Why did it take a tampon shortage for the New York Times to start talking about period poverty?  Whether we think we are directly impacted by this shortage or not, cost, safety, accessibility, and environmental impact of period products are issues integral to the functioning of our societies.  In the US, issues that directly impact women’s reproductive health are being decided with little consideration of the women most affected by those decisions. And because of the cultural, societal, religious, gender, economic, and stigmatizing reasons, the US in 2022 is still very uncomfortable talking about menstruation, and even less comfortable discussing period poverty.

Now amid a tampon shortage, this lack of conversation has left women seemingly without options. But that’s not the case at all. Women have options.

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In fact, with the menstrual cup, women and girls have that cost-effective, environmentally friendly, and healthier option. The CouldYou? Cup costs as little as $10 per cup, while several other brands are priced at around $30 per cup. It is an initial upfront cost, but one that will save women and girls thousands of dollars over their lifetimes. So why don’t more women use the cup? It is a complicated question that brings up issues of strong, entrenched, and sophisticated marketing for tampons and pads by manufacturing giants, but also the lack of public debate on any issue that concerns menstruation.

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The menstrual cup isn’t new. It was invented by American actor Leona Chalmers who patented the cup in 1937. Despite the early existence of the product, even now in 2022 it is still a little-known option. Despite the documented dangers with tampons and toxic shock syndrome, and the disastrous impact paper period products have on the environment (it can take 500-800 years for nonorganic menstrual products to decompose), tampons and pads are still considered the only options for many women.

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Even in legislation, such as the 2017 Dignity Act introduced by Senators Cory Booker and Elizabeth Warren to address the treatment of incarcerated women, includes only “tampons and sanitary napkins” under healthcare products. Tampons and pads, even over the course of one year, cost significantly more than the one menstrual cup per woman that would be needed in an institutional setting.

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There is similar restriction of definition in Congresswoman Grace Meng’s Menstrual Equity for All Act of 2021 which also defines “period products” as tampons and pads throughout the text of the bill. The same is true California’s AB 367, The Menstrual Equity Act of 2021, introduced by Assemblymember Cristina Garcia and signed by California Governor Newsom this last October. The narrow definition of a menstrual product does not diminish the importance of these acts, which provide women access to the products they need.

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What Senator Booker and Senator Warren in the Dignity Act, Congresswoman Meng in Menstrual Equity Act, Assemblyperson Garcia’s AB 367, and at least 62 menstrual equity laws passed in the US have done is begin to reduce the stigma around discussion of this normal bodily function. However, the narrow definition of what constitutes menstrual products denies women a choice in how they handle their reproductive health. It also means that students only have access to tampons/pads during school hours.  One menstrual cup would meet the menstrual needs of one a student for their entire Jr/Sr High career; including nights, weekends, holidays and summers.

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Christine Garde-Denning, founder and CEO of CouldYou?, the non-profit behind the CouldYou? Cup recently met with Congresswoman Meng’s staff on the Menstrual Equity Act to talk about the menstrual cup. “It was a positive meeting,” said Garde-Denning, “but just a first step in ensuring women have access to the different products available to them. Adding the words “not limited to” to the definition of period products, would open the option of including the menstrual cup and period underwear as choices for women.”

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Garde-Denning, a firm supporter of Congresswoman Meng’s bill, agrees that lack of access to period products adversely affects an individual’s health and well-being. Period poverty exacerbates the vicious cycle of poverty. It further marginalizes women during menstruation, causing them to withdraw from daily life, forego pay, or miss educational opportunities.

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To Garde-Denning, who has spent significant time on the ground in Africa working to eradicate period poverty globally, period poverty forces the difficult choice many women make between buying a meal or menstrual products. Worse still are the choices many women are forced to make to obtain menstrual products, which can include transactional sex.

In the US alone, one in four women cannot afford menstrual products, one in five miss school during menstruation, and one in ten female college students miss classes during menstruation. For this reason, Garde-Denning wants the bill to go farther. “We want the term ‘menstrual products,’ which the bill defines as ‘sanitary napkins and tampons that conform to applicable industry standards’ to also include the menstrual cup,” Garde-Denning states. “We believe this choice will make a viable difference in ending period poverty in the US by 2040, and more importantly will keep girls in school and women in the workforce.”

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There are other benefits to the cup. Compared to pads and tampons, a reusable cup is more accessible, safer, and better for female health and the environment. It can hold five times as much liquid as a tampon and can be worn for up to 12 hours – longer than either a pad or tampon. Unlike disposable products, the cup can be washed and reused for up to 10 years, significantly reducing the financial burden of period care. This cost advantage is crucial for women experiencing period poverty. The price difference can mean no longer being forced to make those difficult choices, and no longer missing school or work because of lack of period products.

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The menstrual cup, made of medical grade silicone, is also a safer option than pads, tampons, and other methods women resort to when period products are inaccessible. These disposable products can cause infection, lead to toxic shock syndrome, and inflict sometimes fatal harm. Not only is the cup safer for women, it is also better for the planet. Whereas pads and tampons generate seven million pounds of waste a year, the cup is zero-waste and the CouldYou? Cup, in particular, can be recycled into green energy through the non-profit’s partnership with Stericycle.

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Next to cost, perhaps the biggest impediment women face is knowing what products are available to them. This lack of education and discourse has led to other difficulties. Garde-Denning has a waiting list of more 150,000 women who need the cup, including a significant number of menstruating youths in the US and Ukrainian refugees. At just $10 a cup, one would think raising funds to serve the needs of these women and girls at home and abroad would be easy. It has been anything but.

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Right now, CouldYou? has received initial funding to provide 6,000 of the 25,000 CouldYou? Cups requested for Ukrainian refugees and women in hospitals and on the front line in Ukraine. By year-end CouldYou? will distribute 100,000 CouldYou? Cups globally, with a 91% acceptability rate. But this barely makes a dent into the 150,000-long (and growing) waiting list for a cup. To help kickstart donations, CouldYou? is offering a “Get 1/Give 1” program on their website. For $20 plus shipping and handling, each cup purchased means another is donated to a women on the waiting list.

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“We need partnerships; we need interest,” Garde-Denning continues: “With $1.5 million in grant funding, we’d be well on the way to ending period by 2040. We just need to get the word out.”

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To learn more about how you can help to end period poverty, go to couldyoucup.org