as a Mailman MPH student, I met Dr. Marni Sommer, a leading researcher in menstrual health and Mailman professor. I soon became intrigued by her work and decided to take her class on the Global Menstrual Movement. I learned that across the U.S. and globally, there is a growing movement for menstrual equity, which calls for laws and policies that ensure menstrual products are safe, available, and affordable for all. Menstrual health and hygiene moves beyond just accessible products to include the holistic needs of people who menstruate, such as safe and easy access to information, facilities, and supplies.
For one of the class assignments, my friend and I did audit fieldwork of public toilets to better understand restroom access and the availability (or not!) of free menstrual products. Unsurprisingly, toilet access was limited as we searched through parks, bodegas, pharmacies, grocery stores, and coffee shops. Moreover, menstrual products were absent from all the restrooms we checked. Addressing this deficiency would improve menstrual equity, specifically for low income-individuals, people experiencing homelessness, or anyone who gets their period when not expecting it. This assignment got me thinking: Since menstrual products are not publicly available, how much must individuals pay for them, and do prices vary by location?
Following my curiosity about research in the menstrual world, I applied and was offered a summer practicum fellowship with Dr. Sommer’s team, the GATE (Gender, Adolescent Transitions, and Environment), as the Sid Lerner Women’s and Adolescent Health Fellow. Through my fellowship, I hit the streets once again to continue investigating menstrual product access and accessibility. Expanding upon the previous work of the GATE team, I began testing and refining their data collection tool, which provides structure to collect data on types of available products (e.g., pads, tampons, menstrual cups), brands, prices, and the location of menstrual products within the store itself.
Before entering the field, I converted the menstrual product audit tool into a digital survey to pull up on my phone—less conspicuous than pulling out a clipboard and pen in the period aisle! After planning our route, GATE team member and Mailman graduate, Susi Martinez, MPH ’21, and I visited pharmacies and bodegas in Washington Heights to test our initial iteration of the tool. This first expedition left us scratching our heads after encountering real-world scenarios that we hadn’t foreseen. Inside pharmacies, it was a little overwhelming to make sense of varying package sizes, absorbency levels, brands, and even sub-brands. How could we compare the price of menstrual products if each store had a different assortment of options?
Our solution was to narrow our scope to three pharmacy chains and three brands per menstrual product that were—in theory—available at each store. I focused on three neighborhoods: Washington Heights (where Mailman is located), the Upper West Side, and Astoria. Given the nationwide tampon shortage, some stores were better stocked than others. While every store had some gaps on their shelves, the shortage was least noticeable in the Upper West Side and most drastic in Washington Heights.
Back in the bodegas of Washington Heights, my team member and I talked to several workers to try to understand why pads and tampons were always placed on the highest shelves. Initially, we thought this placement might act as a physical barrier to access, and further met with the social barrier of having to interact with predominately male staff. The cashiers told us that products are placed higher if a) they are expensive, to minimize theft, or b) they are lightweight, to minimize injury if they fall on someone. Through an informal conversation with my friend, she told me that she only buys pads from her local bodega in Astoria, where menstrual products are placed on an accessible, low shelf. This could imply that demand for the products also plays into their placement.
In Astoria and Washington Heights, I visited several dollar stores. These stores appeared fully stocked, did not have any expired products, and even offered smaller packages of leading brands. In one, I was met with a stark reminder of the urgency of menstrual equity. I found that someone had ripped a hole in a package of generic pads and taken a few loose products (see photo). This evidence highlights the necessity of available and affordable, if not free, menstrual products, specifically in low-resource settings.
Menstrual equity extends far beyond an individual deciding between product and price point. Access to menstrual products sometimes means navigating social taboos, limitations in the built environment, supply chain shortages, and inflation. As economic conditions continue to exacerbate period poverty through the tampon shortage, my hope is that we recognize the essential nature of menstrual products and prioritize affordable and reliable access for all.
Micaela Camozzi is a second-year MPH candidate in the Department of Sociomedical Sciences, earning a Certificate in Health Policy and Practice. She was the 2022 Sid Lerner Women and Adolescent Health Fellow at Gender, Adolescent Transitions, and Environment (GATE).