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Mahnoor Omer, who was raised in the city of Rawalpindi and is close to Islamabad, recalls the shame and anxiety she experienced during her period in school. Going to the toilet with a sanitary pad was an act of stealth, like trying to cover up a crime.

Omer, who is from a middle-class family with her father a businessman and her mother a homemaker, recalls how she used to hide her pad up her sleeve like I was taking narcotics to the bathroom. Teachers would dismiss you if someone mentioned it. A classmate once told her that her mother considered pads “a waste of money”.

Omer remarks, “That’s when it hit me.” Imagine how far out of reach these products are for others if middle-class families think that.

Now 25, Omer has gone from cautious schoolgirl to national centrestage in a battle that could reshape menstrual hygiene in Pakistan, a country where critics say economics is compounding social stigma to punish women – simply for being women.

What she and many others claim is a “period tax” that Pakistan’s more than 100 million women are actually subject to in September, Omer, a lawyer, filed a petition with the Lahore High Court in September.

According to the Sales Tax Act of 1990, Pakistani governments have long imposed customs duties of 25% on imported sanitary pads, as well as on raw materials used to make them, on top of the country’s sales tax law. Add on other local taxes, and UNICEF Pakistan says that these pads are often effectively taxed at about 40 percent.

In contrast to a number of constitutional rights, including those that protect equality and dignity, eradication of exploitation, and promotion of social justice, Omer’s petition contends that these taxes, which specifically affect women, are discriminatory.

Omer and other legal professionals who back the petition claim that the taxes make it even more difficult for most Pakistani women to obtain sanitary products in a nation where menstruation is already a taboo topic for most families. A standard pack of commercially branded sanitary pads in Pakistan currently costs about 450 rupees ($1.60) for 10 pieces. That’s the price of a meal of rotis and dal for a low-income family of four in a nation with a monthly per capita income of $120. Reduce the cost by 40%, and the calculations are easier to compare to sanitary pads.

At the moment, only 12 percent of Pakistani women use commercially produced sanitary pads, according to a 2024 study by UNICEF and the WaterAid nonprofit. The rest frequently don’t have access to clean water and frequently use improvised materials like cloth or other materials.

Hira Amjad, the founder and executive director of the Pakistani nonprofit Dastak Foundation, says that if the petition is circulated, it will make pads more affordable.

And that, say lawyers and activists, could serve as a spark for broader social change.

The case is Mahnoor Omer vs. senior Pakistani government officials, according to the court docket. However, Omer doesn’t experience that type of emotion.

“It feels like women versus Pakistan”.

It’s not blatant, they say.

Bushra Mahnoor, founder of Mahwari Justice, a Pakistani student-led organisation whose name translates to “menstrual justice”, realised early just how much of a struggle it could be to access sanitary pads.

No relation to Omer, Mahnoor had four sisters growing up in Attock, a city in the Punjab province of Pakistan. I had to check whether there were enough pads each month. If my period came when one of my sisters had hers too”, finding a pad was a challenge, she says.

The conflict persisted in the classroom, where periods were associated with shame, as was the case with Omer. One teacher once forced a classmate to stand for two entire lectures due to the stained uniform of her teacher. “That was dehumanising”, she says.

Mahnoor’s first period was when she was 10 years old. “I was unsure of how to use a pad.” I stuck it upside down, the sticky side touched my skin. It caused pain. Nobody teaches you how to handle it.

She says that shame was never hers alone, but it’s part of a silence which starts at home and accompanies girls into adulthood. According to a study on menstrual health in Pakistan, eight out of ten girls express embarrassed or uneasy feelings when discussing periods, and two out of three girls claim to never have been informed about menstruation before it started. This silence, according to research published in the Frontiers in Public Health journal in 2023, is related to poor hygiene, social exclusion, and missed school days.

In 2022, when floods devastated Pakistan, Mahnoor began Mahwari Justice to ensure that relief camps did not overlook the menstrual needs of women. She says, “We started distributing pads, but we later realized there was so much more to be done.” Her organization has produced rap songs and comics to normalize conversations about menstruation, as well as distributed more than 100, 000 period kits containing pads, soap, underwear, detergent, and painkillers. “When you say the word ‘ mahwari ‘ out loud, you’re teaching people it’s not shameful”, she says. It’s simply life, they say.

Even though Amjad, the founder of the Dastak Foundation, has been in business for ten years, was affected by the same floods. Its work now also includes distributing period kits during natural disasters.

According to Amjad, the social stigma associated with menstruation is also closely related to economics in terms of how Pakistani women are affected by its effects.

She says that in the majority of households, men are responsible for making financial decisions. “Even if the woman is bringing the money, she’s giving it to the man, and he is deciding where that money needs to go”.

And that’s frequently compromised if the health of women feels too expensive. There is no discussion about whether we should buy pads in many homes because of the tax’s exorbitant prices, she says. “It’s an expense they cannot afford organically”.

Over half of Pakistani women are unable to purchase sanitary pads, according to the Frontiers in Public Health study conducted in 2023.

The advantages of menstrual hygiene will go beyond just being healthy, according to Amjad, if the taxes are eliminated and menstrual hygiene is made more affordable.

School attendance rates for girls could improve, she said. According to the United Nations, more than half of Pakistan’s girls between the ages of five and sixteen are not currently in school. “We will have women who are stress-free.” We will have happier and healthier women”.

“Feel of justice”

Omer says her interest in women’s and minority rights began early. She says, “Seeing the blatant mistreatment every day inspired me.” “I never felt comfortable with the economic, physical, or verbal exploitation that women experience on the streets, in the media, or inside homes.”

She credits her mother for making her grow up to be an empathetic and understanding person.

She worked at Crossroads Consultants, a Pakistan-based company that collaborates with NGOs and development partners on gender and criminal justice reform after graduating from college. She has since made a commitment to volunteering at Aurat March, an annual women’s rights protest that takes place every year in Pakistan on International Women’s Day, which she attended when she was 19 years old.

Her first step into activism came at 16, when she and her friends started putting together “dignity kits”, small care packages for women in low-income neighbourhoods of Islamabad. She recalls that “we would use our own money to raise money from bake sales or use our own.”

With the funding she received, she was able to distribute about 300 dignity kits that she and her friends made themselves. They each contained pads, underwear, pain medication and wipes. But she desired more.

In the spring of 2025, she began working as a law clerk at the Supreme Court. She’s currently pursuing postgraduate studies in gender, peace and security at the London School of Economics and says that she will go back to Pakistan to resume her practice after she graduates.

She and fellow lawyer Ahsan Jehangir Khan, who is skilled in constitutional law and taxation, became close friends. Their discussions revealed the strategies to challenge the “period tax.”

“He pushed me to file this petition and try to get justice instead of just sitting around”.

Khan, a co-petitioner in the case, asserts that justice is the key to reducing the taxes rather than accessibility and affordability of sanitary pads. He claims that it’s a tax on a biological function.

Tax policies in Pakistan, he says, are written by “a privileged elite, mostly men who have never had to think about what this tax means for ordinary women”. He continues, “it is very clear that you can’t have anything discriminatory against any gender whatsoever,” according to the constitution.

The fight for menstrual hygiene is closely linked to Amjad, the founder of the Dastak Foundation, to her other passion, which is the fight against climate change. The extreme weather-related crisis, such as floods, that Pakistan has faced in recent times, she says, hit women particularly hard.

She recalls the trauma that many of the women she worked with described to her in the 2022 floods. She says, “Imagine you are sleeping in a tent and experiencing mahwari [menstruation] for the first time.” “You are not mentally prepared for it. You are attempting to save your life. You are not in charge of security or safety. That trauma is a trauma for life”.

Women will need to change sanitary pads more frequently during their periods, according to Amjad, and a lack of adequate access will become a bigger issue. She supports the elimination of taxes on cotton-based sanitary pads, but only those that are made of cotton rather than plastic ones, which “take thousands of years to decompose.”

Amjad is also campaigning for paid menstruation leave. She claims that “I’ve seen women who were fired because they couldn’t work because of their pain.” One area of your brain is engaged in menstruation, according to the saying. You can’t really focus properly”.

In the meantime, tax opponents hope that Omer’s petition will encourage Pakistan to impose itself on its own country, including India, Nepal, and the United Kingdom, which have all abolished their period taxes.

Omer struggled to accept that position in opposition to the government’s policies. Her parents, she says, were nervous at first about their daughter going to court against the government. She claims that taking on the state is never a wise decision.

They are now proud of her, she claims. “They understand why this matters”.