In the last couple of years, the number of ecological alternatives to traditional tampons and sanitary pads has exploded on the femcare market, from menstrual cups and reusable pads to period panties. Most of these products are not innovations. On the contrary, they have long histories and have failed to succeed in the past.

Socio-political structures in Western culture have shaped our perceptions of menstruation to sell products that are harmful to human health and the environment. They have created a system that feeds off and reinforces negative perceptions of menstruation: menstrual capitalism. Looking at the evolution of these perceptions from the 1800s reveals how the menstrual care industry and its marketing strategies are born from the inequalities of patriarchal society.

Menstrual activism highlights the multifaceted problems of this system, both in terms of its gendered and ecological impacts. Radical menstrual activists propose a way forward that puts aside the interests of femcare corporations to instead serve the environment and human health in an inclusive way.

Perceptions of menstruation: a brief history

Nearly every civilisation has socially constructed taboos about menstruation. Prior to the rise of modern science in Western countries during the late 19th century, menstrual blood was shrouded in contradictions based on fear, misunderstanding, and the beliefs of mainly patriarchal religions such as Judaism, Christianity, Islam, and Hinduism. Such taboos remain current in many parts of the world today. In India, almost 80 per cent of menstruating girls observe religious restrictions, half observe restrictions on touching people or special foods, and a quarter sit or sleep separately from other family members.

Through this education, girls internalise the male gaze attached to feelings of shame and disgust, and the need to hide and conceal menstrual blood.

In the Western world, the medical sciences shifted perceptions of menstruation from pre-modern taboos to medicalisation focused on hygiene. Yet the male-centred view retained its influence. The belief that menstrual blood was toxic and abject persisted in medical sciences through the 20th century but its roots lie in ancient superstition. The Greek physician Hippocrates, the “Father of Medicine”, claimed that menstruation served to rid the body of harmful substances. In 1920, Dr Bela Schick coined the term “menotoxin” after concluding that flowers handled by a menstruating nurse wilted more quickly. Menotoxin was thought to be the source of the toxicity of menstrual blood. During the first decades of the 20th century, menstruation was still believed to be a way to get rid of “bad blood”. This theory was only disproved in the late 1950s. More than just blood, the menstruation process as a whole began to be seen as a feminine handicap. Medical texts framing menstruation as dirty and taboo date back to the 13th century, but it was until well into the 20th century that swimming or taking a bath during menstruation was thought to induce illness. 

The rise of medical knowledge and its importance in daily life enabled subtle forms of social control over the human body. Today, pubescent girls are instructed on the “proper way” to menstruate and what it means for their body: they are able to procreate. Socially, this rite has often been linked to entering womanhood and perpetuates “feminine” stereotypes such as the “crazy menstruating woman”, or assumptions that all women menstruate. Through this education, girls internalise the male gaze attached to feelings of shame and disgust, and the need to hide and conceal menstrual blood. Because it is mostly women that menstruate, menstruation is associated with inferiority, legitimising women’s oppression.

Corporate control

In the UK, this control most notably plays out through the education system. Femcare companies donate period education lesson plans and product samples to schools. These are branded and point students to the brand’s website for more information (such as Always in the UK and the US). These marketing techniques are disguised as “corporate social responsibility” to improve the school attendance of female pupils. The environmental impacts of the products are ignored and few lesson plans present alternatives to the companies’ single-use products. 

While menstrual education and school attendance are important, the need for branded samples and teaching resources is debatable. It is the only school subject reliant on branded materials. Policymakers need to help schools form a curriculum which provides holistic and impartial menstruation education, without the involvement of private interests. Schools should provide unbranded products and make toilets available and clean at all times, with water, dryers, and bins. In the UK, the Period Positive campaign aims to change perceptions of menstruation by developing positive narratives through a menstrual literacy programme for teenagers.

Today, periods are characterised as a shameful hassle, best kept hidden even from the person menstruating. Femcare companies capitalise on this taboo, creating products that will help the menstruator to erase the reality of menstruation. Reminders like stains are markers of the stigmatisation of menstruators as unclean and irrational, and often result in social distancing. Some go to great hygienic lengths, using products and practices such as douching to “pass” as non-bleeders. For some, disposable products are an effective way for women to hide their periods.^[1] Yet the promotion of “passing” reinforces the shame associated with this bodily process, a perception handed down to the next generation. Tampax applicator tampons are one of the oldest and most successful products on the global femcare market, in part due to their disposability and a design that makes it unnecessary to touch blood. The success of menstrual cups has been much more unsteady, for precisely the opposite reason. Adverts promote products that can be opened silently, are discreet and easy to dispose of. Brands push “innovative” products at a higher price but these innovations tend to come down to aesthetics: the product may “smell like flowers”, be “odourless”, or have new packaging.

As these corporations spread their products across the world, they spread the ideal of the modern menstruator as discreet, clean, active, female, and white.

Corporations use processes of international development to extend their control over menstruating bodies. Global North-based corporations have long donated menstrual education programmes and products to developing countries, often in collaboration with policymakers. Procter & Gamble, for example, conducts a programme across India’s schools to educate young girls about menstruation and the importance of sanitary products for hygiene. This project is based on a logic assuming that the use of cloth or natural materials rather than disposable products is “backwards”.

As these corporations spread their products across the world, they spread the ideal of the modern menstruator as discreet, clean, active, female, and white. This notionally emancipated and sophisticated Western version of menstruation creates a disparity between individuals who can afford disposable menstrual products and those who cannot. Moreover, the commodification contributes to the increasing flow of wealth to Western countries from less-developed nations.

Another marketing ploy is the appropriation of feminist or environmental messaging. This pink- and green-washing is apparent in Always’ “Always Keeping Girls in School” campaign in Africa or, more globally, Tampax’s organic tampons. Such strategies play on the idea of empowerment through making periods less time-consuming and inconvenient at work. Disposable products are presented as more hygienic, easier, and more comfortable.

The idea of emancipation through the control of menstruation was also promoted by parts of second-wave feminism.^[2] Some third-wave feminists, however, distance themselves from this view and criticise it as being manipulated by corporations and blinded by taboo. From this critique, two strands of activism have emerged: feminist spiritualist menstrual activism – focused on challenging the taboo and the denigration of menstruation and the female body – and radical menstruation, which sits at the intersection of third-wave feminism, environmental concern, and consumer rights.

Menstruation as a social concern

The Toxic Shock Syndrome (TSS) scandal of the 1980s marks a key moment in the history of menstrual activism. At the time, activism focused on reforms and holding corporations to account. When activists pushed for uniform tampon absorbency ratings, they were trying to improve the existing femcare industry. Health issues associated with tampons (such as micro lacerations of the vaginal wall) are often down to misuse due to a lack of information. Catering to the taboo associated with period blood, menstrual products are made to appear as clean as possible, often using dangerous and toxic products for bleaching. Consumers in the US have demanded more transparency on what is in menstrual products, and the State of New York now requires full disclosure of ingredients on product packaging. Whilst producers now must also mention the risk of toxicity associated with highly absorbent internal products, this is usually not clear enough to customers: many know about TSS but do not link it to the product’s absorbency. In the EU, no specific legislation is in place for menstrual products, which fall under the General Product Safety Directive (only safe products can be placed on the market); producers do not have to disclose what the products are made of.

Aside from human health, the taboos surrounding menstruation also have a negative ecological impact. The chemicals used for bleaching products can damage the environment as well as our bodies. Plastic is another issue, both in terms of production and waste. With the popularisation of plastic wrappers, corporations began to use plastic in all of their products. Tampon applicators, for example, went from being cardboard-based to plastic. Most menstruators are expected to produce around 150 kilograms of waste in their lifetime, of which a significant amount will end up in environmentally sensitive areas such as coastal regions. Today, tampon applicators are the fifth most common item found on European beaches. A report by Zero Waste Europe found that in 2017 the EU-28 generated about 590 000 tonnes of waste from over 49 billion disposable menstrual products.

Most menstruators are expected to produce around 150 kilograms of waste in their lifetime, of which a significant amount will end up in environmentally sensitive areas such as coastal regions.

Just as plastic straws are being progressively banned all over the world, menstrual products should not be excluded from debates about plastic waste. Sanitary pads are composed of up to 90 per cent plastic. The processing of polyethylene used in tampon applicators and pads requires large amounts of fossil fuel-generated energy. Each of those products takes 500 to 1000 years to decompose. Many component chemicals pollute groundwater and soil, while those flushed into the underground water system clog drains and pollute the oceans with microplastics. 

Looking to the start of the product lifecycle, the raw materials used in production also create soil and water pollution. Most tampons and pads are made of cotton, or a blend of cotton and rayon. Cotton production degrades soil and uses large amounts of agro-chemicals and water. The production of rayon, a synthetic fibre created from wood pulp, is highly energy- and water-intensive, and causes deforestation and soil impoverishment.

When it comes to carbon footprint, the 46 billion tonnes of menstrual products used yearly in Europe equates to the equivalent of 245 000 tonnes of CO₂, equivalent to the annual impact of 52 000 cars. Research has found that using sanitary pads for one year (approximately 240 products) amounts to the equivalent of 8.5 kilograms of CO₂ (7.2 kilogrammes for organic pads). The figure falls to 5.3 kilograms for tampons and between 0.02 and 0.04 kilograms for menstrual cups. Environmental impact assessments of reusable menstrual products are currently harder to find but, on the whole, reusable menstrual products are far more environmentally friendly than single-use ones.

The economic dimension of menstruation should also not be overlooked. Buying menstrual products represents a significant cost, especially considering the socio-economic disadvantage already faced by women. This cost is compounded by the “pink tax”. Period products – in countries such as US and UK – are classed as “luxury items” and are taxed at higher rates. The rate applied to menstrual products varies from place to place, from 5 per cent in the UK to up to 27 per cent in Hungary in 2019. The estimated lifetime cost depends on various physiological and social factors but range from 1730 euros according to the BBC in 2017 to an estimated 5360 euros according to NGO Bloody Good Period. Whatever the cost, it is prohibitively high for some, with students and the homeless most affected.

A red warning: menstrual activism

Menstrual activism attributes the harmful environmental, health and economic effects to the corporate and capitalist system, more concerned with profit than ecological concerns or consumer wellbeing.^[3] It advocates not reform of the system but its outright rejection, and it challenges the corporate control of the femcare industry over menstruators through their creation of a manufactured dependency on disposable products. Radical menstruation activists oppose the stigma faced by menstruators and the association of menstruation with femininity and womanhood, preferring a more inclusive gender-neutral approach. They recognise the importance of including all genders, specifically trans, non-gender conforming, and non-binary individuals, as well as giving a voice to trans men who menstruate (by putting bins in all bathrooms, for instance) and trans women who do not bleed but still experience a hormonal cycle (through the appearance of certain symptoms). They use the term “menstruators” instead of “women who menstruate” as a strategy to disgender menstruation through language.

Inspired by the punk movement, menstrual activists propose taking power and control over their bodies and menstruation back from corporations. Through shock actions, festivals, and workshops, they present alternatives and deconstruct the “passing” ideal menstruator.

Inspired by the punk movement, menstrual activists propose taking power and control over their bodies and menstruation back from corporations.

The Bloodsisters are widely considered the leaders of the radical menstruation movement.^[4] Founded in Montreal in 1995 by Courtney Dailey amongst others, the Bloodsisters fused aesthetic sensibility with political analysis to challenge the status quo on menstruation. Their actions were diverse: zines; activist information networks; graffiti; health, DIY, and self-help workshops; art exhibitions; and industry boycotts. Building on the work of second-wave activists before them (such as the Boston-based women’s collective Our Bodies Ourselves^[5]), they rendered the invisible visible, translating menstruation into public actions.

But feminism was not the only movement taking action. The Student Environmental Action Coalition in the US led a campaign in the early 2000s to replace corporate menstrual products. Their Tampaction campaign included traditional workshops and talks but also radical cheerleading.^[6] Today, the UK-based Women’s Environmental Network and the NGO Zero Waste Europe have campaigned on the environmental impacts of menstrual products. While the former focuses on education and awareness-raising (through a dedicated “environmenstrual” week), the latter has published reports on the environmental and economic costs of single-use menstrual products and potential solutions, calling for European countries to take action.

In recent years, menstrual activism has made a comeback in the mainstream. In April 2016, the premier news magazine Newsweek ran a feature on menstrual activism. As the movement has grown, it has become more dynamic and difficult to categorise. While their approaches vary, these activists all confront and resist a medical and consumer culture which exploits the menstrual experience for profit and devalues the menstruating body as inferior, dirty, and sick.^[7]

The end of menstrual capitalism?

We are still far from having healthier, more inclusive and environmentally friendly menstrual practices and products. Our current habits have emerged from a patriarchal capitalist society and are shaped by increasing commodification. A feminist political ecology approach, which considers the social constructs around menstruation practices as well as economic and environmental considerations, challenges this. It looks at traditional gender roles and perceptions of menstruation as socioecological dimensions of economic processes.

Future generations should understand that periods are not something to be ashamed of and that menstrual practices and choices cannot be separated from the environment or our wider societies.

Menstrual activism frames menstruation and the practices surrounding it as an important factor in decisions concerning environmental and health policy. Recognising this would radically change the way we perceive menstruation. The stigmas around menstruation can be broken, through education and a conscious effort from governments to better promote reusable and toxic-free alternatives, still unknown to the majority of the population. Future generations should understand that periods are not something to be ashamed of and that menstrual practices and choices cannot be separated from the environment or our wider societies.