Menstrual health inequities in carceral settings: a global systematic review.

Abstract

This study aimed to synthesise global evidence on menstrual health experiences, needs, and barriers among incarcerated populations and identify opportunities to advance menstrual health equity in prison settings. Following PRISMA guidelines, we systematically searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar for studies published between January 2000 and December 2025. Quantitative, qualitative, mixed-methods studies, and relevant grey literature were included. Two reviewers independently screened studies, extracted data, appraised quality, and synthesised findings narratively. Twenty-two studies from 12 countries across six continents were included. Severe menstrual inequities were consistently reported, including inadequate access to menstrual products, poor sanitation, limited healthcare, and widespread stigma. Product shortages forced prolonged use, increasing risk of infection and toxic shock syndrome. Inadequate water, privacy, and hygiene facilities compromised menstrual management. Correctional staff frequently controlled access to products, with reports of humiliation, denial of supplies, and coercive practices during menstruation. Menopausal women, transgender and gender-diverse individuals, and those with heavy bleeding experienced compounded neglect due to non-inclusive policies and inadequate healthcare. Menstrual health inequities in prisons represent a significant public health and human rights concern. Policy reform and ensuring access to adequate menstrual products, sanitation and gender-responsive healthcare is essential in correctional settings.