Beyond water scarcity and waste: Safe periods in a climate crisis

"It gets itchy around my privates, to the point where I get rashes. It gets worse when I walk, and I'm afraid my pad will fall out of place," said 26-year-old Sumi.

Sumi's story may echo the common discomfort many girls and women face with irritating sanitary pads, but this is where the similarities end.  Sumi has spent all her life in Koyra. Koyra is about a 3-hour drive and almost 100 kilometres away from the city of Khulna. It is a disaster-prone coastal region with frequent cyclones, and scarce clean water due to rising salinity & lowering water level.

The salty water has proven to be difficult to drink and even more difficult to properly wash menstrual rags with. For women like Sumi, these shape the most intimate aspects of her daily life, including how she manages her period. With clean water becoming a luxury, Sumi had no choice but to switch to disposable pads, which come with limitations too. 

While living on a household monthly income of Tk20,000, she can only afford to spend 45 to 50 taka on the cheapest sanitary napkin brand from the corner drugstore. This means Sumi gets by with changing her pads only twice a day, every time her period comes—an unsafe routine she has been forced to normalise.

In a place where even finding water to rinse a cloth can be a challenge, menstrual care becomes an unsustainable feat.

Ground Zero: Southern coastal Bangladesh

Bangladesh, though responsible for less than 1% of global greenhouse gas emissions, is often referred to as ground zero for climate change. Bangladesh experienced 185 extreme weather events between 2000 and 2019, resulting in the loss of 11,450 lives and economic damages totalling $3.72 billion. This small South Asian nation is paying a disproportionately high price for a problem it didn't cause.

The country's vulnerability lies in its geography, and these features place southern coastal Bangladesh on the frontlines of climate-induced hazards. Nowhere is this more evident than in the Khulna Division. Take Koyra- Sumi's home, as a case in point. Koyra sits at the edge of the Sundarbans and is criss-crossed by seven rivers. Residents here are no strangers to loss, which is a perennial crisis. 

They've survived Aila (2009), Fani (2019), Amphan (2020), Yaas (2021), and most recently, Remal (2024). Each storm leaves behind a trail of broken embankments, flooded fields, uprooted homes, and families stripped of basic necessities.

The slow poison, however, is not the weather—it's the salt. Among the most persistent and insidious threats are sea-level rise and saline intrusion. On May 25, 2009, Cyclone Aila submerged six unions of Koyra in brackish water. Residents had to walk miles to drink safe water. And then there's commercial shrimp aquaculture. Freshwater ponds are turned into saltwater enclosures to raise shrimp for export. But over the years, the salt has seeped into the surroundings. 

A 2010 survey confirmed that salinity had increased by 26% in Bangladesh within the last four decades. A UNDP survey found that 73%of the people living in five coastal upazilas, including Koyra, drink unsafe saline water. Even the food is salty. 

The impacts are not limited to a drinking water crisis. Prolonged exposure to saline water is driving a public health crisis: rising cases of high blood pressure, skin conditions, waterborne diseases, and reproductive and menstrual health complications. 

Intersection of climate change and women's health

Climate change is not gender-neutral. For many women and girls along Bangladesh's coast, the climate crisis arrives every month. Coastal women face the double burden of not having water available to wash clothes in, and having only salty or dirty water to do so when it is accessible.

More than 80%of women and girls in Bangladesh still rely on menstrual cloths. A 2019 study found that around 72% of the over 100 participants of a study in Koyra reported using reused cloths rinsed in saline water. Repeating this every cycle exposes them to genitourinary infections. 

Doctors are seeing an uptick in urinary tract infections, vaginal infections, pelvic complications and in severe cases, women undergo hysterectomies, which is the removal of the uterus. There are also reports of elevated cervical cancer risks. Hospital records show a worrying increase in miscarriages, and Icddr b  has found that women living closer to the coast were more likely to miscarry than those farther inland.

Women and adolescents have begun taking birth control pills to stop menstruating during dry seasons. This comes with real risks to both mental and reproductive health, experts warn.

For many, the issue comes down to cost. Sanitary pads would offer a safer and water-efficient option, but they're out of reach for many. There is no investment in locally available alternatives that could offer both cost relief and reduce pressure on scarce freshwater resources.

However, while anecdotal evidence and hospital records suggest a correlation between salinity and women's health issues, no one knows with certainty the cause since no concrete research has been conducted yet.  The stories are real, but the data is sparse.

A climate-adaptable solution - cupvert

Intensifying climate change calls for innovation tailored to the unique challenges faced by climate-vulnerable communities.  One intervention that has shown promise on the coast is Cupvert, a menstrual cup awareness campaign that challenges both affordability and access in coastal Bangladesh. A menstrual cup is a period product made of medical grade silicon, that is to be inserted in the vaginal canal during menstruation. 

By promoting menstrual cups — a one-time investment that can last up to 10 years — Cupvert offers a sustainable alternative to single-use pads that not only reduces waste and long-term costs but also minimises water usage. 

Unlike cloth pads that require frequent washing, menstrual cups can be cleaned with a small amount of boiled water, making them a practical solution for women in saline or water-scarce regions. Beyond free-of-cost product distribution, Cupvert works to dismantle menstrual stigma through education and peer-led support, ensuring that adoption is safe, informed, and empowering.

Cupvert began as a pilot by Give Bangladesh in early 2025, developed in response to urgent conversations with women in Koyra, an area affected by salinity, water scarcity, and poverty. The project started small, selecting seven interested women with the support of a local partner. The cohort spanned from ages 18 to 35+, and was a medley of marital statuses and parity. Some were homemakers; some were students.

Each participant received a reusable menstrual cup during a detailed hands-on training led by a physician, and an instruction manual written in Bangla. The initiative included regular follow-ups over three months by volunteers, a phone hotline for ongoing support, and incorporated data collection to track the acceptability and feasibility of the cup over time and across cohorts.

"Previously,  I used to get 'infections' during every period, but not this time. I used to feel damp all the time, but with the cup, I don't feel anything at all—no fear of leakage, and I'm using less water"- Sumi reported, two months into using the menstrual cup. 

By May, these women gained confidence and became Cup Ambassadors in their villages. After observing positive impacts such as improved comfort, reduced irritation, and water efficiency, Give Bangladesh has planned to launch Phase 2 around Menstrual Hygiene Day with fifty more interested women. This phase will expand to two new cohorts, aiming to serve more than one hundred beneficiaries.

Necessity in the face of climate change

"I've already told a few women in my circle. Some of them just laughed and couldn't believe that a cup could actually be used. Others asked in disbelief if it really works!"- 30-year-old Salma, a homemaker, shared with the Cupvert team. "To them, I replied, 'If those 'apus' can use it, why can't we?' "

As climate change intensifies, embracing innovation is crucial. Supporting and scaling solutions, and tailoring safe period products to the local context, is a vital step toward safeguarding women's well-being and advancing public health in an era of climate uncertainty.

Dr Sadah Hasan is a public health researcher and was the campaign manager of Cupvert under the Give Bangladesh Foundation. 

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