Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 2;22(1):156.
doi: 10.1186/s12978-025-02103-0.

Mapping the health outcomes of menstrual inequity: a comprehensive scoping review

Andrea García-Egea #  1   2 , Georgina Pujolar-Díaz #  1   2 , Astrid Boe Hüttel  1   2 , Anna Sofie Holst  1 , Constanza Jacques-Aviñó  1   2   3 , Laura Medina-Perucha  4   5   6
Affiliations

Mapping the health outcomes of menstrual inequity: a comprehensive scoping review

Andrea García-Egea et al. Reprod Health. .

Abstract
in English, Spanish

Introduction: Menstrual inequity refers to the systematic and avoidable differences experienced by women and people who menstruate, based on having a menstrual cycle and menstruating. Given the paucity of prior research examining the impact of menstrual inequity on health, a scoping review was conducted to explore and map out the menstrual inequities and their association with health outcomes in women and people who menstruate within the published academic literature.

Methodology: Two searches were conducted in May 2022 and March 2024 in PubMed and Scopus. Academic literature published until December 2023 was included. Following the screening process, 74 articles published between 1990 and 2023 were included in the review. Results were then synthesised through narrative analysis and organised into nine categories.

Results: A range of both physical and emotional health outcomes were documented to be associated with menstrual inequity. Urinary tract infection, reproductive tract infection, and other genital discomforts (e.g. itching) were linked to certain menstrual discomforts (e.g. dysmenorrhea) as well as a lack of access to menstrual products, menstrual management facilities and/or menstrual information. The emotional health outcomes, especially anxiety, distress and depression, were salient and were shown to be related to menstrual stigma, the lack of menstrual information and the limited access to menstrual-related healthcare.

Conclusions: The majority of the included studies were focused on menstrual management, being one of the most addressed themes concerning menstruation, and the health outcomes were mainly reproductive tract infection and emotional/mental health. Expanding the range of health outcomes studied will strengthen research and inform policy. Further research is needed to better understand the complex association between menstrual inequities and other potential health outcomes.

Resumen: INTRODUCCIóN: La inequidad menstrual se refiere a las diferencias sistemáticas y evitables que experimentan las mujeres y las personas que menstrúan, basadas en el hecho de tener un ciclo menstrual y menstruar. Dada la escasez de investigaciones previas que examinen el impacto de la inequidad menstrual en la salud, se llevó a cabo una revisión de alcance para explorar y mapear las inequidades menstruales y su asociación con los resultados de salud en mujeres y personas que menstrúan dentro de la literatura académica publicada. METODOLOGíA: Se realizaron dos búsquedas en mayo de 2022 y marzo de 2024 en PubMed y Scopus. Se incluyó la literatura académica publicada hasta diciembre de 2023. Tras el proceso de cribado, se incluyeron en la revisión 74 artículos publicados entre 1990 y 2023. Los resultados se sintetizaron mediante un análisis narrativo y se organizaron en nueve categorías.

Resultados: Se documentaron una serie de resultados en salud, tanto físicos como emocionales, asociados a la inequidad menstrual. Las infecciones del tracto urinario, las infecciones del tracto reproductivo y otras molestias genitales (p. ej., picor) se relacionaron con ciertas molestias menstruales (p. ej., dismenorrea), así como con la falta de acceso a productos menstruales, instalaciones para la gestión menstrual y/o información menstrual. Los resultados de salud emocional, especialmente la ansiedad, la angustia y la depresión, se destacaron y se demostró que estaban relacionados con el estigma menstrual, la falta de información menstrual y el acceso limitado a la asistencia sanitaria relacionada con la menstruación.

Conclusiones: La mayoría de los estudios incluidos se centraron en el manejo menstrual, siendo uno de los temas más abordados en relación con la menstruación, y los resultados en salud principalmente reportados fueron las infecciones del tracto reproductivo y la salud emocional/mental. Ampliar la variedad de resultados en salud fortalecerá la investigación y orientará las potenciales políticas. Es necesario realizar investigaciones para comprender mejor la compleja relación entre las inequidades menstruales y otros posibles resultados en salud.

Keywords: Emotional health; Health outcomes; Menstrual inequity; Menstruation; Reproductive tract infections; Scoping review; Social determinants of health.

Plain language summary

Menstruation and the menstrual cycle are connected to the overall health of women and other people who menstruate. Menstrual inequity refers to the unfair situations and barriers that women and people who menstruate face because they menstruate. These include not having access to proper menstrual healthcare, menstrual education and knowledge, menstrual products, lacking services and facilities for menstrual management, experiencing menstrual stigma and discrimination, and the ability to fully participate in social, community, political and economic spheres. All these challenges can have an impact on their overall health. This study had the objective to explore these menstrual inequities and their association with health outcomes in women and people who menstruate in the published academic literature. We included information from 74 articles published until December 2023. The findings showed that menstrual inequity is linked to various health issues. For example, physical healthproblems, like urinary or reproductive tract infections, were often linked to difficulties managing menstruation. Moreover, emotional health issues like anxiety, distress, and depression were connected to experiences of menstrual stigma and discrimination, and having limited access to menstrual healthcare and education. This review also found that more research is needed about the relationship between menstrual inequity and health outcomes to fully understand how menstrual inequity affects women and people who menstruate. By doing so, researchers can provide better information to guide policies and improve health of women and people who menstruate.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the ethics committee of the Institut de Recerca en Atenció Primària Jordi Gol i Gurina (IDIAPJGol) (Research Institute in Primary Health Jordi Gol i Gurina). Ethical approvals were obtained on 2nd of June 2022 (REF. 19/178-P). All activities included in the study were carried out according to existing guidance in ethics as indicated in the Universal Declaration on Bioethics and Human Rights adopted by UNESCO (19/10/2005); the Council of Europe Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (1997) and its additional protocol on biomedical research (2005); the Helsinki Declaration (2013) and relevant EU laws (European Parliament and Council Directive 2001/20/EC); the Spanish Law on Biomedical Research (14/2007) and the LOPD (Spanish Law on Personal Data Protection) (3/2018). Consent for publication: Not applicable. Competing interests: The authors declare having recently received funds from DIM Protect to support the team’s research on equity and menstrual health in Spain. DIM Protect was not involved in the conceptualization or development of this study. The authors declare no other conflict of interest.

Figures

Fig. 1
Fig. 1
Flow-chart of study screening process. *Several studies were excluded for multiple reasons, so the sum of these is not equivalent to the total of excluded articles
Fig. 2
Fig. 2
Categories of menstrual inequities that guided the analysis
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Holst AS, Jacques-Aviñó C, Berenguera A, Pinzón-Sanabria D, Valls-Llobet C, Munrós-Feliu J et al. Experiences of menstrual inequity and menstrual health among women and people who menstruate in the Barcelona area (Spain): a qualitative study. Reprod Health. 2022;1–16. - PMC - PubMed
    1. Sharp GC, De Menarche GL. Menstruation, menopause and mental health (4 M): a consortium facilitating interdisciplinary research at the intersection of menstrual and mental health. Front Glob Women’s Heal. 2023;4:1258973. - PMC - PubMed
    1. Mirin AA. Gender disparity in the funding of diseases by the U.S. National institutes of health. J Women’s Heal. 2021;30(7):956–63. - PMC - PubMed
    1. Bailey AH, LaFrance M, Dovidio JF. Is man the measure of all things?? A social cognitive account of androcentrism. Personal Soc Psychol Rev. 2019;23(4):307–31. - PubMed
    1. Lara-Vargas EJ. Los Viejos caminos y Las nuevas posibilidades: Marcas androcéntricas y epistemologías Feministas En Las representaciones sociales de La menstruación. Rev Estud Contemp Del Sur Glob. 2022;3(9).

Publication types

LinkOut - more resources