The burden of sanitary pads on fertility: The hidden reality

For nearly a decade of advocating for the removal of the 20 per cent taxes on menstrual products by some gender advocates and civil society organisations in Ghana, no action has been taken by any government in the country in that regard, except the usual political rhetorics by government’s officials that seem to suggest that an action will be taken to scrap such a tax. 

For many gender activists, the 20 per cent tax on sanitary pads is an act against womanhood—menstrual hygiene, particularly on poor girls and women. This is because with such taxes on sanitary pads, poor girls and women are unable to buy them, as importers transfer the tax cost unto the end users.

In rural communities, for instance, the high cost of sanitary pads have compelled some girls and young women to resort to the overdue use of menstrual pads, as well as untreated fabrics and tissue papers, which have dire health consequences on their lives, including fertility issues—it affects the fertility of reproductive women.

The latest 2021 National Housing and Population Census conducted by the Ghana Statistical Service (GSS), which put the country’s population at 34 million, women formed 51 per cent. What it means is that there are more women in Ghana and majority of these women are young people who use sanitary pads.

Many health experts have stressed the need for girls and women to ensure menstrual hygiene.  For instance, the World Menstrual Hygiene Day is celebrated on May 28 each year to raise awareness and to highlight the importance of good menstrual hygiene management at a global level. Making sanitary pads more affordable will help to improve menstrual hygiene in Ghana.

Victim speaks 

Mina Kumi (not real name) is a 55-year-old woman who resides in Otiakrom in the Eastern Region with the husband. Mina married his secondary school lover, Kwame Charles (not his real name), right after school at the age of 17 when her family realised she was pregnant for him (Kwame).

Unluckily for Mina, she lost the pregnancy to miscarriage. With a high hope of conceiving again, Mina’s expectation never came to a reality. She tried, and tried on many occasions, but to no avail.

For her, her failure to reconceive after losing her first pregnancy brought her all the pains in the world, especially living in a rural community where everyone knows everyone.

“Every day presented a new cause for me to be sorrowful; it has been my constant worry all these years” she remarked, pausing momentarily to reflect on situation.

For Mina, living in a village as a married woman without a child is nothing more than giving people the reason to constantly mock you.

“People are quick to cast insinuations that reminds you of your childless. You are reminded of your childlessness in every quarrel,” she observed, adding “Suicide has at a point crossed my mind.”

Following many years on stigma and mocking, Mina says she has now developed a thick skin to such mockery stunts.

“Now I am used to the stigma and nothing you say really bothers me anymore,” she indicates.

How I met Mina

I got to know Mina’s predicament when I attended a three-day workshop on infertility in the Eastern Region. Neatly dressed in Kente, Mina shared her story on infertility and the stigma she had endured in her village over the years.

The 55-year-old woman in her submission narrated how she came from a poor background and couldn’t afford a three square meal to talk of sanitary pads at the end of the month.

“My upkeep at then was 500.000 which is now equivalent to GH¢5. This, according to her, made it unable to afford all her sanitary pad needs. 

“There are instances where I don’t have enough money to buy the pad, so I either wear a pad for a prolonged period before changing or use toilet roll or tissue. In the end, there’ll be some blood stains in my dress,” she recounted.

Mina added, “While I battle with affordability, I never knew my activities were causing harm to my pelvic.”

Menstrual hygiene and fertility

According to research by Offman (2002), no matter how light your flow is, or even if there is no flow, bacteria can build up at your genital area and cause infections.

“It is expected that you change your pad every 3 or 4 hours to prevent bacteria building up at the place,” he noted, stressing that “if girls are not educated on the right use of the pad, it can lead to reproductive complications.” 

Like Mina’s case, many young girls and women are unable to afford sanitary pads, hence resorting to different materials when there are in their menses. What most of these girls and young women do not know is that such an act could have a dire implications on their childbirth—infertility.


Infertility is a major health condition around the world. The World Health Organisation (WHO), for instance, states that infertility affects up to 15 per cent of reproductive-aged couples worldwide. 

WHO demographic studies from 2004 shows that in sub-Saharan Africa, more than 30 per cent of women aged 25 to 49 suffer from secondary infertility—the failure to conceive after an initial pregnancy.

Infertility is defined as the failure to conceive after a 12-month period of regular unprotected sexual intercourse. This condition is further subdivided into primary infertility (couple that never ever conceive before) and secondary infertility (couple that has conceived before but now failing to fall pregnant again).

An expert’s view

Dr Emmanuel Kuma, a Senior Consultant and Head of department at Gynaecology & Obstetrics at the At Anton Medical Hospital, Kotobabi, Accra, in an interview with Ghanaian Times said over worn sanitary towels could cause urinary tract infections, vaginal infections and rashes, which could lead to complications. 

“Some women may suffer from genital infections due to poor menstrual hygiene or pelvic pain, which could lead to infertility. Pelvic infections can also cause heavy periods which may cause anemia and women tend to be negligent about these hygiene measures,” he explained.  

For him, more often than not, it was because of lack of adequate information as well as the tardiness of some women to consult gynaecologist on time that mostly lead to their inability to conceive especially with treatable conditions.

“An unclean or a dried out pad, worn over a long time can cause lot of localised allergic reaction, leading to irritation, itching and uneasiness” Dr Kuma indicated.

For him, excessively damp pad could harbour microorganisms and cause infection that in turn, can cause urinary tract and vaginal infections.

“Cleaning every time you use the washroom,  changing into a new pad frequently during your time of the month and avoiding the use of vaginal wash which has the tendency to kill the good bacteria are some of the good practices one can follow “he added.

He advised girls and all women who use sanitary pads to stick to one brand, as frequently changing brands could make you feel uncomfortable.


Convener of Alliance of Women in Media, a non-governmental organisation, Shamima Muslim, has appealed to the government to scrap taxes on sanitary pads, saying maintaining the taxes means “denying girls in the rural areas the use of sanitary pads due to the hike in prices of the product.” 

She is of the view that the taxes on sanitary pads was a disincentive to promoting sexual and reproductive health rights of women and girls in the country.

She also proposed that government invest in alternative local materials and support the local industries to produce affordable and easily accessible sanitary pads.

Ms Muslim bemoaned the case of sanitary pads being expensive for a “natural phenomenon” as opposed to other products which could be purchased by choice.

“Girls have no control over menstruation. Every month, we naturally menstruate and to think that a pad costs nearly GH¢15.00 now and expensive for the ordinary girl to purchase is unfair,” she noted. 

She added, “As we plead with the government to reduce the tax on pads, we must intensify research into these alternatives such that we ensure they are handled hygienically and doesn’t expose them to other health problems.”


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