The average for menarche, the first menstrual cycle, is 12, and the average age for menopause is 52. Because much of the efforts to eradicate period poverty are focused on low-income countries, we must remember that period poverty is defined by income, not a geographical location. Approximately 11.5 million people in the United States between the ages of 12 and 52 who live below the poverty line identify as female (See Table 1). Understanding the difference between the period tax and period poverty influences how we frame the financial burden of purchasing menstrual products for these women.
Table 1. Number of Females Between the Ages of 12 and 52 Below the Poverty Line
Source: Calculations by the Women’s Institute for Science, Equity and Race using the 2024 Annual Social and Economic Supplement, Current Population Survey, United States Census Bureau.
Period Tax vs. Period Poverty
Period tax (tampon or pink tax) is the tax paid on menstrual or feminine hygiene products purchased. Households with menstruating females and below the poverty line have less income to buy feminine hygiene products. Suppose these households can not purchase these products. In that case, they do not pay a period tax but experience period poverty – the lack of income to buy menstrual supplies. Approximately 1 in five households below the poverty line have more than one female who may have a menstrual cycle (see Table 2).
Table 2. Number of Households with Women Between the Ages of 12 and 52
Source: Calculations by the Women’s Institute for Science, Equity and Race using the 2024 Annual Social and Economic Supplement, Current Population Survey, United States Census Bureau.
A Cramp in the Pocketbook
To estimate the financial burden to households with females of menstruating age, we completed the following steps.
Calculated the cost of feminine hygiene products (excluding additional costs like pain medication for cramps or new underwear) using prices of name-brand menstruation products, such as Tampax Pearl tampons and Always Ultra Thin pads, as well as value brands like Walmart’s Equate. We determined the average unit price by dividing the price per box by the number of units in each box. Next, we multiplied the average unit price of each product by 50 to facilitate a comparison of box prices and observe any price changes for products designed for regular versus heavy periods. Additionally, we calculated the average cost of each type of product to compare the expenses of pads and tampons with those of period underwear. The values are presented in Table 3.
Table 3. Lifetime Menstrual Cost Based on Flow Type
Source: Calculations by the Women’s Institute for Science, Equity and Race.
Next, we identified the characteristics of the menstrual products needed for the different menstrual cycles. A scant (light) flow is defined as “may only bleed for a few days and may not even require a pad or tampon” (See Table 3). If products are used, they may only need to be changed every 8 to 12 hours. The MEPS data did not record any observations for this type of menstrual cycle.
A regular cycle is defined as lasting between 3 and 5 days, with blood loss of 60 milliliters or less (2 ounces). Menstrual products are generally changed every 4 to 6 hours during a regular cycle. These definitions provide insight into the varying characteristics of menstrual cycles and the associated product needs.
Heavy menstrual cycles are characterized by lasting more than 7 days, requiring a new tampon or pad every 2 hours, the passage of large blood clots, and/or the loss of more than 80 milliliters of blood. Uterine fibroids, uterine polyps, hormonal imbalances, or “other” bleeding disorders may cause this type of cycle as well. These classifications highlight menstrual products’ varying needs and costs, as heavy cycles demand more frequent changes and higher product usage than light or regular flows. The presence of conditions like uterine abnormalities or bleeding disorders further emphasizes the challenges of managing a heavy flow (see Table 4).
Table 4. Menstrual Flow Types 
Medical Expenditure Panel Survey (MEPS), National Health Interview Survey (NHIS), Northwestern Medicine Health Beat, and National Library of Medicine
Finally, we generate the period cost burden, which is the expenditures on feminine hygiene products divided by the Federal Poverty Guideline Threshold. We also calculated the recommended household budget allocation for health and medical spending (see Table 5).
Period Cost Burden
When examining the lifetime costs of menstrual care, the disparity between regular and heavy flow is over $11,000. A woman with a regular flow, without insurance coverage for her birth control, spends approximately $21,367 on period-related expenses over her lifetime, while a woman with a heavy flow incurs costs as high as $32,489 (see Table 3). This $11,122 difference is attributed to the increased need for tampons, pads, panty liners, and even new underwear due to the frequency and volume of bleeding.
For low-income households, the period cost burden can strain a limited budget, forcing trade-offs with other essential needs. When birth control is excluded from these calculations, the lifetime costs for managing regular and heavy periods range from $9,367 to $20,489; therefore, even without contraceptives, menstrual care remains a substantial expense (see Table 3).
In a two-person household where both individuals menstruate, the financial impact of managing periods can vary depending on their flow types. For example, a mother and her dependent daughter —one with a “regular” flow and the other with a heavy flow. Based on estimates in Table 3, a regular menstrual flow costs $534 annually. In contrast, a heavy flow increases the expense to $812 with birth control in both totals. It is recommended that 10 percent of the budget be allocated for medical and health expenditures. Assuming the maximum income allowed by Federal Poverty Guidelines, the period cost burden for this household is between 5.23% and 7.95% (see Table 5). The period cost burden is more than 50% of the recommended health and medical allocation. The period cost burden will be higher if the household income is lower than the poverty threshold.
Table 5. Menstrual Burden Calculator: Product Costs to Earnings
Source: HHS Poverty Guidelines for 2024
Period Subsidy Instead of a Period Tax
The period cost burden may exacerbate the financial stress experienced by low-income households with menstruating individuals, especially when their menstrual flow is heavy. A subsidy provided to persons while menstruating, modeled after the Women, Infants, and Children Program, or requiring insurance companies to cover the costs of menstrual supplies, as with diabetic supplies, would provide financial relief for these households.
