Sexual-health counselor Lynette Medley planned to discuss self-esteem and healthy relationships with the 15-year-old girl who walked into her Mount Airy office in 2016.
But almost immediately, the girl brought up a much more pressing concern: she couldn’t afford tampons or pads.
She told Medley that she scavenged in lost-and-found boxes for socks and gloves, which she would wrap in toilet paper and layer with construction paper to absorb excess blood.
“How am I supposed to respect my body,” the girl asked, “when one week a month, I don’t even have supplies to take care of it?”
Medley set out to provide an answer. The 50-year-old CEO and founder of No More Secrets Mind Body Spirit, a sexuality awareness and counseling organization, began buying menstrual cycle products and collecting donations of pads and tampons from others to distribute to girls and women in need.
Three years later, Medley now delivers free pads, tampons, and feminine wipes to more than 75 homes across Philadelphia each week. She also drops off bins of products at local libraries, recreation centers, and churches.
The inability to afford period products is so common that it actually has a name: period poverty. It’s gained attention in recent years as an issue in developing countries, and a documentary on the topic produced by a University of Pennsylvania student recently won an Oscar.
But “people don’t even realize it exists here, too,” Medley said.
Nearly two-thirds of women surveyed in St. Louis were unable to afford pads or tampons at some point last year, according to a study published in February. For one in five, affordability was an issue every month. Many women said they had to choose between buying food and buying period supplies.
Pads and tampons are not covered by Supplemental Nutrition Assistance Program benefits, commonly known as food stamps, or other government programs to assist low-income families.
Access is further complicated by societal taboos that discourage open conversation about menstruation, and leave many women embarrassed to ask for help.
In the St. Louis study, some women turned to hospital emergency rooms for pads and tampons, while others made do with cloths, tissues, or diapers. A few women admitted they had stolen pads or tampons out of desperation.
The findings don’t surprise Medley. Girls often tell her they use toilet paper, paper towels, and newspapers when they can’t afford pads or tampons.
When Medley suggested one girl try a menstrual cup — a reusable container that has been shown to safely collect blood inside the vagina — the girl explained she doesn’t consistently have running water at home to clean the cup.
It’s not just women who are homeless or out of work who experience period poverty, Medley said. Many women who ask for donations are hourly wage earners struggling to meet their family’s needs.
Magda Martinez makes $12 an hour as an assistant teacher at a North Philadelphia preschool. As a single mother supporting four daughters, finding $40 a month to buy pads and tampons for all of them can be hard. Sometimes she borrows money from her mother.
“I am very careful that my daughters never have to go without,” said Martinez, 33.
Earlier this month, Martinez saw a post on Instagram about a woman delivering free period products in Philadelphia.
Martinez reached out and soon received four pink shopping bags from Medley filled with pads, tampons, and panty liners — enough to last five or six months.
That’s $200-plus in savings, she said. “It’s a blessing and a relief.”
In Medley’s Mount Airy office, pink bins cover three-quarters of the floor, overflowing with orange Always pads and blue Tampax boxes. Packages of Carefree panty liners lean against U by Kotex boxes. Purple overnight pads are piled precariously high, in danger of toppling.
“Those are the most requested ones,” Medley said. Many younger girls tell her they need thicker pads as they learn to manage heavy flows. If the girls buy cheaper products from the Dollar Store, they often have to use two at a time, negating any potential savings.
To request products, people message Medley on Instagram, visit her office, or fill out an online form. Medley and her 27-year-old daughter Nya McGlone then pack pink bags with about $50 worth of products for each person. They also pack larger bins with about $300 of products to drop off at churches, schools, and libraries.
In Philadelphia, where nearly 26 percent of the population is impoverished, including more than 126,000 children, many requests come from teenage girls or their parents.
Kimana Neblett, 17, works two part-time jobs. She saves up to buy a pack of pads each month from her neighborhood Walgreens in West Philadelphia. But if her paycheck is late or she works fewer hours in a given week, she sometimes has to ask friends for spares.
In California and New York, public schools are required to provide period products for free. Although there’s no such law in Pennsylvania or New Jersey, many school nurses keep supplies. This last school year, Philabundance donated 1,600 cases of pads to local schools, said Megan Lello, Philadelphia School District spokesperson.
But students say they’re typically given one pad or tampon to tide them over until they get home, and it can be embarrassing to ask for more.
“I might tell you I’m hungry or don’t have something to wear,” Medley said. “But they are so afraid of telling someone they don’t have access to [pads or tampons] because periods are so taboo.”
For 17-year-old Amirra Jenkins, of East Germantown, the pads provided by her school nurse weren’t thick enough, leaving her worried about ruining her clothes. Since Jenkins found Medley on Instagram, she’s received pads for her and her two teenaged sisters.
“Lynette even throws in goodies like a loofah sometimes,” Jenkins said.
Families with multiple daughters, who often get their periods at the same time, will sometimes try to ration products, Medley said. Make one pad or tampon last the whole day, for example.
But that can be dangerous, said Rachael Polis, a pediatric and adolescent gynecologist with the Crozer-Keystone Health System.
Pads should generally be changed every four to eight hours and tampons every four to six hours. Leaving a tampon in longer can put girls at risk for a rare but potentially life-threatening condition known as toxic shock syndrome, she said. And those who use makeshift pads of toilet paper or construction paper can develop rashes, vaginal infections, and abnormal bleeding or discharge.
Medley said some girls have told her they’ll take unprescribed birth control pills, collected from family or friends, at high doses in an attempt to stop their periods altogether.
Many are afraid to see a doctor because they think child welfare services will be called, she said.
“That’s the thing with period poverty,” Medley said. “It stops you from getting every other service you need.”
One man who heard about Medley’s work thought periods were a voluntary action, like urination, and asked her why girls couldn’t “just hold it” until they went to the bathroom.
Now Medley uses every period product delivery as an opportunity to educate and get people talking about periods more openly.
During a trip to drop off products at Open Door Mission True Light Church on 52nd Street in West Philadelphia, Medley struck up a conversation with Bishop Maureen Davis. Although discussions of periods can be taboo in religious communities, Davis said the pad and tampon donations were crucial for her church. Many parishioners struggle to afford food, let alone period products.
“We can’t maybe preach about this topic at the pulpit,” Davis said, “but in smaller group events, we can talk about it and teach youth about it.”
At the South Philadelphia Free Library, children’s librarian Link Ross noticed a need, too. In May, the library began distributing free hygiene kits, which include socks, soap, toothpaste, deodorant, and period products. In two months, Ross gave out more than 70 kits.
“It’s not necessarily the people you’d expect who request them,” Ross said. One woman, for example, is a regular patron who is now between jobs.
Since grant funding for the program ran out, the library has been relying on donations. The products Medley donated will supply pads and tampons for the kits for months, Ross said.
Medley hopes that, one day, period products become commonplace — as normal in a school restroom, gym, or library as they are in her office. Until then, she’ll keep delivering them herself.
After one recent home delivery in West Philadelphia, Medley walked across the street, approaching a group of women watching over their kids splashing around in an inflatable pool. “Y’all don’t know me,” she said, handing them a business card. “But if you ever need some pads or tampons, call me.”