Cycles and Crisis: Menstrual Health for Climate Justice

By guest contributors Nadirah Babji, Dr. Jennifer S. Martin, Dr. Bismah Nayyer, Dr. Muskaan Bhan, and Nour Toukan

Image credit

President.az, CC BY 4.0 , via Wikimedia Commons

The lack of representation of women in world leader delegations at the current COP29 in Azerbaijan could be an indicator of why women’s, girls’, and gender-diverse individuals’ rights are not central to the climate debate. As the planet faces the unprecedented challenge of climate change, it is critical that we address the basic unmet needs of half of the world’s population.

There is a growing body of evidence that suggests that climate change harms sexual and reproductive health outcomes in women and girls. The UNFPA (2023) suggests that women, girls, and vulnerable populations will be disproportionately impacted by climate change, which can increase the rates of child marriage, adolescent unplanned birth rates, maternal mortality, and gender-based violence. Imagine experiencing a climate disaster; you are displaced with no access to health services or private spaces, and you are menstruating.

Menstrual health is vital to the overall well-being of women, girls, and gender-diverse people who menstruate, but managing it becomes challenging during heatwaves and forced migration due to climate events like floods, droughts, or wildfires. High temperatures can worsen symptoms, and inadequate hygiene, water, and sanitation can increase the risk of infections, inflammation, and dehydration. Poor infrastructure in hot climates further complicates menstrual health. It’s crucial to prioritize menstrual health efforts in the climate crisis to protect the dignity and health of those affected.

Climate crisis events like heat waves and floods invite conversation around hygiene management and affect women’s and girls’ hormonal levels. Heat also means that bacteria thrive mainly in the urinary and genital tracts, consequently increasing cases of UTI and bacterial vaginosis. Heat waves not only mean higher temperatures, but the socioeconomic effects are equally significant, encompassing water and energy consumption issues and the general quality of life. Women from low-income backgrounds are compelled to make various choices since the spike in economic costs impacts them the most. Food and cooling, in some cases, become necessities, while the much-needed menstrual products are considered luxuries.

In Southeast Asian countries like Malaysia and Pakistan,  menstrual products are still limited, albeit more so in rural areas than urban areas; however, the major problem is cost. Menstruation is a constant struggle, and heat waves in those countries have added additional barriers to the cost of maintaining menstruation with WASH, education, and dignity.

The case is not much different when it comes to flash floods. Flash floods cause widespread damage, destroying homes, roads, and infrastructure like primary health centers and disrupting the supply chain. With livestock lost and farmland ruined, income sources vanish, leading to poverty and forced migration. This is particularly evident in Pakistan, among the top-ranked countries facing the brunt of the climate crisis due to floods. After the 2022 flash floods, many young girls reported early menarche and painful menstruation, which Pakistani OBGYNs attributed to an increase in stress. Intense stress can interfere with the function of glands that regulate hormones, like cortisol, and play a vital role in releasing estrogen, essential for female reproductive health.

Another hidden cost of the climate crisis is early child marriages. Pakistan has seen this as a form of ‘’Moonson Child-Brides’’ since its 2022 floods. The term “monsoon child brides” highlights a socio-cultural crisis where traditional practices and increasing economic hardship drive young girls into early marriages, a situation worsened by climate change. UNICEF (2023) predicts that extreme weather-related flooding in Pakistan will lead to an 18% rise in child marriage rates, undoing five years of progress. Girls who marry before 18 are at greater risk of school dropout, gender-based violence, poverty, unintended pregnancy, reproductive health issues, poor mental health, and sexually transmitted infections, including HIV/AIDS. Period poverty, inadequate WASH facilities, stigma, and a lack of menstrual education cause many girls to miss school, and some ultimately drop out. As such, child marriage often becomes the fallback option.

Climate change intensifies gender and social inequalities, undermines safety and security, and amplifies vulnerabilities, significantly impacting the lives and experiences of people who menstruate. Therefore, we are calling on world leaders for:

1. Menstrual health inclusion under the SRHR in the climate change adaptation initiatives and policies to guarantee appropriate product distribution in emergency situations during hot climates and natural disasters like floods. Incorporating gender-responsive menstrual health into policy agendas ensures support during disasters.
2. Ensure access to a variety of menstrual products, including reusable products, and comprehensive sexual education that addresses menstrual health across the life course so that individuals can make informed decisions about the products they use.
3. Make holistic menstrual health a component of WASH programs in disaster and relief efforts, including access to safe and discreet WASH facilities to change and clean products and municipal services for menstrual waste disposal.
4. Levey the pink tax on menstrual products and protect supply chains in countries most affected by climate change so that products are affordable and available in times of crisis.
5. Gender-responsive climate financing by setting up a grants scheme or direct conditional cash transfers for communities most affected by climate change. These funds can support microfinancing for families with daughters, enabling them to start small businesses or invest in farming, reducing economic and food insecurity.
6. The inclusion of women, youth, gender-diverse people, and Indigenous people’s voices in gender-focused climate action will ensure that future climate-related resolutions respond to the needs of women, girls, and gender-diverse people.

Women, girls, and gender-diverse individuals, particularly from vulnerable communities, are disproportionately impacted by the climate crisis. Addressing the growing impacts of the climate crisis must prioritize the intersection of menstrual health and climate resilience. For climate justice, access to WASH and cost-effective menstrual products for women, girls, and gender-disease people who menstruate must be provided under gender-responsive programming and climate financing. That way, every person who menstruates can attain menstrual health safely and with dignity. 

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Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.

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