Maribel Guillet, a single mother of a special-needs son who has lived in a Bronx shelter for over two years, said she tries to wash at her uncle’s apartment during weekends. That way, her son can avoid using the shelter’s facilities. The freezing temperatures in the shelter have exacerbated her asthma, she said, which prompted her visit to Care for the Homeless on a recent winter morning.

“I try to not let him drink liquids at night so he doesn't have to be go to the bathroom at night,” said Guillet, 36. “I don't trust the people there. I don’t know who’s who.” Sometimes the shelter’s showers are too dirty to bathe her son there, she added. “I had to disinfect, so I’m always buying stuff to clean before he’s in the shower.”

For Guillet, who said her period typically lasts about 10 days, with heavy bleeding that requires changing her sanitary pad “every 20 minutes,” the shelter’s bathroom restrictions become particularly cumbersome. “Sometimes the lady's nice. Other ladies is not,” she said, referring to shelter supervisors. “Some of them won't work with you.”

Many shelters and homeless centers hand their female residents female hygiene products, along with toothpaste and shampoo. But social workers said that pads and tampons are often harder to source from public donors.

Rosanna Montilla, an associate at Care for the Homeless, said the organization is running out of tampons. Its latest donation drive in November yielded just one contribution of tampons, she said. Similar problems plague its sister branch in Orlando, Florida, where a University of Central Florida student recently launched a fundraising campaign to buy menstrual products for homeless women.

“It’s not one of the items that people automatically think of when they donate toiletries,” said Montilla. “When you get to specific items like female hygiene products, you have to specifically ask for it.”

It’s hardly the only need of homeless women, but the struggles to stay clean can be a confounding factor. A recent study of 328 mothers in the city’s shelter system that Fletcher-Blake helped direct, one-third of women screened positive for depression. Of those who participated in a follow-up study, only 12 reported receiving treatment for their condition in the last three months, despite some showing severe trauma and anxiety.

“As homelessness explodes,” said Fletcher-Blake, “more resources are necessary to take care of women who have experience with any type of trauma in their lives and on the streets.”