Period products, including tampons and sanitary pads, are now free of cost in Scotland to anyone who needs them.

Starting this week, menstrual products will be available in places like pharmacies and community centers, thanks to legislation approved by Scotland's parliament in 2020.

"Providing access to free period products is fundamental to equality and dignity, and removes the financial barriers to accessing them," said Social Justice Secretary Shona Robison in a statement, calling the move "more important than ever" in an era of rising costs of living.

"Proud of what we have achieved in Scotland. We are the first but won't be the last," said Scottish parliament member Monica Lennon, who began floating the proposal in 2016.

Awareness has grown in recent years about how access to period products can affect education and economic stability for people who need them.

Scotland is the first country to offer period products free of charge on a national scale. Others, including New Zealand and Kenya, distribute products for free in public schools.

In the U.S., a package of tampons or menstrual pads costs around $7 to $10 for a supply that may last a month or two. (Other products are designed to be reused, like period underwear or menstrual cups, and have a higher upfront cost.) Supply chain disruptions have affected availability and driven up costs.

About 14% of American college students struggle to afford period products, a number higher among Black and Latina women, according to a recent study by George Mason University. And those who regularly struggled to afford them were more likely to experience depression, researchers found.

Women who struggle to afford basic necessities may choose to skip the cost of a box of tampons, turning to toilet paper or socks instead. A survey of low-income women in St. Louis published in 2019 found that nearly half reported having to choose between food and menstrual products at some point during the year. Assistance programs like SNAP and WIC generally do not cover the cost of period products.

Research has shown that a lack of access to period products can cause women and girls to miss school or work.

"Imagine trying to take a math test being so scared that you're going to have an accident," said Dr. Shelby Davies at the Children's Hospital of Philadelphia, speaking in an interview with NPR last year. "Like, how do you focus on that?"

Toilet paper and soap are provided for free in public restrooms, advocates say, so why not period products?

In the U.S., some states have passed legislation requiring public K-12 schools to provide period products free of cost, including New York, Virginia and Oregon. About a dozen states have exempted period products from sales tax.

At the federal level, New York Rep. Grace Meng, a Democrat, introduced legislation last year that would require Medicaid to cover period products, along with providing grants and other assistance to improve access in K-12 schools, colleges and universities, public federal buildings and incarceration facilities. The bill remains in committee.