What the rules provide
VAT is the only thing the Union regulates here. For years the VAT directive allowed only a reduced rate of at least 5 % on sanitary protection (European Commission); Directive (EU) 2022/542 of 5 April 2022 now lets member states apply a super-reduced rate below 5 %, or a zero rate (European Commission) (EUR-Lex, Directive 2022/542), to “female sanitary protection products”. Each state remains free to use it or not.
Taxation and public health remain largely national competences: the European Commission can act only through taxation, funding and product safety (European Parliament (EPRS), 2025). The EU programmes Erasmus+ and ESF+ have supported projects on menstrual health education and material assistance only indirectly, and in May 2024 the Commission convened an information conference on period poverty (European Parliament (EPRS), 2025).
In its resolution of 24 June 2021 on sexual and reproductive health and rights, the European Parliament called for an end to period poverty and for greater awareness of endometriosis (European Parliament, 2021); these are recommendations, not obligations. There is neither a European menstrual leave nor a European endometriosis strategy: the work-life balance directive does not address the question.
Anyone moving within the Union therefore keeps the rules of the state where they buy; the products can be freely marketed everywhere, under the same product-safety framework (see below).
VAT country by country
The result is a patchwork. Four states apply a zero rate: Ireland, where pads and tampons are zero-rated (Revenue (Ireland), 2023) under a regime obtained before European harmonisation (European Parliament (EPRS), 2025); Austria, where the 10 % VAT disappeared on 1 January 2026 (Austrian Ministry of Economy, 2025); Malta, since January 2025, and Cyprus, since 31 October 2023 (European Parliament (EPRS), 2025). Spain went from 10 % to 4 % with the 2023 finance law (BOE, Law 31/2022), and Luxembourg and Poland sit between 3 % and 5 % (European Parliament (EPRS), 2025).
Next come France at 5.5 % (BOFiP, 2016), Belgium at 6 %, a rate cut from 21 % to 6 % by a decree approved by the government in October 2017 (Belgian Government, 2017), Germany at 7 % (BMJ), Finland at 14 % since 1 January 2025 against 25.5 % previously (European Parliament (EPRS), 2025), and Italy at 10 % (Agenzia delle Entrate, 2024). Denmark, Hungary and Sweden apply their standard rate, between 25 % and 27 % (European Parliament (EPRS), 2025).
The Italian case shows how fragile these choices are: the rate was cut from 22 % to 10 % by the 2022 finance law, then to 5 % in 2023 (European Parliament (EPRS), 2025), before going back up to 10 % on 1 January 2024 (Agenzia delle Entrate, 2024). No European rule imposes free provision: distributions in schools, universities or public places are decided by states, regions or cities.
The European Parliament was already asking states in 2021 to apply an exemption or a zero rate to these products (European Parliament (EPRS), 2025) (European Parliament, 2021). A move from one rate to another does not, however, say who benefits: the “State of research” section below summarises the studies on how far these cuts are passed on to prices.
Period poverty and free products
There is no harmonised European statistic on period poverty, that is, the lack of access to products, toilets or menstrual education. The European Parliament describes it as affecting about one woman in ten in Europe (European Parliament, 2021), and its 2025 research briefing reports national surveys pointing the same way: 12 % of 12-25 year-olds in Flemish Belgium, and 45 % of those living in poverty, according to Caritas (European Parliament (EPRS), 2025); 23 % of the participants in a German online survey, who find the monthly expense burdensome (European Parliament (EPRS), 2025); more than 15 % of young women in a representative sample from Barcelona (European Parliament (EPRS), 2025); 20 % of young French women according to Ifop (European Parliament (EPRS), 2025). These figures come from surveys with different methods: they cannot be compared from one country to another.
The responses are national or local. In Spain, Organic Law 1/2023 requires educational establishments to provide menstrual products free of charge “where necessary”, and provides the same free provision in social centres for women at risk of exclusion and in places of detention (BOE, Organic Law 1/2023); Catalonia launched a universal, free distribution of reusable products in pharmacies in April 2024 (European Parliament (EPRS), 2025). In France, free dispensers have been installed in universities since September 2021 (European Parliament (EPRS), 2025). Since 1 October 2026, the Assurance Maladie has reimbursed reusable period underwear and menstrual cups sold in pharmacies: 60 % of the price for people under 26, in full for beneficiaries of the complementary health insurance for low-income households (complémentaire santé solidaire), within the limit of two products per twelve-month period and of €19 per pair of underwear and €15.80 per cup (Assurance Maladie, 2026). Disposable tampons and pads are not included.
Elsewhere, Greece distributed fourteen million products to pupils in 200 schools in early 2024 (European Parliament (EPRS), 2025), Ireland committed in 2022 to providing them in public schools and higher-education institutions (European Parliament (EPRS), 2025), and the Polish city of Gdańsk has offered free “pink boxes” since late 2019 (European Parliament (EPRS), 2025). Outside the Union, Scotland made free provision a legal duty for local authorities by a 2021 law (Scottish Parliament, 2021).
Menstrual leave
Spain is the only member state for which we found a dedicated scheme: Organic Law 1/2023, published in the Official State Gazette (BOE) on 1 March 2023, recognises a special situation of temporary incapacity for “incapacitating secondary menstruation”, that is, dysmenorrhoea caused by an already diagnosed condition (BOE, Organic Law 1/2023). The law's list notably cites endometriosis, fibroids, pelvic inflammatory disease, adenomyosis, endometrial polyps and polycystic ovaries (BOE, Organic Law 1/2023). The benefit is paid by Social Security from the first day of the sick leave, with no minimum contribution period (BOE, Organic Law 1/2023), and these provisions came into force three months after the law was published (BOE, Organic Law 1/2023).
It is therefore not an automatic leave of a few days a month: a sick note prescribed by a doctor for an identified condition is required. In the sources we consulted, the other member states have no comparable scheme; at Union level, no text provides for one.
Endometriosis and national policies
The European Parliament's 2021 resolution recalls that endometriosis affects one woman in ten of reproductive age, that it is the leading cause of female infertility, that it takes on average eight years to be diagnosed and that it has no curative treatment (European Parliament, 2021). It asks states to launch large information campaigns aimed at the public, health professionals and legislators (European Parliament, 2021).
Care policies remain national. On 11 January 2022 France launched a national strategy against endometriosis with three objectives: research, a diagnostic pathway identifiable everywhere, and an “endometriosis reflex” among all audiences (Élysée, 2022). Clinical guidelines, by contrast, are European: the learned society ESHRE published in 2022 a 109-point recommendation on diagnosis and management (ESHRE, 2022).
Diagnostic delay varies widely from one study to another: a systematic review of 17 observational studies reports delays of 0.3 to 12 years, depending on the definition used and the country (De Corte et al., 2025). For the condition itself, see our article on endometriosis.
Product safety: what European law says
According to the European Commission, pads, tampons and menstrual cups are not medical devices, because periods are not considered a medical condition; they are not listed in Annex XVI of the Medical Devices Regulation and fall under Regulation (EU) 2023/988 on general product safety (European Commission, reply of 28 May 2024).
In France, Anses has assessed the safety of these products since 2018: chemical substances are detected in tampons, cups, pads or panty liners, but “without exceeding health thresholds”, and the main risk remains toxic shock syndrome, linked to conditions of use (prolonged wear, absorbency higher than needed) (Anses, 2026). Since 1 April 2024, a decree requires the list of components, precautions for use and adverse effects, including toxic shock, to be shown on the labelling or leaflet; it is now recommended not to wear a tampon or a cup for more than six hours (DGCCRF, 2024). This is a French rule.
A laboratory study on products on the market did not show that menstrual cups are safer than tampons with regard to the toxic shock toxin: they call for similar precautions (Nonfoux et al., 2018).
Cycle-tracking apps and health data
The dates of periods, symptoms or sexual intercourse entered in a tracking app fall under the special categories of data of the GDPR, whose processing is in principle prohibited unless an exception applies, such as explicit consent (GDPR, Article 9). The Dutch Data Protection Authority has warned that nearly a quarter of Dutch women use a cycle or fertility app, that these apps cannot in principle collect such data without explicit consent, and that it does not rule out opening an investigation (Dutch Data Protection Authority, 2026). This is a warning, not a penalty.
In practice, before installing an app: read what you are consenting to, refuse advertising sharing where possible, and do not enter what you want to keep private.
Hormonal contraception: access and coverage
Access to contraception depends entirely on the states. The 2026 atlas of the European Parliamentary Forum for Sexual and Reproductive Rights (EPF) ranks 47 European countries; in February 2026, France comes first with 97.9 %, ahead of Luxembourg (93.3 %) and Belgium (89.8 %), while Poland scores 38.9 % and Hungary 36.9 % (EPF, contraception atlas, 2026). Of these 47 countries, eight supply emergency contraception free of charge and eleven dispense it without a prescription; Hungary and Poland are the only two to require one, Poland having a pilot programme under way (EPF, contraception atlas, 2026).
In France, people under 26 have certain contraceptives covered by the Assurance Maladie with no upfront payment (Service-Public). Hormonal contraception is also among the possible treatments for endometriosis-related pain, on medical advice (ESHRE, 2022).
Key points
| VAT | Directive (EU) 2022/542: reduced, super-reduced or zero rate possible, at each state's choice (European Commission) (EUR-Lex, Directive 2022/542) |
|---|---|
| Rates in force | Ireland 0 % (Revenue (Ireland), 2023), Austria 0 % (2026) (Austrian Ministry of Economy, 2025), Spain 4 % (BOE, Law 31/2022), France 5.5 % (BOFiP, 2016), Belgium 6 % (Belgian Government, 2017), Germany 7 % (BMJ), Italy 10 % (Agenzia delle Entrate, 2024) |
| Free provision | No European rule; national, regional or municipal decisions (European Parliament (EPRS), 2025) |
| Menstrual leave | No European text; in Spain, sick leave for incapacitating secondary menstruation since the 2023 law (BOE, Organic Law 1/2023) |
| Endometriosis | European Parliament resolution of 2021 (European Parliament, 2021); no common strategy |
| Product safety | Regulation (EU) 2023/988; no medical-device status (European Commission, reply of 28 May 2024) |
| Health data | GDPR, Article 9: explicit consent (GDPR, Article 9) |
In practice
- Check your country's rate on its own page: it explains part of the price gap.
- Free provision is local: ask the school, university or town hall.
- For endometriosis, expert centres and care pathways are national; the cross-border care directive lets you consult in another member state at your own insurer's rate (European Commission).
- Read the composition and the leaflet of your products: tampons and cups must not be worn beyond the time stated by the manufacturer.
- Before installing a cycle-tracking app, check what it shares and with whom.
What it costs
No European cost or reimbursement; everything depends on the state of residence. In France, reusable underwear and cups have been reimbursed at 60 % for people under 26 since 1 October 2026 (Assurance Maladie, 2026); disposable products are not reimbursed (Assurance Maladie, 2026).
What has changed recently
The 2022 directive removed the 5 % floor that blocked a zero rate (European Commission); Austria used it in 2026 (Austrian Ministry of Economy, 2025), after Ireland, which never needed it, and France has reimbursed certain reusable products since 1 October 2026 (Assurance Maladie, 2026).
State of research
Research carried out as of the page’s update date, in peer-reviewed publications, official sources and European Parliament briefings. What follows summarises what the data show; it is not medical advice.
Do VAT cuts benefit consumers?
Two peer-reviewed economic studies look at Germany's 2020 VAT cut: one concludes that it was fully passed on to prices, by more than 100 % depending on the product, largely because retailers rounded prices down (Frey and Haucap, 2023) (European Parliament (EPRS), 2025); the other, which compares with Italy using checkout data, finds that the tax burden fell entirely on consumers and that demand is not very sensitive to price (Buettner et al., 2025). These results concern a large, permanent cut in Germany: they do not transfer automatically to a smaller cut or another market.
For the United Kingdom, outside the Union, an analysis published in 2022 by a tax consultancy (Tax Policy Associates) estimates that at least 80 % of the saving from the removal of the 5 % VAT on 1 January 2021 stayed with retailers and that prices fell by only about 1 % at most (Tax Policy Associates, 2022); this is not a peer-reviewed publication. A VAT cut is therefore no guarantee of lower prices: compare prices, not rates.
Endometriosis, chemicals and toxic shock
For endometriosis, the reference is the 2022 ESHRE recommendation (ESHRE, 2022), supplemented by the systematic review on diagnostic delays, whose 17 studies are all observational and of quality judged “poor to good” (De Corte et al., 2025).
On chemical substances, a systematic review of 15 articles detected phthalates, volatile organic compounds, parabens, phenols, fragrances and dioxins in menstrual products, while noting the lack of studies on period underwear and menstrual cups (Marroquin et al., 2024). These detections do not in themselves say what risk results: Anses finds no exceedance of health thresholds in the products it tested (Anses, 2026).
Limits: the data on period poverty come from non-comparable surveys; the VAT studies concern specific markets; a single result is never a consensus.
Worth knowing
A reduced rate does not guarantee a low price: in the United Kingdom, the 2022 analysis cited above concludes that the removal of VAT was almost entirely absorbed by retailers (Tax Policy Associates, 2022), whereas in Germany the cut was passed on to prices (Frey and Haucap, 2023). Compare prices, not rates.
Where to find help
- European Commission — VAT rules and Annex III of Directive 2006/112/EC (European Commission).
- European Parliament — resolutions on period poverty and endometriosis.
- National contact point for cross-border healthcare.
- Your national data protection authority, if an app uses your health data without your consent.
Frequently asked questions
Does the EU set a VAT rate on period products?
No. It sets a framework: since 2022 each state may go down to a zero rate (European Commission). The choice is national.
Is there a European menstrual leave?
No. No EU text provides for one; only a handful of states worldwide have one. Spain created in 2023 a sick leave for incapacitating secondary menstruation (BOE, Organic Law 1/2023).
Can I buy cheaper products in another member state?
Yes, circulation is free. The rate that applies is that of the country of purchase.
Are period products medical devices?
No, according to the European Commission: they fall under the general product safety regulation (European Commission, reply of 28 May 2024).
Is the data I enter in a cycle app protected?
Yes: it is health data, subject to reinforced rules and, in principle, to your explicit consent (GDPR, Article 9).
In which country is contraception most accessible?
According to the EPF's 2026 atlas, France comes first of the 47 countries ranked, with 97.9 % (EPF, contraception atlas, 2026).
Official sources and links
- World Health Organization — international reference on this topic
- WHO Regional Office for Europe — data and programmes for the European Region
