This is the second blog in our series that examines how social determinants influence gender biases in public health research, menstrual hygiene product development, and women’s health outcomes.
Women’s sexual health 101
The average menstruating individual will experience 13 cycles per year and will menstruate around 500 times during their reproductive life span between the ages of 12 and 51. While teenagers prefer to use sanitary napkins or pads during the onset of their menstruating years, this preference typically shifts to tampons by the time they reach age 20. As such, the average menstruator will prefer tampons for most of the 500 periods they will have. During adolescent and young adult years, fertility and hormonal disruptions are mostly of minimal concern for young people, as their focus is on preventing pregnancy during this phase of life. However, research has shown that toxic metals—such as arsenic, lead, and cadmium—interfere with hormone regulation and cause fertility issues due to chronic exposure. Unfortunately, these toxic metals have been found in tampons. This new research raises grave concerns for menstruating individuals, particularly college students.
The community college campus and women’s sexual and reproductive health
The demographic makeup of community colleges is diverse and essential to many communities. In fall 2021, the Community College Research Center found that approximately 5.7 million students were enrolled in community colleges (36% of fall undergraduate enrollment in the United States). Of the community college student population during that year, 58% of students identified as a woman, 43% worked full-time, 32% were the first in their families to attend college, and 13% were single parents. The average age of a community college student is 27 while the median age is 23. It is also worth noting that two-thirds of Black women in higher education attend a community college, and of those, over two-thirds, or 74%, are single mothers. In addition, 72% of students attending two-year institutions pay for the cost of their own education, which is reflected in the non-traditional age of community college students. Consequently, students attending two-year institutions while funding their own education take longer to complete their program compared to their four-year counterparts. Students attending community college require flexibility to manage their coursework, take care of their family/personal needs, and address their external commitments, such as working.
It is common for students to arrive at college with minimal knowledge of how their bodies function. Gaps in knowledge pertaining to sexual and reproductive function may be attributed to varied access to comprehensive and scientifically based sexual health education in K-12 schools. Community college students are at a particular disadvantage because few community college campuses have health clinics or resource centers on campus to meet students’ health needs. Thus, community colleges rely on external partnerships to provide sexual and reproductive health services to support their students. Some external partnerships involve local health departments, such as the Howard County Health Department and Howard Community College in Columbia, Maryland, as well as public hospital systems, such as the collaboration between Parkland Health and Dallas College in Dallas, Texas. Other partnerships include national support from nonprofit organizations, such as the American Society for Emergency Contraception and Advocates for Youth.
In light of this issue—the lack of health services on community college campuses—the Institute for Women’s Policy Research launched Connect for Success, a national research and learning initiative that examines partnerships and synthesizes best practices to facilitate the expansion of sexual and reproductive health services and related support for community college students. One of the supports explored under this initiative examines how community colleges promote period education and combat period poverty on their respective campuses. Period poverty is an overlooked concern in the context of sexual and reproductive health needs and leads to negative health impacts for college students, including anxiety, depression, and financial vulnerability. To combat these stressors, it is recommended that access to menstrual products should be classified as a basic need for menstruating individuals. To increase access, some campuses offer tampons and maxi pads free or at a reduced cost on campus for students; however, this access does not extend to every college campus. Unfortunately, while the lack of access to tampons and maxi pads is still a huge problem, now tampon users must contend with the danger tampons present due to the toxic metals found in them.
Although it is not clear how concerned individuals should be about exposure to toxic metals when using tampons, there are known negative health risks associated with increased exposure to toxic metals. Specifically, consistent exposure to lead can complicate a student’s ability to engage in class and complete their coursework. It can lead to a range of issues, including fatigue, headaches, and abdominal pain to more serious problems related to kidney damage and cardiovascular conditions. In addition to considering the long-term health risks around hormone regulation and fertility, continued exposure to toxic metals may increase the risk of cancer for menstruating individuals. This is particularly concerning for menstruating BIPOC (Black, Indigenous, and people of color) individuals who are at an increased risk of developing and dying from cancer due to environmental exposure to toxic chemicals.
While sanitary napkins and tampons are usually preferred by adolescents and young adults, educators should encourage them to explore other menstrual products currently on the market. Some of these products include menstrual cups or discs. Not only do they have a lowered risk of Toxic Shock Syndrome (TSS) but they are considered more cost effective than sanitary napkins or tampons because they are reusable. Additionally, community college students exploring these alternative options may find that cups or discs are a better fit for their busy schedules. Furthermore, having community college students incorporate these alternative options into their lives earlier may decrease their exposure to toxic metals, thereby minimizing their risks of experiencing adverse health conditions.
Over the years, on a federal level, many bills were introduced related to menstrual health, equity, access, and/or taxation of products. In 2023, proposed federal legislation was introduced, known as the Menstrual Equity for All Act. This bill aims to address period poverty and includes provisions that would benefit institutions of higher education. If passed, it would offer incentives for colleges to provide free menstrual products (pads, tampons, and discs) on campus, ensuring that students have reliable access to these essential items.
Community colleges should look to the bill as an example and offer students access to these alternative options through programming and by utilizing various funding mechanisms. With adequate funding, community colleges can create on-campus period supply banks where students may receive menstrual products when they experience financial hardship. Establishing partnerships with local and national organizations that offer menstrual products and education support will aid in meeting menstruating students’ needs as well. Community colleges should seek sources of funding from foundations and corporate sponsorships that support health and well-being initiatives. Campus activity grants are another great way to support campus initiatives and increase outreach efforts around menstrual health.
When community colleges provide access to alternative menstrual products that are safe and affordable, they are doing their part in minimizing period poverty and ensuring students’ basic needs are met. Meeting this basic need allows students to fully participate in their education experience without unnecessary interruptions, increasing their chance of completing their program.
-
Acknowledgements and disclosures
The Brookings Institution recognizes individual diverse gender identities and is committed to upholding our values of diversity, equity, and inclusion while striving to use gender-inclusive language in our publications. Based upon the literature we have examined, this series uses definitions to highlight the gender spectrum, and the preferred language will be to use “women” and “men” referencing those who self-identify as these genders. Brookings acknowledges that non-binary and gender non-conforming individuals may face similar and different barriers and challenges to those who self-identify as women and men. The term is intended to include those who are discriminated against based on their gender identities and biological sex.
Commentary
Women’s sexual and reproductive health at community colleges
October 22, 2024