Overview
Menstrual health is a major area of reproductive health often overshadowed for the estimated 79.8 percent of those in carceral facilities of reproductive age. For some, menstrual hygiene products are easily accessible, whereas for others it is a constant struggle. Meaningful progress toward comprehensive menstrual equity for all incarcerated individuals remains limited and inconsistent across jurisdictions.
Reproductive rights remain an important focus of public health, with the discourse often centering around abortion and contraception. However, there is a major area of reproductive health that receives relatively little attention despite its clear relevance to the day-to-day lives of millions of people in the United States. The topic is menstruation. There are approximately two billion people in the world who menstruate, and about 800 million on any given day. Yet, menstrual health is often overshadowed in carceral facilities. For some, menstrual hygiene products are easily accessible, whereas for others it is a constant struggle. Regardless of where a person is or what resources they have access to; basic health needs should remain the same.
Menstrual hygiene is a public health issue that raises concerns of health equity — the principle that everyone should have a fair and just opportunity to attain their highest level of health, regardless of socioeconomic status, race, or location. Menstrual hygiene management is the ability to “use sanitary materials to absorb menstrual blood, change and dispose of these materials in privacy as needed, and have access to soap and water to keep clean.”
Those who are incarcerated often face significant barriers to menstrual hygiene, including having limited or inconsistent access to pads, tampons, panty liners, and clean facilities to care for their reproductive needs. Imagine beginning your menstrual cycle, and your first thought is, “I hope there are hygiene products available for me to use.” And since menstruation does not stop when someone is incarcerated, this question plagues people who are incarcerated every cycle.
Lack of menstrual health products and supportive care can lead to negative impacts on the physical and mental well-being of those incarcerated. These basic needs are frequently minimized in correctional health policies, leading to indignity, discomfort, humiliation, and health risks. Those who lack adequate hygiene products are often forced to use unsafe alternatives like inserting toilet paper, mattress filling, or dirty rags to manage their menstrual flow —putting them at serious risk for bacterial infection and other health complications. “There is no dignity, no humanity, no compassion in a system that makes a person have to beg, borrow, or even make her own basic hygiene items.” Such concerns call for urgency to prioritize menstrual hygiene as a fundamental aspect of care in incarceration facilities.
The rate of incarcerated female prisoners has been growing at a rapid pace since the 1980’s. According to the Federal Bureau of Prisons, approximately 79.8 percent of incarcerated females in federal prisons are at the reproductive age, meaning the vast majority experience a menstrual cycle while behind prison walls. Despite these rising numbers and some legal and policy advancements on menstrual access, meaningful progress toward comprehensive menstrual equity for all incarcerated individuals remains limited and inconsistent across jurisdictions. A closer look at recent federal legislation and state-level policies reveals the gaps and disparities that still exist.
In 2018, Congress passed the First Step Act to promote a more equitable sentencing system by encouraging rehabilitation and reduce excessive sentencing. One provision of the law requires that, in federal prisons, people who menstruate be provided with free pads and tampons. But this provision does not apply to state prisons or local jails. Advocates and leaders nationwide, including the National Coalition to End Period Poverty, have welcomed the reintroduction of H.R. 3644- Menstrual Equity for All Act 2025 by Representative Grace Meng (NY-06-D). This legislation emphasizes the responsibility of each state’s attorney general, along with the Bureau of Prisons, to supply menstrual products to incarcerated individuals and detainees.
Only three states— Alabama, Colorado, and New York provide broad support for menstrual product access for incarcerated individuals across state laws, correctional policies, and facility handbooks. In contrast, Forty-three states have taken only limited steps, typically addressing menstrual hygiene in just one area — whether its legislation, policy, or facility guidelines. Wyoming, Massachusetts, and Iowa are the remaining states that make no mention of menstrual product access at all. So, while a majority of states have passed some form of legislation aimed at improving menstrual equity in correctional settings, challenges remain in ensuring that incarcerated individuals actually receive the products when requested.
In states with laws and policies that ensures access to menstrual products, another barrier persists: delays in providing menstrual products when they are needed most. For example, a study of New York state institutions found that greater than 50 percent of incarcerated people in state prisons reported not getting sufficient menstrual supplies monthly. Unlike in schools and workspaces where menstrual supplies are often readily available, incarcerated individuals must request tampons and pads from prison staff and making the request doesn’t guarantee they’ll receive them timely.
In Texas, women report that sometimes they get scrutinized by guards when they ask for more tampons or pads. An investigation by the L.A. Times found that some of them even face retaliation or are pressured into providing sexual favors, forms of both physical and mental experiences faced when asking for supplies that are essential. These barriers can cause health impacts for people who are incarcerated.
In California, despite implementing a state law that is meant to ensure access to personal hygiene products, including those related to menstruation, officials realized that those menstruating were still not receiving the products they needed. In response, the California Department of Justice (DOJ) reviewed jail manuals from 53 of the state’s 58 counties to assess compliance with state laws across seven reproductive health policy areas. The DOJ concluded that “of the 53 facility manuals evaluated, only 10 were ‘fully compliant’ with California law.” This highlights a troubling gap between policy and practice, demonstrating how the existence of a law does not guarantee its consistent or equitable implementation.
In a society where the public health concerns of incarcerated people are too often overlooked, policymakers and others must consider how to ensure consistent access to essential, everyday resources without unnecessary barriers. Organizations and institutions must continue to advocate for a more just and humane system that upholds dignity and addresses the basic needs of all people, regardless of their circumstances.
Such advocacy paves the way for fair and equitable laws and regulations. As public health lawyers, professionals, analysts, and advocates continue to broadcast this shortcoming for those incarcerated, it is critical that policymakers and correctional institutions respond with meaningful reforms that guarantee access to menstrual products and comprehensive healthcare, and the fundamental respect that every person deserves.
This post was written by Naisha Mercury, Equal Justice Works Fellow, Network for Public Health Law – Mid States Region. The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document do not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.
