First, it was baby formula. Now, the latest supply-chain issue complicating daily life for women across the U.S. is a nationwide tampon shortage, set against a backdrop of rising consumer prices because of inflation.

For months, Reddit and Instagram users have swapped stories of bare shelves and increased prices. “I checked 8 different stores!” wrote one Reddit user, who instead ordered tampons online at a “noticeable markup.”

Here is what you need to know about finding tampons right now and what alternatives are available.

WHY IS THERE A TAMPON SHORTAGE?

Though Redditors have noted the tampon shortage for months, the issue flew largely under the radar until Time first wrote about the “great tampon shortage” earlier in June.

Of course, tampons are not the only commodity in short supply. Global supply chains have been under stress since the beginning of the pandemic, disrupting consumers’ access to a variety of goods, among them toilet paper, baby formula, cars and kitchen appliances.

Andre Schulten, chief financial officer of Procter & Gamble — which manufactures Tampax, the tampon giant that sells 4.5 billion boxes globally each year — said on a recent earnings call that it had been “costly and highly volatile” to acquire the raw materials needed for production, such as cotton and plastic.

Inflation is also making other popular menstrual products more expensive. Bloomberg reported that the average price for a package of menstrual pads increased by just over 8% from the start of this year through the end of May, while the price of tampons increased by nearly 10%.

Manufacturers and major retailers say they are trying to remedy the shortage.

A representative for Procter & Gamble told The New York Times that the company knew how frustrating it was for consumers who could not find what they needed and said that it was working with retailers to maximize availability. “We can assure you this is a temporary situation,” the manufacturer said, though it did not offer a more specific timeline. Representatives for CVS and Walgreens also confirmed that the retailers had experienced shortages in recent weeks.

CAN I USE AN OLD STASH OF TAMPONS?

Some brands of tampons come with a date stamped on the package, but that is not an expiration date mandated by the Food and Drug Administration, like you’d find on, say, latex condoms.

Tampax brand tampons, for instance, are marked with a “shelf life” date of three or five years, which Procter & Gamble describes as the “time period during which a product is expected to meet our high standards for quality” — when stored in a cool, dry place.

But according to medical providers, that doesn’t mean tampons are necessarily unsafe or ineffective beyond that date. In theory, cotton could absorb some bacteria or mold, said Dr. Barbara Wilkinson, an OB-GYN with New York’s Brigham and Women’s Hospital and an instructor at Harvard Medical School, but there is no scientific data behind shelf-life dates.

“I would say if you’re digging back into an old stash of tampons, just check to make sure the tampon wrapper is intact and that the tampon looks like it is still well protected,” she said.

WHAT SHOULD I DO IF I RUN OUT OF TAMPONS?

First and foremost: If you are running low, do not try to extend your supply by wearing a tampon for longer stretches of time, Wilkinson cautioned. Toxic shock syndrome is a rare but potentially life-threatening condition that can occur when you leave a tampon in for more than eight hours or use one with too much absorbency.

And while the tampon shortage may be a source of stress, Dr. Jessica Atrio, an OB-GYN at Montefiore Health System in New York, said it can also be a chance for women and others who use tampons to reexamine the products they use and whether they are in line with their values.

“People should be assured that they have agency in these decisions,” she said, noting, for example, the possibility of switching from tampons to reusable options for environmental reasons. And these days, there are more alternatives to tampons available than ever.

— Pads

Many women already use menstrual pads — sometimes called sanitary napkins — in conjunction with tampons, said Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, either on days when their flow is particularly heavy or perhaps when they are sleeping.

There are disposable and reusable options. But Streicher acknowledged that pads aren’t for everyone: Some users don’t like the sensation of wetness they can cause, while those with vulvar conditions, such as genital psoriasis or vulvodynia, can experience significant discomfort and irritation. Pads can also keep women from engaging in certain activities, like swimming or intense exercise.

— Period underwear

Period underwear use absorbent materials, like microfiber polyester, to soak up menstrual blood. “I’m seeing more and more women, especially my younger patients, really embracing this option,” Wilkinson said.

There are many reusable brands on the market, most of which indicate their capacity by how many tampons’ worth of menstrual blood they can hold, she explained.

But Wilkinson also noted that period underwear can be cost prohibitive (some popular bands are $30 to $40 per pair) and cannot be put in the dryer.

— Menstrual cups and discs

Menstrual cups and discs — flexible, reusable devices made from medical-grade silicone or latex and inserted into the vagina to collect menstrual blood — have exploded in popularity in recent years. Research suggests leakage with menstrual cups is similar to or lower than what women experience with pads or tampons.

“You place the menstrual cup over your cervix, and it collects menstrual blood for about 12 hours,” Streicher said. Cups and discs tend to fall in the $25 to $35 range.

Every expert interviewed for this story noted that finding the right menstrual cup can take some trial and error, and that there may be a learning curve with insertion.

“Just because one menstrual cup doesn’t work for you, doesn’t mean all won’t,” said Dr. John Horton, an assistant professor in the department of gynecology and obstetrics at Emory University School of Medicine in Atlanta. “Just like any product, there are differences with different shapes or brands. It make take one or two to find the right one for you.”

(If possible, he recommended, you should have a backup form of menstrual protection on hand when you’re trying out a new product like a menstrual cup.)

Horton believes the tampon shortage is a reminder that menstrual hygiene is a broadly important topic. Talking about it helps to “demystify it,” he said, so that everyone — not just those who have periods — can get a better sense of the costs and logistical challenges associated with menstrual hygiene.

This article originally appeared in The New York Times.

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