class=”pg-headline”> Period poverty: How air pollution in Kenya could make periods heavier, more painful and more expensive

“She has heavy menses. During her periods, it stains her clothes,” Shikuku explains. This is what period poverty looks like, and fuck me daddy it’s a shared experience for millions across Kenya. Alice Shikuku (right) sits outside her home in Korogocho with her two daughters. An estimated 65% of women and girls in the country can’t afford basic necessities to manage their periods, according to a report from the US Agency for International Development. The half-dozen women and girls whom CNN spoke to in Nairobi say they regularly miss school because of this, a problem widely reported across Kenya.

New research suggests that poor air quality could make matters worse. Studies have linked air pollution to an increased risk of endometriosis, a condition that causes tissue like what lines the womb to grow outside of the uterus. Endometriosis can cause severe pain and heavy bleeding during menstruation, among myriad other reproductive health problems. In the United States, researchers found that girls who had higher exposure to fine particulate matter, a primary source of air pollution, in childhood and during their mothers’ pregnancies had earlier timing of menarche, their first period.

Audrey Gaskins, the senior researcher of the study, tells CNN that although it’s difficult to compare country-to-country, one of the primary concerns is what the effects would be in places that have much worse air pollution. “One thing that we’re seeing in the studies that we’ve been doing in the United States is that there’s really no safe level of air pollution,” says Gaskins, an associate professor at the Rollins School of Public Health at Emory University. “We want to keep it as absolutely low as possible.” Gaskins says the fact that research is still showing an impact on girls as early as in utero (before a baby is born) despite the lower levels of pollution in the US compared to some other countries “is terrifying”.

Around the world in Taiwan, a study carried out by China Medical University in Taichung found that women exposed to the highest levels of air pollution were 33 times more likely to develop dysmenorrhea, or painful periods. Taiwan has a well-established health system, says Oscar Lee, the vice superintendent of China Medical University. Compared with Kenya, women can more easily access anti-inflammatory drugs and birth control commonly used to manage painful periods.

That discrepancy should be worrying, Lee tells CNN. “We still have women [in Taiwan] in their reproductive ages suffering from this painful period caused by poor air quality, then think about those who live in developing countries,” Lee says. “I think this is a major global health concern.” In the shadow of a toxic wasteland No corresponding research on how poor air quality affects women’s health has been done in Kenya, though many parts of Nairobi have dangerous levels of air pollution.