Comprehensive menstrual policy frameworks for an integrated future: bridging health, education, economic, and mental wellbeing gaps
Abstract
BackgroundAn estimated 1.8 billion people menstruate globally each month, yet menstrual health remains one of the least integrated issues in mainstream public policy. For most of the past century, government engagement with menstruation was confined to isolated product-distribution schemes or reactive responses to acute period poverty crises, rather than to coordinated legislative frameworks. This fragmentation has consequences that extend well beyond hygiene: menstrual stigma restricts access to nutrition, healthcare, mobility, education, and paid work, while unmanaged menstrual distress is independently associated with school absenteeism, reduced workforce participation, and adverse mental-health outcomes.ObjectiveTo synthesize the evidence base on the multi-sectoral consequences of fragmented menstrual policy; comparatively analyse selected national and sub-national policy models; propose a Comprehensive Menstrual Policy Framework (CMPF) integrating psychosocial wellbeing alongside product access, education, and environmental sustainability; and offer a strategic roadmap for implementation.MethodsNarrative policy review of national and sub-national menstrual health legislation, guidance, and gray literature published between January 2000 and April 2026, supplemented by peer-reviewed health-policy scholarship. Case studies were purposively selected to illustrate distinct policy trajectories (Scotland, Spain, India, the European Union, and the United States) and were assessed against a four-pillar analytic framework covering health/psychosocial wellbeing, education, economic equity, and environmental sustainability.FindingsThree developments over the past five years indicate the policy landscape is shifting from single-issue reform toward more integrated frameworks: (i) tax policy has moved decisively against the tampon tax, with Malta, Pakistan, and multiple US states removing menstrual-product taxes in 2025; (ii) labor law has begun to recognize menstrual health as an occupational welfare issue, with Spain (2023) and Karnataka, India (2025) as recent exemplars; and (iii) environmental regulation has begun to intersect with menstrual policy, notably through EU Ecolabel criteria. However, current interventions remain largely siloed by sector, and mental health remains under-addressed across all jurisdictions surveyed.Conclusions and policy implicationsA genuinely comprehensive menstrual policy framework must treat health, education, labor, tax, and environmental policy domains as interdependent, and must explicitly incorporate psychosocial wellbeing as a fourth pillar rather than a downstream by product. The paper concludes with a five-step strategic roadmap for policymakers, educators, and institutions.
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BibTeX
@article{rajaselvi2026comprehensive,
title = {{Comprehensive menstrual policy frameworks for an integrated future: bridging health, education, economic, and mental wellbeing gaps}},
author = {Jeneefer Jeba Rajaselvi and Navin Kumar},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1939401},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1939401},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comprehensive menstrual policy frameworks for an integrated future: bridging health, education, economic, and mental wellbeing gaps
AU - Jeneefer Jeba Rajaselvi
AU - Navin Kumar
PY - 2026
DA - 2026/11/12
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1939401
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1939401
AB - BackgroundAn estimated 1.8 billion people menstruate globally each month, yet menstrual health remains one of the least integrated issues in mainstream public policy. For most of the past century, government engagement with menstruation was confined to isolated product-distribution schemes or reactive responses to acute period poverty crises, rather than to coordinated legislative frameworks. This fragmentation has consequences that extend well beyond hygiene: menstrual stigma restricts access to nutrition, healthcare, mobility, education, and paid work, while unmanaged menstrual distress is independently associated with school absenteeism, reduced workforce participation, and adverse mental-health outcomes.ObjectiveTo synthesize the evidence base on the multi-sectoral consequences of fragmented menstrual policy; comparatively analyse selected national and sub-national policy models; propose a Comprehensive Menstrual Policy Framework (CMPF) integrating psychosocial wellbeing alongside product access, education, and environmental sustainability; and offer a strategic roadmap for implementation.MethodsNarrative policy review of national and sub-national menstrual health legislation, guidance, and gray literature published between January 2000 and April 2026, supplemented by peer-reviewed health-policy scholarship. Case studies were purposively selected to illustrate distinct policy trajectories (Scotland, Spain, India, the European Union, and the United States) and were assessed against a four-pillar analytic framework covering health/psychosocial wellbeing, education, economic equity, and environmental sustainability.FindingsThree developments over the past five years indicate the policy landscape is shifting from single-issue reform toward more integrated frameworks: (i) tax policy has moved decisively against the tampon tax, with Malta, Pakistan, and multiple US states removing menstrual-product taxes in 2025; (ii) labor law has begun to recognize menstrual health as an occupational welfare issue, with Spain (2023) and Karnataka, India (2025) as recent exemplars; and (iii) environmental regulation has begun to intersect with menstrual policy, notably through EU Ecolabel criteria. However, current interventions remain largely siloed by sector, and mental health remains under-addressed across all jurisdictions surveyed.Conclusions and policy implicationsA genuinely comprehensive menstrual policy framework must treat health, education, labor, tax, and environmental policy domains as interdependent, and must explicitly incorporate psychosocial wellbeing as a fourth pillar rather than a downstream by product. The paper concludes with a five-step strategic roadmap for policymakers, educators, and institutions.
SN - 2296-2565
ER -