Desperation at a lack of safe sanitation is driving women and girls to intentionally stop their periods.
Instead of trying to deal with bleeding without anywhere clean to wash themselves or do laundry, some are turning to medication instead, taking hormonal contraceptives back-to-back so their menstrual cycle is disrupted or using other potentially risky pills.
The issue was highlighted to the UK government by youth ambassador for Water Aid, Samia Anwar Rafa, who visited London last month to present an open letter to Keir Starmer.
She told how in some areas of the world, ‘you open the tap and there’s no water to drink or use’ due to water sources drying up, while deadly heatwaves and destructive cyclones have destroyed sanitation systems.
‘‘Even in calmer times, increased salinity due to climate change is making water sources unusable,’ her letter reads.
‘In desperation, some girls start taking contraceptive pills at an early age to stop their periods and avoid the risk of infections, something that in the long run could have associated health risks.’
Rafa told Metro that many women cannot access sanitary pads, and use rags instead which they wash and reuse.
In southwestern Bangladesh, where water has become more saline, partly due to sea level rise, they are forced to wash these cloths in salty water which then irritates their skin and increases the rate of infection, as well as causing severe itching.
‘In Bangladesh, I am seeing my community suffering with the lack of access to water every day and climate change intensifying the extent of it,’ Rafa said. ‘It’s taking away people’s lives, it’s taking away people’s livelihoods, and it’s putting them in a position that’s very hard for them.’
In the south west, where saltwater prawn farming is a major industry, the issue of women seeking to stop their periods has been particularly highlighted.
One girl living here, aged 15, told journalist Jesmin Papri in Bangladeshi newspaper the Daily Star: ‘During my periods, I always used pieces of old rags which I washed with dirty and salty water. I’ve seen my mother suffer from uterine diseases for a long time. I do not want to experience the same thing.’
To avoid having to wash with saline water, she told how a neighbour gave her birth control pills so she could stop her period altogether, which she had done for five months at the time of the interview.
Two of her friends had also done the same thing, which the newspaper said were just a few cases of a widespread issue of people taking the pills ‘without any medical advice’.
Dr Farhana Dewan, secretary-general of the Obstetrical and Gynecological Society of Bangladesh (OGSB), told the newspaper that skipping one period was unlikely to have ill effects, but if done repeatedly it could impact on fertility, potentially making it more difficult to resume regular periods later on.
A study last year looking at the impacts of increased salinity in coastal Bangladesh wrote: ‘During the menstrual cycle, [women] wash their used old clothes in saline water and dry them in hidden places in the house and they use the same clothes for four to six months.
‘After every wash with saline water, the clothes get stiffer and harder, creating discomfort for every subsequent use.
‘A woman added, “Wearing hard clothes we must take a long walk for water fetching. You will be unable to imagine the discomfort and sufferings we face during menstruation”.’
It continues: ‘Salt water creates itching in their sensitive areas, rash and fungal infections, urinary tract infections, and feeling uncomfortable during menstruation.
‘Besides, the consumption of saline water to a large extent creates unbearable gynecological health complexities.’
Period poverty has been in the headlines in recent years, in the UK as well as globally.
In 2020, the UK launched a scheme to provide free tampons and pads in schools after campaigns highlighted how pupils were skipping school to avoid having to go in without hygiene products.
Last year, Al Jazeera reported that women in Gaza were taking medication to delay their periods amid the Israeli offensive which has seen almost two million people displaced, and living in overcrowded conditions without access to hygiene products due to a blockade on imports.
They reported that some had resorted to taking norethisterone tablets, which is a synthetic form of the natural hormone progesterone.
It delays periods by stopping ovulation and is available in the UK in Boots, but the chemist warned it should not be used for more than 27 days, as there is an increased risk of side effects the longer it is taken including worsening migraine, diabetes, asthma, depression, and epilepsy.
Mum-of-four Ruba told the broadcaster how she had taken the medication and was not the only one in her circle to do so: ‘Other women around me in the school have asked me for these pills. One of them told me that she had gone through the worst period in her life. I know of their negative side effects, but these pills cannot be more harmful than the missiles, death and destruction all around us.’
Rafa told Metro how rural women and girls already face challenges with water and sanitation, from generally being the ones sent to fetch fresh water, which puts them at risk on what can be a long trek alone, to being vulnerable while using communal toilets.
After floods or cyclones, the issue is compounded: ‘Imagine having water everywhere around you and there’s no clean water to drink and no toilet that you can use.’
In the most recent severe flooding to hit Bangladesh this summer, almost 100% of the water points and toilets were not functioning in some villages, she said, with whole toilets and taps underwater.
‘If you are a girl and you are menstruating and you don’t have a clean toilet to use, that holds you back and is a problem for you,’ she said.
Her open letter calls on the government to ‘prioritise clean water across your international policy and investment decisions’ and for countries to work together to fulfil their promises made when they adopted hen they adopted the United Nations Sustainable Development Goals (SDGs) in 2015.
Read the full letter here.
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