New Menstrual Health State Report Card Highlights Policy Gaps

One-third of states received an overall grade of “D” or below for menstrual health

April 20, 2026

A new Menstrual Health State Report Card for each state was released by Days for Girls International in partnership with ISSA, the Association for Cleaning and Facility Solutions. The report reveals significant gaps in how states address period poverty, while pointing to clear, bipartisan solutions already working across the country.

The report cards evaluate all 50 states across five core policy areas:

  1. menstrual product taxation
  2. provision of products in schools
  3. provision in public buildings
  4. provision in incarceration facilities
  5. Good Samaritan liability protections for donated menstrual products

The findings are stark: Nearly one-third of states received an overall grade of “D” or below, while only five states earned an “A” or “A-” for their menstrual health policy landscape.

“This is a policy blind spot for many states, and one that can be fixed through advocacy and awareness,” said Jess Strait, Days for Girls International senior global advocacy manager. “These report cards show that menstrual health remains one of the few bipartisan bridge-builders in American politics today.”

Despite uneven progress nationwide, the report highlights that these policies do not follow partisan lines. For each policy category measured, both Republican- and Democrat-led states achieved top scores, demonstrating that access to period products is a shared public health and dignity issue—not a political wedge.

“These report cards make something unmistakably clear—that making period products as available as toilet paper and paper towels is not only the right thing to do but it is also good public policy,” said John Nothdurft, Vice President of Government and Public Affairs at ISSA. “The cleaning and facility solutions industry has a critical role to play in addressing period poverty because our industry manages restrooms, supply chains, and procurement decisions in buildings across America. When states increase access to period products in public facilities, it’s our industry that implements those policies on the ground. We need clear, consistent legislation that allows us to ensure dignity and access for everyone who walks through the doors of the buildings we serve.”

The Menstrual Health State Report Cards are designed as a practical advocacy tool, translating complex statutes into an accessible, state-by-state snapshot that policymakers, advocates, and stakeholders can use to drive reform. Each state’s report card includes tailored recommendations to improve scores and expand access—from eliminating the tampon tax to ensuring free menstrual products in schools and public buildings.

Click here for the full Menstrual Health State Report Cards and state‑specific recommendations.

To learn more about ISSA’s campaign to End Period Poverty, contact John Nothdurft.

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