Global HealthNewsNewsletter

Menstrual Hygiene Management

By Luce Mosselmans, Uppsala University


Every woman gets periods, yet there are still taboos around them especially concerning safe and hygienic management of menstruation. The most striking example of this is tampon TV commercials, where periods are a blue liquid. This taboo is linked to culture, and I can only speak from my own experiences in Western Europe. When I first considered changing from tampons to a menstrual cup, I did not feel like this was a socially acceptable topic to discuss with other women around me. This led to hours of research on the internet and not always reassuring information about what is called “menstrual hygiene management” (or MHM).

It is common for menstrual hygiene products to be advertised with a blue or purple liquid, which is more discreet for viewers (Source:

Every girl needs to find out what MHM suits her best. Pads are probably the easiest to use, and tampons are mostly well tolerated as a hygienic method. However, both can be a hazard to safety if not used correctly. They need to be changed at least every 4 to 7 hours. In the 80s, tampons were associated with Toxic Shock Syndrome (TSS), which led to a change in the chemical composition of tampons. In spite of this, consumers still face a mystery around what exactly is in a tampon or a pad, as regulations do not require producers to list elements of composition and chemicals used. Additionally, they are broadly available and consumers sometimes don’t really have another choice. This is slowly changing with the rise in popularity of menstrual cups as an alternative MHM method. Cups have been around even before tampons were invented but have not been very popular in the last decades, maybe because tampons are perceived as more practical and hygienic, but also possibly because some people make a lot of money out of tampons and pads. Cups collect menstrual blood, when tampons absorb it. This means they do not require chemicals and are less disturbing for the vaginal flora, as natural secretions are not absorbed.

Which type of menstrual hygiene product is the best and safest to use? You decide for yourself. However, every method can be a hazard if not used correctly (Source: Pinterest)

One factor that should not be neglected, is the ecological and economical importance of those products. Studies estimated women need an average of 14 pads or tampons per cycle, or 168 per year. This means Swedish women all together use 630 million pads and tampons in one year, and each woman spends an average of 672kr a year on MHM (assuming the price of a box of tampons to be 50kr). This is a huge cost for women, and is worrisome for women in precarious financial situations. Every month women are put in a crisis situation if they can’t afford this, and may have to stay at home, or prioritize MHM over food.  Homeless women are particularly vulnerable since they also lack sanitation infrastructure to safely and hygienically manage their periods, and are often forced to put their health at risk on top of being denied dignity.

There are still girls who do not have access to adequate MHM, with consequences on their education, ability to work and on the long-term gender inequality. UNESCO reports 1 in 10 girls missed school during their period in Sub-Saharan Africa, and this figure was 25% in a study in India. A large number of girls simply drop out of school altogether when their periods start. Cups seem to be a sustainable, ecologic and economic solution to be implemented in areas where MHM products are insufficient. However, this may not be feasible in low income countries since it requires water and sanitation facilities, as they need to be sterilized between each cycle to be safe to use. Additionally, a barrier to adequate MHM is often the taboo surrounding periods, with cultures where menstruating is perceived as something shameful and harmful rites such as isolation of menstruating women and girls are part of daily life. In rural Nepal, women have died in menstrual huts, because tradition says menstruating women are not to sleep in the house or touch men and animals. Cultures that give a lot of importance to virginity may not accept tampons and cups for unmarried women, as they can break the hymen and make a girl impure.

Lack of adequate information, access to products and facilities to safely manage menstrual periods are harmful to girls and woman all over the world, and efforts need to be made to fill this gap.




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