Luladay Abraham treats the arrival of her menstrual cycle less as a private inconvenience than as a monthly test of endurance. The 32-year-old accountant, who works for a construction firm on Gabon Street and lives in CMC, has hypermenorrhea, an unusually heavy and prolonged menstrual flow that turns a routine biological cycle into a disruption of work, sleep and movement.

Doctors told her the condition is rare but natural, not an illness. They offered hormonal and non-hormonal medicines to control the bleeding. She found them temporary and feared the consequences of prolonged use.

“I decided I have to accept it rather than face the long-term medical side effects,” Luladay told Fortune.

Her period usually lasts seven days. The week is marked by discomfort, worry and the search for products that can hold up to her body’s demands. She stopped taking the medicines and turned again to external products, where acceptance is expensive.

"I always feel a sense of shame,” Luladay told Fortune. “The sanitary pads available are often too short, too narrow, and far too thin for my needs.”

In 12 hours, Luladay can use four single pads. Over one cycle, she goes through about three full packs. She changes them every few hours, not only because of the volume of bleeding but because the pads often shift out of place. She found that the adhesive strips do not hold firmly, especially at night.

The problem is not only cost. Luladay’s most emphatic complaint is quality. Pads produce lint, whose cotton filling clumps or separates, and whose materials can cause chemical burns and allergic reactions. The products add to the "nagging backaches" and cramps that already come with her cycle. The market carries 21 brands, 11 of them washable or reusable pads and the rest are disposable.

A pack of sanitary pads that once cost between 60 Br and 70 Br now sells for 150 Br. For Luladay, the increase has collided with scarcity, weak product design and limited access to comfortable choices. Her case is medically specific, but the market she faces is ordinary. For a worker expected to keep office routines in a demanding construction sector, the product failure is not a minor irritation. It shapes how she sits, travels, sleeps and calculates the possibility of staining her clothes in public.

Menstrual hygiene has become a question of income, supply chains, public health and social stigma. According to data from the United Nations Population Fund (UNFPA), by 2026, around 45 million to 47 million Ethiopian women aged 12 and above will be in the common menstrual age group. The national figures give scale to what is usually treated as a private matter. They also show why product choice, price and distribution are no longer peripheral consumer issues but a basic part of women’s participation in school and work.

The choice does not arrive as a single dramatic event. It is repeated each month, when cash on hand decides whether a girl buys a pad, eats properly, or improvises with what is available at home.

In Bahir Dar, 21-year-old Samra Manaye has made a harsher calculation. She lives in Yinesa village and works as a small retailer after poverty pushed her out of school. She has not used a sanitary pad since ninth grade. Cloth scraps became the cheaper option, part of what she calls the "math of poverty" that trades comfort and dignity for household survival.

Samra now supports her 16-year-old sister, buying for her what she has denied herself. The younger girl sees the support as indulgence. However, Samra knows it is temporary, given the family’s finances. She expects her sister, too, will shift to cloth scrap, a quiet passage from the last protection of childhood into the same economy of sacrifice.

That experience is the market Yetenayet Solomon entered when she founded Yeti Pads in 2023.

Yeti Pads makes washable sanitary pads from soft cotton fabric, absorbent inner layers and waterproof protective layers. The design is meant to balance comfort, hygiene and durability while lowering waste through reusable components. The promise is that one purchase can replace repeated spending on disposable products.

“Due to my personal experience and the challenges many women and girls face in accessing affordable menstrual hygiene products," said Yetenayet, "I wanted to create a solution that supports women’s health, dignity, and confidence while also protecting the environment and creating job opportunities for women, including women with disabilities.”

The business, however, faces the same constraints that shape the broader market. However, the Yeti Pads founder seems undeterred by constraints on the business, from high material costs and limited machinery to logistical challenges in reaching rural areas. While financial constraints and cultural stigmas challenge the company's growth, Yetenayet's resolve remains firm.

"We're seeking strategic partners to help us modernise our production and break down social barriers," Yetenayet said.

At Bahir Dar University, 24-year-old Adina Abebaw, an industrial chemistry student, measures the same problem through her meal budget. As a child, she used old clothes during her period and remembers secretly washing and drying them. The secrecy, more than the cloth itself, stayed with her.

Now she watches friends manage leaks and discomfort with rags. Determined not to return to that routine, Adina spends from her 3,000 Br food allowance on sanitary pads, sometimes going hungry to avoid the shame she associates with her childhood. The University offers support, but the paperwork needed to prove poverty feels like red tape and humiliation.

“My friends do help me a lot by sharing my financial burdens with peer-to-peer initiatives sometimes," she said. "But, it’s still not enough.”

Some institutional support has survived beyond formal programmes. The Reach Project, a collaboration between DKT Ethiopia and the Netherlands Embassy, ended its official partnership a few years ago, but had delivered more than 1.6 million menstrual hygiene products to schools and universities. Students have since organised clubs and dormitory networks to help peers facing "period poverty."

The pressure is also visible on the production side. Policymakers' drive for import substitution in hygiene products has run into issues of taxes, foreign exchange shortages, transport costs, and uncertain policy implementation. Local manufacturers, including Ethiopian Sanitary House, found the burden heavy even before products reach shelves.

The largest known local producer, with a capacity of about 86 million pads a year, is Lilac Sanitary Napkins & Baby Diapers Manufacturing Enterprise, in Qality District. Other producers include HNM Agro Industry, G.P.Y Sanitary Products Manufacturing, Ethio Hygienic Industries, Ontex Hygienic Disposables, Nice Paper, MOAB, The Twins, and Maryod, which operate in the reusable and washable pad segment.

Many are small-scale operators, and others depend heavily on imported inputs, including pulp, adhesives, absorbent materials and packaging, creating an industrial policy trap. The shortage of finished imported pads gives local producers room to sell more, yet the same foreign-exchange squeeze restricts their ability to import materials. According to a 2019 estimate, annual demand for sanitary napkins and diapers exceeded one billion pieces. Even so, Lilac’s capacity covers only a modest share of national requirements.

Producers face a 15pc tax on packaging and more than five percent in duties on some imported inputs, while local cotton prices do not provide an advantage over imports. The government reduced import duties on sanitary pads from 30pc to 10pc, yet menstrual hygiene products remain subject to 15pc VAT and were excluded from the Ministry of Finance's June 2023 VAT holiday for selected essential goods. Kenya and Rwanda have gone further by eliminating taxes on such items entirely.

High inland transport costs push wholesale prices to 93.75 Br, and retail prices climb further through the distribution chain. The result is a locally made product that remains difficult for low-income consumers to buy.

According to Haireya Ahmed, managing director of Ethiopian Sanitary House, relief on inputs would quickly lower prices.

”If the taxes on imported materials are at least exempted, the price would be less than 98.75 Br a pack,” she said.