Why Are There So Few Safe Options for Menstrual Care?

We all know that medical research for women lags embarrassingly far behind other medical research. Take this example: The myth that the clitoris has 8,000 nerve endings comes from a study on cows mentioned once in a text from 1976. It was only in 2022 – last year! – that scientists studied tissue samples from the dorsal nerve of a human clitoris, and discovered the average clit likely contains about 10,281 nerve fibers, maybe more. That’s a 20% difference. Dr. Maria Uloko, the study co-author, highlighted the need for more and better research into women’s health, and particularly vulvar conditions:

[T]his [study] highlights the broad scope of knowledge gaps that are present within vulvar health. These fundamental gaps […] ultimately do result in significant consequences for patients… There are numerous statistics regarding the difficulty of access to care for common vulvar conditions, [which] lead to significant healthcare cost[s] to patients as well as the healthcare system. We are talking [about] billions of dollars spent on vulvar and urinary conditions alone. And the societal cost of the psychological symptoms associated with just trying to get a diagnosis really can’t be quantified but they are quite high. This research is the start of reassessing what we know about the vulva and filling in those knowledge gaps.

But it was only a few weeks ago when a report came out about toxic PFAS in Thinx brand period panties (and numerous other period products) that I realized the lack of research around vulvar health also translates directly to a lack of research, and therefore a lack of safety measures, regarding our menstrual care products. Namely, women have an astounding dearth of options when it comes to safe menstrual care.

Period panties. As mentioned above, PFAS in period panties were the catalyst for this post. “PFAS” is short for “per- and polyfluoroalkyl substances,” manufacturing chemicals linked to a plethora of medical problems, including: decreased fertility, high blood pressure during pregnancy, increased risk of various cancers, low birthweight and developmental delays in children, hormonal disruption, high cholesterol, immunodeficiency, and more. PFAS are ominously, and aptly, known as “forever chemicals” because they literally stick around for thousands of years before breaking down, making them dangerously persistent and impossible to remove from your favorite pair of Thinx of Knix brand panties. PFAS were also found in an alarming number of other menstrual products, including most non-organic pads and tampons.

What’s especially concerning when dealing with menstrual products, which touch the vulva directly, is that vulvar/vaginal skin is especially permeable and vascular, and can more easily absorb the chemicals present in period products than other skin on the body.

So what can you do? Well, first of all, read the study and/or check this article to see if the period panties or other menstrual products you use were found to contain PFAS in the study. Then check out this guide to buying safer period panties.

Tampons and pads. Just as with period panties, an alarming number of the pads, tampons, and panty liners found on shelves in stores contain toxic PFAS. Major brands including Tampax, Playtex, and Always make products that contain these chemicals – and there’s no way to differentiate safe products from unsafe ones without customers doing some serious research before going shopping. Organic pads and tampons were found to be the most reliably PFAS-free products available, but menstrual products are already expensive and the higher cost is a prohibitive factor for many women.

Hormonal birth control. Hormonal birth control is often prescribed as period care, to deal with irregular bleeding, painful cramps, and other menstrual troubles. Not even taking into account the “normal” side effects of most hormonal methods – which can range from weight gain to drastic mood swings to a dead sex drive, but are brushed off by most doctors – hormonal birth control is a minefield of potential problems. All hormonal birth control pills (even the so-called “mini-pill”) carry a small but nonetheless excess risk of breast cancer, and “low-dose” birth control pills can cause vulvodynia – they did for me, and it took years of expensive treatment (and going through a gauntlet of gynos who didn’t believe birth control pills could be the source of my pain) to recover from. Because hormonal birth control directly affects your hormones, there is unfortunately always the potential for certain risks. Women deserve more and better non-hormonal options, period.

IUDs and the fallout of doctors who refuse to listen to patients. When it comes to having adverse symptoms acknowledged, women are all too often ignored entirely. A wave of women dealing with what they believe to be adverse effects from their IUDs – medical devices often prescribed to alleviate menstrual symptoms – are currently facing an increasing number of doctors who refuse to remove the devices early upon request: “‘Clinicians intentionally delay and deny early-removal requests,’ using long wait times or insisting the IUD is not the cause of patients’ symptoms, said Jamie Manzer, a medical sociologist researching IUD access.” And while insertion of an IUD is free, removal is not (and is often not covered by health insurance, making it too expensive for some to afford), something many doctors fail to mention when patients are making the choice to get an IUD. For all of these reasons, women are removing their own IUDs at home more and more, which can be unnecessarily painful and potentially dangerous. The salient point being: doctors’ mistrust in women’s personal experiences is often the very thing that drives those patients towards riskier choices.

Menstrual cups. If not used properly, menstrual cups may have the potential to cause pelvic organ prolapse. Granted, there doesn’t seem to be a huge risk of this for average women, and there are no studies conclusively linking cups to prolapse, but I’m mentioning it because there is evidence for some connection between incorrect cup usage and organ prolapse, and as with everything else on this list, very little research has been done on the topic. In any case, “proper usage” is a fairly nebulous term that varies by cup and brand, which likely results in a fair amount of “improper” usage. Whether you like and use a cup or not, I think women deserve a wider range of menstrual care options that aren’t potentially linked to organ prolapse – is that so crazy?

So we’re back where we started, then: There are simply far too few safe, accessible options out there for menstrual care. Science neglects women while doctors fail to acknowledge our experiences, and it all results in more dangerous conditions surrounding a bodily function that’s as old as human existence. Frankly, I think that’s a fucking travesty.

What are your feelings on the subject? Are you frustrated with the lack of research into women’s menstrual care? Do you have trouble finding period products that feel safe?

(Note: I am not a doctor and this is not medical advice; I’m presenting my own experiences for informational purposes, but you should consult with your doctor before making any changes that may affect your health.)

Header image via Unsplash.