Bako Orionzi
Menstrual poverty (ie, the systemic lack of access to menstrual hygiene products, education, and sanitation) represents a profound barrier to health equity. This article examines the physical, psychological, and socioeconomic toll of period poverty, with a particular focus on adolescent, as well as transgender and gender-diverse, populations who face unique structural vulnerabilities. While state-level legislation expanding product access in public schools has proliferated, critical implementation deficits remain regarding comprehensive education and physical infrastructure. At the local level, evaluations reveal that administrative friction and structural barriers continue to marginalize underserved cohorts. To dismantle these inequities, pediatric primary care and adolescent medicine clinicians must play a transformative role. By operationalizing menstruation as the fifth vital sign through clinical screening, establishing cost-free distribution networks, and engaging in legislative advocacy (eg, lobbying for sales tax elimination, expanding federal assistance frameworks), clinicians can lead the movement toward comprehensive menstrual health equity.