When people talk about period poverty, they often focus on access to free or cheaper period products.

But products are only half the story. A recent report by Slovak NGO Intymyta links the problem to broader sanitation issues. It found that 28% of respondents across Slovakia – disproportionately from low-income families and marginalised groups – don't have access to warm water, and 25% don’t have access to a shower or a flushing toilet.

These issues feed into so-called menstrual exclusion, a term describing the social exclusion many experience during their period.

Natália Blahová, the author of Intymyta's report, told us that exclusion varies depending on where you live and how old you are: “Among younger menstruators, exclusion may manifest through school absences, while adults may experience difficulties participating fully in social life or meeting workplace expectations.”

In Germany, for example, a 2022 survey found that 29% of women stay home during their period because they fear ill-equipped or dirty toilets outside their home.

“The school toilets are a catastrophe! In Berlin, 60% of school bathrooms are not functional,” Ina Jurga, international coordinator of the Menstrual Hygiene Day, told us.

Besides insufficient access to products and sanitation facilities, exclusion also manifests in lacking medical care and information about period health. Last year, a Europe-wide survey found that 54% of respondents – both men and women – had never heard of any medical condition related to menstruation.

Without reliable information about their health and bodies, young girls can fall into a cycle of school absence.

“Because young people encounter information in many different environments, responsibility should be shared between families, schools, and healthcare systems,” Blahová told us.

“Schools play a particularly important role in ensuring equal access to accurate information, especially for children who may not receive such support at home.”