class time, reduced participation, teasing, fear and shame, and risky adaptive behaviors. Further challenges that menstruating school girls face are a lack of knowledge, communication, and practical guidance prior to menarche and during menstruation; inadequate water, sanitation, and hygiene (WASH) facilities; and ineffective or unavailable menstrual management materials. In many parts of sub-Saharan Africa, girls can miss up to 5 days of school a month or drop out entirely due to insufficient access to water, sanitation and hygiene (WASH) facilities and menstrual hygiene products. Improving access to WASH facilities can actually increase girls' attendance at school. A program for school sanitation in Bangladesh increased girls' enrollment at school by 11%. Menstrual waste is largely ignored in schools in developing countries, despite it being a significant problem. Girls' access to water and sanitation at school is only available at 47% and 46% of all schools globally. Often, school toilets for girls (if they even exist) are missing bins for menstrual waste collection with the result that pads may be spread all around the school compound area. This pollutes the environment and also causes embarrassment for the school girls. In the United States, among other countries, girls who are unable to afford feminine hygiene products may miss school in order "to avoid the embarrassment of staining their clothes". Period poverty Period poverty is a term used to describe the lack of access to adequate menstrual hygiene management supplies and education, including sanitary products (e.g., tampons, pads, liners, menstrual cups), washing facilities, and disposal management. Period poverty is a global health issue that affects many individuals living in low- and middle-income countries, with many young adolescents using materials such as mud, leaves, old paper, cotton, or animal skin to manage their periods. The use of alternative products, or using products longer than intended, can lead to health complications, infections, and long-term health issues. "In a 2018 study commissioned by U by Kotex, one in four women surveyed struggled to purchase period products. In the same study, one in five low-wage women reported missing work, school or similar events due to lack of access to period supplies. These instances were linked to reported feelings of embarrassment, disappointment and depression." Despite known health consequences, period poverty is often overlooked and not discussed due to social and cultural stigmas and taboos. In recent years, many governments have actively increased access to affordable sanitary products and changing