Pakistan just ended its 18% tampon tax, while 18 U.S. states still tax period products as 'luxury goods' — Americans are struggling to afford them

But activists have scored a big win in Pakistan, where the federal government is now removing the sales tax on menstrual products and contraceptives.

In the U.S., however, 18 states still fall behind — and people with periods in the U.S. are struggling to afford what many argue are basic necessities.

Raising awareness about the “tampon tax”

Bushra Mahnoor told NPR that growing up in Pakistan, she and her sisters would have to ration menstrual products. When they didn’t have enough, she would have to use a rag or a cloth, and worry about whether it would leak.

Mahnoor also told NPR that when she was a teen, she would often miss school when she had her period.

“When I knew I might not have a pad and I had to rely on a cloth, those were the times I could not even imagine going to the school,” Mahnoor, 25, told NPR.

The UNICEF report estimates that one in five girls in Pakistan “miss school because of their menstrual cycle, which adds up to missing a minimum one year’s worth of education.”

That’s why Mahnoor — the executive director at Mahwari Justice, a nonprofit that gathered more than 10,000 signatures on a petition to end the tax on menstrual products — was pushing for a change.

In September 2025, a lawsuit was launched by lawyers Mahnoor Omer and Ahsan Khan to stop the taxes on menstrual products, and have them reclassified as essential goods, NPR reported earlier this year.

Omer told NPR that she was “very happy” with the news that the tax had been eliminated, but said there was more work to do, since other taxes, such as import duties, still remained, and can add as much as 20%.

She added that the financial barrier was not the only issue, as the stigma around menstruation also remains. Access still remains an issue, as well.

Access to menstrual products “is an issue pretty much everywhere,” Marni Sommer, a professor of socio-medical sciences at Columbia University’s Mailman School of Public Health, told NPR.

The U.S. has fallen behind

In the past few decades, several countries have taken steps to eliminate taxes on menstrual products, also referred to as a “period tax,” including Malawi, India, Ireland and Nepal. Kenya was the first country to eliminate sales tax on menstrual products, in 2004.

However, the “period tax” is still an issue in the U.S., and a study from 2023 found that almost a quarter of teens and one-third of adults in the U.S. struggle to afford menstrual products.

In many states, period products are taxed at the same rate as luxury items — like decor, electronics, makeup and toys — according to the Alliance for Period Supplies (AFPS).