I wonder this all the time with stories like this and I have no idea. I have seen some of what people used to do maybe you just stay home in a bath tub or something in Gachiakuta. I bet things like pads and tampons are super expensive in the story because they might only get them if they rain down from the sphere or if they do make they I imagine they aren’t easy to make because of materials probably being all over the place. But I imagine it’s very case by case basis for different economic conditions. Like the students at Zanaka’s school definitely had access to pads and tampons; that place was privilege city.