Pandemic Periods: How Covid-19 Affects Menstrual Health and Equity

While COVID-19 has had a profound impact on lives globally, it has had a disproportionately negative impact on women and those who menstruate. Throughout the course of the pandemic, statistics reveal a rise in gender-based violence, a decline of women in the workplace, and an impact on women and girls’ access to education. While those are important topics, let's look specifically at pandemic periods. There are several ways COVID-19 has impacted people who menstruate; specifically on the availability of sexual and reproductive health services, access to menstrual products and adequate sanitation, and menstrual health as a whole.

The Impact of COVID-19 on Sexual & Reproductive Health Services

A diversion in the allocation of resources to sexual and reproductive health services for people who menstruate has left many without access to basic care, and in many cases, without access to contraceptives. In a policy brief by the United Nations (2020), it states that “in Latin America and the Caribbean [alone] it is estimated that “up to 18 million women will lose regular access to modern contraceptives, given the [current] context of COVID-19 pandemic”.

The reason for this? Ongoing lockdown and sanitation measures disrupt supply chains, which brings a major disruption to the availability and affordability of contraceptives, including birth control pills, IUDs, and even condoms (IPPF, 2020). While this impact has been felt less as the pandemic continues, the UNFPA (2021) estimates the pandemic disrupted contraceptive use for about 12 million women with a consequence of nearly 1.4 million unintended pregnancies during 2020 across 115 low- and middle-income countries”.

The Impact of COVID-19 on Access to Menstrual Products

UNICEF (2020) writes that “an estimated 1.8 billion girls, women, and gender non-binary persons menstruate, yet millions of menstruators across the world cannot manage their monthly cycle in a dignified, healthy way.” To make matters worse, COVID-19 lockdowns create the perfect storm for pandemic periods in which these conditions are exacerbated. Physical distancing measures, global lockdowns, economic hardship, and disruption in global supply chain stranslates into price increases on menstrual care products, restricted access due to supply chain disruption or stay at home orders, and the lack of safe and hygienic sanitation facilities for menstruators. As a result, many are left vulnerable to the use of alternative or homemade menstrual care products, which can lead to an increase in infections and disrupt the ability of menstruators to participate in day to day activities (UNICEF, 2020).

The Impact of COVID-19 on Menstrual Health

We’ve seen now how the pandemic has had an impact on sexual and reproductive health services, as well as on access to menstrual care products, but what about the impact on menstrual health?

Across the globe people who menstruate have reported changes to their menstrual cycles throughout the course of the pandemic. While more time is needed to understand the reason behind these irregularities, researchers believe that in part, they could be caused by the virus itself. In a study of “177 patients with menstrual records, 45 (25%) patients presented with menstrual volume changes, and 50 (28%) patients had menstrual cycle changes, mainly a decreased volume (20%) and a prolonged cycle (19%)” (NCBI, 2021).

The other explanation that has been studied is the psychological effects of long-term stress that many menstruators are reporting as a result of pandemic periods (NCBI, 2021). It has been well documented that prolonged mental and physical stress has a significant effect on the menstrual cycle.

The Impact of COVID-19 on People Who Menstruate in Canada

Globally, there is ample data showing how COVID-19 has disproportionately impacted people who menstruate—but in Canada, not so much. While we know about the impact, the data isn’t there--at least not yet or that we can access. It has been documented that early on in the pandemic Canada faced contraceptive shortages and elective health services were disrupted as many hospitals and clinics across the country prepared for an influx of sick patients.

Not only that, but during lockdown measures, many services for those on the margins of society also closed. People who accessed menstrual products through government services suddenly lost access, leaving non-profit organizations to pick up the slack. One positive to come from this is Period Packs’ partnership with the City of Ottawa. When Period Packs stepped up to distribute monthly supplies when other services were closed, the City of Ottawa stepped up with funding and that was something joni was a part of as well. Today, a new partnership has flourished into a city-wide initiative to supply free organic pads and other menstrual products in all municipal facilities and community centres.

Nationally, the Canadian government has put a strong focus on ending period poverty in Canada in recent years; and while it’s a start, the journey is far from over.

What Will the Long-term Impacts of COVID-19 be on People Who Menstruate in Canada?

While the pandemic is not yet over, and supply chains are still facing disruption, sexual and reproductive health care services are beginning to resume, and for many, life is heading towards more normalcy—whatever that looks like. However, in the coming months and years ahead, attention must be given by researchers and humanitarian organizations to further understand the long-term impact of COVID-19 on people who menstruate and what systematic changes are required toward achieving equity.

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