Feminine hygiene products like tampons and pads cost too much for some women to spend, forcing them to use other material to absorb menstrual blood during their periods. The experience is known as period poverty and the measures might be more common than people think.

Upcoming research from the Scotland-based group Women for Independence, which focuses on women’s issues and on Scottish independence from the United Kingdom, shows that almost one in every five women in that country has had difficulty affording sanitary products, according to a report in The Guardian.

When they can’t pay for things like pads and tampons, they have turned to toilet paper, clothes, newspapers and rags, the report said, or leaned on friends or a charity organization like a food bank.

The issue has negatively affected their hygiene and, in turn, their health — developing a urinary tract infection from the unsanitary condition, for example. The problem also affects emotional health and has social ramifications.

“For the first time we have a picture of what women are going through every day,” Victoria Heaney, who is with Women for Independence, told the Guardian. “The emotional labor spent concealing that you are going without products has such a detrimental impact.”

It is more than just an issue in Scotland — it is a problem women deal with all around the world.

A tally in the Huffington Post has estimated the average cost of a period throughout an American woman’s lifetime and for just tampons, underwear liners and new underwear that cost comes out to almost $5,000. Adding in pain medication, birth control and heating pads up the price tag considerably.

In developing countries, a young woman’s period can have serious negative consequences for her education and on a social level. Many girls around the world are pulled out of school while they are on their period, and in some cultures a menstruating female is cast out of the house during her period, sometimes staying in a shed or outside, exposed to the elements.