Bleeding Behind Bars: Menstrual Policy, Dignity, and Inequality in U.S. Prisons

Introduction

While period poverty impacts women all over the globe, it is especially prevalent in prisons. Currently, women are the fastest growing segment of  prison populations across the country, and the majority of incarcerated women are in reproductive ages, experiencing menstruation. Lack of access to safe and effective menstrual products create health risks and stress among incarcerated women, and often leave women in desperate positions to create their own products or exist in unsanitary conditions. Some incarcerated women report using scraps of T-shirts  to create their own pads, or toilet paper to serve as tampons. Others view menstruation as one of the worst parts of their incarcerated experience.

In an article published in the Guardian, an incarcerated woman describes only being able to change her menstrual product once a day during her cycle, and notes others go several days using the same soiled product, because more products were not available. The same article details that some of the products offered in prison are ineffective, with one describing prison tampons as nonabsorbent , or “essentially waterproof,” and noting that prison pads do not have the same adhesive capabilities as traditional maxi pads. Another account from a woman in Oklahoma describes how in a single day she bled through every pair of her allotted prison underwear, and how there are no available resources to adequately launder blood stains from clothing and sheets. One journalist described getting your period in prison as “hell.” Her article went into detail about the horrors of vaginal infections from unsanitary products, stringing multiple pads together due to low quality absorbency, leaking blood on bedding and floors, and the decision some incarcerated women have to make between purchasing menstrual hygiene or calling their children. While each of these stories are equally chilling, the underlying, unspoken revulsion is the state’s callousness at allowing these conditions to persist

Although some prisons offer the option for those incarcerated to purchase their own menstrual products from the prison commissary, the availability to make these purchases are often dependent on the cost of the products, how much the woman earns in a prison job, whether or not family are able to financially support the incarcerated woman by depositing money in their prison account, and whether they have other needs that also require purchase (for example, toothpaste, deodorant, or shampoo). Sometimes, incarcerated women are largely priced-out of menstrual hygiene purchases, leaving them with limited options to hygienically control their bleeding. One study determined that in a prison in Missouri, one box of tampons cost roughly the equivalent of a month’s worth of pay for an entry-level prison job.

The lack of consistency in quantity and quality of prison menstrual hygiene products, along with high costs, lack of options, and the coercive environment of prisons can make effective product procurement difficult or impossible.  This has led some researchers to acknowledge the “menstruation frustration” that plagues many incarcerated women. 

Statutory Review

As scholars who were both shocked and horrified by narratives of the plight of incarcerated women and the challenges they face securing basic menstrual hygiene products, we embarked on a study to gain a comprehensive insight into jurisdiction prison policy and procedure regarding access to menstrual products. To understand how incarcerated people in the United States access menstrual products, we reviewed every jurisdiction’s laws and Department of Corrections (DOC) policies. Our team searched multiple sources—including LexisNexis, Google, DOC websites, and the University of Utah law library—to locate any statutes, rule books, or policy manuals that mentioned menstrual products. We used a wide range of search terms and combinations to capture different phrases jurisdictions might use. Below is a list search terms we used for menstruation, incarceration, and policy.

• Menstruation: menstru*, menstruation, menstrual, menstruator, period
• Incarceration: incarcera*, incarcerated, incarceration, prison, jail, detention, carceral
• Policy: policy, regulation, statute, rule, handbook

For each jurisdiction, we examined whether a policy existed and what it covered. We focused on five key issues: whether the jurisdiction had a policy at all, how many products were provided, the types and quality of products available, how people requested them, and whether they had to pay. After identifying the policies, we used content analysis to see which concerns each policy addressed. We then compared jurisdictions’ approaches and looked at whether political affiliation was linked to differences in policy content.

Our review covered policies from all 50 U.S. jurisdictions to understand how they address menstrual product access for people who are incarcerated. Nearly all jurisdictions—46 out of 50—had at least one written policy, whether in state law, administrative rules, or Department of Corrections (DOC) handbooks. Only four jurisdictions had no written guidance at all: Iowa, Kansas, Massachusetts, and Wyoming.

Inadequacy of Policy and Law

Explore the interactive map of prison menstrual policies here.

Even when policies existed, they were often incomplete or vague. Less than half of the jurisdictions with policies (19 out of 46) explained how a person actually obtains menstrual products. The language used tended to be broad and non-specific, relying on phrases like “upon request,” “as needed,” or “appropriate quantity” without saying who approves the request, how quickly products are provided, or what happens if someone needs more. Georgia appeared to have one of the more generous models by stocking hygiene cabinets in housing units, but even this policy did not explain how individuals access those supplies.

Policies were similarly vague about the amount of product available. Seventeen jurisdictions mentioned quantity, but most avoided specifics, using terms such as “sufficient supply” or “reasonable amount.” Only a few jurisdictions provided any numbers, and even then, they did not specify over what period these products were allotted—for example, whether “one box” or “20 items” referred to a monthly distribution or something else.

Product quality was entirely absent from every statute, rule, and handbook. When product types were listed, they usually included pads and sometimes tampons. Only a handful of jurisdictions mentioned additional options such as menstrual cups, sponges, or pantyliners.

When it came to cost, 30 jurisdictions stated that the jurisdiction would cover menstrual products at least in part, usually through the DOC. A few jurisdictions split costs with counties or required individuals to pay for supplemental products.

Finally, we looked at whether political affiliation played a role. Surprisingly, slightly more Republican-led jurisdictions had menstrual product policies (19) compared to Democrat-led (17) or swing jurisdictions (10). A small number of jurisdictions in both parties had no policy at all.

The Menstruation Frustration of Incarcerated Women

This study highlights how menstrual health—often treated as too private or taboo to discuss—is an essential part of overall well-being, especially in carceral settings where individuals depend entirely on institutions for basic needs. Prior research has shown that prisons can intentionally or unintentionally control or demean incarcerated people by limiting menstrual products, offering poor-quality supplies, or restricting access to comfort and hygiene. Our findings reinforce that pattern. While most jurisdictions have at least one policy or statute related to menstrual products, the depth and clarity of these rules vary significantly. Four jurisdictions have no guidance at all, leaving thousands of incarcerated menstruators without basic institutional protection.

Even in jurisdictions that specify product quantity, wording is vague and rarely tied to medical needs or the realities of a menstrual cycle. Past studies show that inadequate product amounts can lead to health and hygiene problems, and our findings suggest that many individuals may still not receive enough supplies. More concerning is that no policy mentions product quality, despite widespread reports that provided items are flimsy, uncomfortable, or ineffective. Similarly, very few jurisdictions offer a meaningful range of products. Because menstruation differs from person to person, limited product choice can create both physical discomfort and medical risk.

Cost coverage is more commonly addressed, but even here, inconsistencies remain. When incarcerated women are expected to pay for supplies, it deepens existing economic hardship and period poverty. We also found that some jurisdictions list a “policy” but fail to describe any details—highlighting a major gap between having policy language and ensuring meaningful menstrual support. Overall, the results show that while progress exists, menstrual care in prisons remains inconsistent, incomplete, and deeply inequitable.

Conclusion

Based on these findings, several key policy changes are needed to ensure menstrual equity in correctional settings.

• Provide free, easily accessible menstrual products
• Offer a variety of product options

Institutions should provide free, easily accessible menstrual products that do not require asking a correctional officer or obtaining formal approval. Unlimited access is essential so that menstruators can take products as often as needed without stigma, scrutiny, or power-based gatekeeping. Product variety is equally important; because menstrual needs differ widely, prisons should offer multiple types of products—including pads, tampons, menstrual cups, and pantyliners—so individuals can choose what best supports their health.

However, addressing access and product choice is only the starting point. Future research should examine the practical realities of distribution by speaking with correctional staff and medical providers, and should explore the health consequences of inadequate menstrual care. Policies must also address overlooked concerns such as menstrual pain, disorders like endometriosis, and the need for additional laundry, bedding, or adjustments to strip searches during menstruation. 

The lack of attention to women’s dignity is both alarming and depressing. While efforts have recently been made to improve the condition of menstruating women in prison, these efforts have been slow, and they are not comprehensive. In discussions about cost and quantity of products, often neglected is a focus on human dignity. If jurisdictions focus first on maintaining the dignity of incarcerated women, viable period policy will inevitably follow, despite the jurisdiction’s political or social agenda. Without these considerations, incarcerated women face unnecessary humiliation, discomfort, and medical risk. Ultimately, true menstrual justice requires comprehensive, detailed policies that prioritize dignity, safety, and bodily autonomy—not minimal or symbolic references within rulebooks.