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What's The Missing Piece In India’s Menstrual Health Crisis?

According to the United Nations Framework Convention on Climate Change, women bear a disproportionate burden of climate change impacts, particularly in terms of health, making climate change a powerful risk multiplier for gender-based health inequalities

Climate change and menstrual health are two critical issues that, while often discussed separately, are deeply intertwined, particularly for women in low- and middle-income countries (LMICs) like India. This intersection reveals a hidden crisis of health inequity, where the escalating environmental challenges disproportionately burden women and girls, making the fundamental aspect of managing menstruation safely and with dignity increasingly difficult.

According to the United Nations Framework Convention on Climate Change, women bear a disproportionate burden of climate change impacts, particularly in terms of health, making climate change a powerful risk multiplier for gender-based health inequalities. India ranks 6th in the Global Climate Risk Index 2025 (Germanwatch), reflecting the country’s frequent and intense climate events.

For millions of women across India, these are not distant threats but daily realities that compromise their health and well-being, especially during menstruation. Imagine Sarita, living in a village in Assam prone to severe flooding. When the waters rise, her home is damaged, the local health centre is inaccessible, and the shops selling sanitary pads are submerged. Navigating waterlogged paths to find a safe, private space to change becomes a dangerous ordeal. Meanwhile, Meena in drought-stricken Rajasthan faces a different struggle. Water scarcity means prioritising drinking and cooking over washing menstrual cloths or bathing, increasing her risk of infection. These are not just inconveniences; they are profound challenges to health, dignity, and equity, amplified by environmental stress.

According to district-level profiling of extreme weather events in India, since 2005, over 55 districts have faced extreme floods year after year, putting 97.51 million people at risk annually, while in the past 15 years, 79 districts have endured recurring extreme droughts, threatening 140.06 million people each year. As India faces both extreme weather events (like cyclones and floods) and slow-onset climate impacts such as rising temperatures and sea-level rise, each of which disrupts essential menstrual health resources in different ways.

Extreme events destroy essential infrastructure such as homes, schools, healthcare facilities, and crucial water, sanitation, and hygiene (WASH) systems.

Power outages disrupt water pumps, and damaged roads cut off supply chains for menstrual products. Women are left without access to safe products, clean water, or private toilets, forced to use unhygienic alternatives like old clothes, often in crowded, unsafe conditions. In the aftermath of Cyclone Amphan (2020), severe disruption to services was witnessed, which forced women in West Bengal and Odisha to resort to unhygienic practices due to the lack or absence of menstrual products. Slow-onset changes are equally damaging. In coastal regions like the Sundarbans, rising sea levels are increasing the salinity of freshwater sources, severely limiting water available for hygiene. Women, often engaged in fishing and other livelihoods that expose them to contaminated saline water, face heightened risks of infections and menstrual health issues.

These climate impacts do not occur in isolation; they intersect with existing social determinants of health, creating deep fault lines of inequity. Widespread poverty, deeply entrenched gender inequality, and limited access to education make women and girls disproportionately vulnerable. Poverty makes essential menstrual products and access to clean water and sanitation unaffordable. Gender inequality means women often bear the brunt of climate impacts, from collecting scarce water to working in hazardous, physically demanding, climate-affected conditions, sometimes leading to severe health issues like uterine prolapse. Lack of education perpetuates harmful myths and taboos, hindering access to information and safe practices. The pervasive social stigma around menstruation further silences women, preventing them from seeking help or even discussing their needs during crises.

India has taken significant steps to improve menstrual health. Innovations like biodegradable pads and menstrual cups are slowly gaining ground. However, large gaps remain as highlighted by the National Family Health Survey-5 (NFHS-5), which shows that only 27.7 per cent of young women aged 15–24 have access to adequate MHH resources – a combination of safe products, clean water, soap, and private sanitation. This figure also masks stark regional disparities, with access significantly lower in central, eastern, and northeastern India. Period poverty, in this context, is not just about affordability; it's a multi-dimensional issue of lacking infrastructure, information, and a supportive environment.

Menstrual health is not only about hygiene, but is about gender equality, not only women empowerment but community empowerment. The intersection of climate change and menstrual health demands urgent, coordinated action to build climate-resilient systems that uphold the rights and dignity of all women and girls. This includes integrating menstrual health into disaster planning, investing in resilient WASH infrastructure, promoting sustainable products, expanding education, improving healthcare access, addressing social determinants, advancing research, and ensuring women's active participation in policy-making.

Echoing the core theme of the International Day of Action for Women's Health: Rights. Equality. Empowerment, addressing the impact of climate change on menstrual health, is not just a public health imperative but a vital step toward achieving gender equality and ensuring that all women and girls can live and participate fully, safely, and with dignity, paving the way to climate-resilient communities.

Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the views of the publication.

The article has been co-authored by Ravneet Kaur, Associate Portfolio Manager, Evidence 2 Impact, Swasti Health Catalyst and Dr. Syama B Syam, Portfolio Manager, Evidence 2 Impact, Swasti Health Catalyst