It’s never too late (or early) to start sustainable menstrual hygiene

Menstruation is more than just a physiological process. In India, it is an event marred by social stigma, poor waste management solutions and illiteracy, thereby resulting in the destruction of our environment. Look up menstrual products in India, and you will find stats reporting that 18- 58% of Indian women use Disposable Sanitary Napkins (DSN). Every year India produces thousands of tons of sanitary waste; for it is estimated that a woman uses 6,000+ sanitary pads during her reproductive age. Imagine making DSNs available to the remaining percentage of women – the numbers will be staggering to say the least. A conventional disposable pad is 90% plastic, which as you know is a hugely problematic substance especially when it comes to holding organic waste.

Our choice of menstrual products has a direct bearing on the world and here are some facts that might aid your selection.

Disposable Sanitary Napkins are a health hazard

DSNs and tampons contain carcinogens, endocrine disruptors and surface irritants, in the form of chemicals, plasticizers and artificial fragrances. Get acquainted with the chemical ‘dioxin’. Flagged by the World Health Organization as a known carcinogenic and immunosuppressant, it is used to bleach the cotton and cellulose wood pulp in pads to give them an air of hygiene. However the vaginal mucous membrane is extremely permeable and our bloodstream can absorb dioxin, resulting in cervical and ovarian cancers, as well as reproductive problems and hormonal imbalances. Plasticizers like BPA and the synthetic lining of sanitary pads, increase the risk of exposure to bacteria, which cause vaginal infections. Sanitary pads also consist of Super Absorbent Polymers, which are mostly petroleum byproducts that can cause allergies, rashes and rarely Toxic Shock Syndrome.

Plasticizers like BPA and the synthetic lining of sanitary pads, increase the risk of exposure to bacteria, which cause vaginal infections.

Dreadful for the environment
In India, we currently do not have a standardized method of sanitary waste disposal, and often the shame and secrecy associated with menstrual periods result in improper disposal. However, there is no ‘right’ way to dispose a DSN. If you bury it, the chemicals will leach into the soil and groundwater; if you burn it, hazardous dioxins are released into the air; if you flush it, they will clog the drains; and if you throw it ‘away’, your pad is destined to end up in our landfills, where the biochemical waste – the blood – will remain undisturbed for decades, without enough moisture or sunlight to decompose. The conditions in a landfill make it impossible even for ‘degradable’ sanitary pads (made from bamboo, cornstarch, etc.) to decompose.

The conditions in a landfill make it impossible even for ‘degradable’ sanitary pads (made from bamboo, cornstarch, etc.) to decompose.

Cloth Pads for the win!
India has a long-standing tradition of using cloth as a menstrual hygiene product as it is mindful, healthy and cost convenient. Today, cloth pads are as convenient as disposables, except you can wash and reuse them several times and hence, create less waste. They come in different sizes and levels of absorbency, which can be used for daily discharge, period flow, mild incontinence and postpartum bleeding. Most cloth pads are made of organic cotton. The top of the pad is made of soft flannel cotton, the inside of the pad is made of ultra-absorbent cotton (the number of layers differs according to the pad model) and the back of the pad is made with a PUL (polyurethane laminate) leak-proof layer.

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India has a long-standing tradition of using cloth as a menstrual hygiene product as it is mindful, healthy and cost convenient.

Menstrual Cups
A menstrual cup is usually made of medical grade silicone. It usually lasts 7+ years. It is worn inside the body during menstruation to catch the menstrual fluid, much like tampons. Unlike tampons, however, one doesn’t have to discard the cup, but merely flush the content, wash and reuse. After use, sterilize it and store it, and re-sterilize and use during the next period. Using a menstrual cup takes a bit of practice, but in a couple of cycles, you can master its use, and no, it will never get stuck inside. With a menstrual cup inserted properly, one wouldn’t feel the cup at all; no rashes or burning and you should feel dry and clean without any leaks.

Using a menstrual cup takes a bit of practice, but in a couple of cycles, you can master its use, and no, it will never get stuck inside.

First-time cup user? Read on…

We understand the inhibitions that come with the first time use of a menstrual cup. Here, let’s address some of that for you.

1.Is there a chance of the cup getting lost inside?

Relax. You’re not the first one to worry about this. It is in fact, the most common concern. But rest assured, that won’t happen. The intrinsic design of the cup (cone-shaped or bell-shaped in some cases) is such that it cannot slide any deeper than it does. What goes up, must come down. 

2. What if I can’t pull it out?
Technique is important when it comes to pulling out a cup and mastering it may take one cycle or even just a couple of days. You must pinch the stem and gently swing it side to side until you can almost feel the cup, at which point you wrap four fingers around it and gently slide it out. And remember to squat!

3. What if I can’t insert it?
There are multiple ways to fold a cup before you insert it – C-fold, Origami fold, Punch down fold etc. Play around a bit and figure what you’re most comfortable with. Remember to always squat during the insertion.

4. Will it stink? How do you wash it?
A cup, unlike a pad gives out no odour at all. Rinse with soap water during a shower. Before and after each cycle, sterlise it in a pot of boiling water for 5-7 minutes. Make sure that the cup doesn’t touch the vessel but just stays afloat.

5. How do I dispose the cup?
Unlike plastic medical grade silicone even though not compostable, isn’t very harmful for the environment. Intima.com suggests that medical grade silicone means “the silicone has been tested and approved by the FDA for biocompatability – so it’s designed to be worn safely inside the body for long periods of time. Medical grade silicone is hypoallergenic, latex-free and containing no toxins, and is also nonporous and so resists bacterial growth.” You can find ways to reuse it – use it as a watering tool for small potted plants – or check with your local hospital about how they dispose their medical grade silicone and piggyback on their disposal method

6. Does it help with cramps?
Yes! The suction caused by the cup helps draw out the menstrual flow in a way that it eases menstrual cramps.  

7. Is it cheaper?
Hell yes! Given that a regular pad costs approx Rs 10 each, 7 years supply costs roughly about Rs 6000. In contrast, a cup costs around Rs 450. That’s a lot of saving!

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Expert view:
Menstrual cup is a device that can be easily reused and cleaned, making it economically as well as environmentally sustainable. It does not contain bleach or dioxin unlike some sanitary pads or tampons, so it is non-carcinogenic. The material, Silastic is an inert substance and causes reactions very, very rarely. It has much less frequency of causing TSS (Toxic Shock Syndrome) as compared to tampons. It also helps with cramps since it remains in the vagina by way of suction and helps draw out the menstrual flow. A menstrual cup can be used comfortably by women of all ages.

Dr Ashwini Ajgaonkar,
MD,DGO.
Consulting Gynecologist since 1993,in Mumbai.