Editor’s choice
In recent years, the discussion on sustainability and menstrual health has mainly focused on the environmental impacts of waste from disposable menstrual products. With 1.8 billion people menstruating each month, numerous statistics have highlighted the significant amount of waste these products generate. Reusable product brands have leveraged this data from a marketing standpoint, promoting their products as more environmentally friendly and better alternatives for both the environment and menstruators (Koskenniemi, 2023). Meanwhile, governments in countries like Argentina and Colombia have used this narrative to advocate for policies that incentivize reusable menstrual products without considering the impacts that climate change, norms and cultural beliefs could have on menstrual practices.
Our brief aims to initiate discussions on menstrual policy that go beyond waste and product choices, advocating for a more holistic approach that connects both social and environmental factors. This can avoid a narrow focus on environmental sustainability that situates the problem of pollution with the consumer for environmentally harmful choices they may have no alternative but to make, which only serves to increase stigma and inequality.
The following recommendations are directed to policymakers, as well as researchers and others working and advocating for menstrual justice (Amery et al., 2023; Johnson, 2019).
The ongoing efforts of the ISO Technical Committee 338 to develop standards for menstrual products are highly promising. These standards, which are expected to be finalized by December 2026, are being created for four categories: 1) single-use pads; 2) single-use tampons; 3) reusable cloth-based products; and 4) reusable menstrual cups (The Sanitation & Hygiene Fund, 2024). While the ISO standards aim to enhance the safety, accessibility and quality of these products for everyone who uses them, these standards are not legally binding. Therefore, it is crucial to raise awareness among consumers, retailers and especially policymakers about these standards to encourage menstrual health product companies to comply with them and to build understanding of the environmental impact of different menstrual products, from manufacturing to disposal.
Comprehensive and local assessments are necessary to ensure these products are adequate in different contexts. A study conducted in France, India and the US found that menstrual cups generally have the lowest environmental impact, while organic pads have the highest negative impacts in terms of land use, carcinogenic effects, ecotoxicity, acidification and eutrophication (Fourcassier et al., 2022). The authors emphasize the importance of conducting local assessments to measure the environmental impacts of these products more accurately, considering locally relevant factors such as impacts on freshwater and biodiversity. Life cycle assessment (LCA) studies evaluating products’ environmental impacts across different regions and contexts are still scarce.
While a focus on waste generated by disposable menstrual products is understandable, current waste management systems often fall short in adequately addressing menstrual waste throughout its lifecycle, from disposal to elimination. Disposable menstrual products have a substantial environmental impact, as these products are frequently buried, incinerated or discarded into bodies of water. The recent uptake of flushable menstrual products has been suggested by some as a solution to the waste problem. However, these products are not suitable for areas with inadequate drainage systems or where decentralized sanitation systems are widely used. If not properly disintegrated, flushable products can cause environmental and infrastructural strains.
A more comprehensive approach to waste, one that extends beyond immediate disposal and considers post-disposal scenarios, is imperative. Research shows that inadequate waste management systems can exacerbate anxiety and stress associated with menstruation, particularly in regions where stigma and taboos surrounding menstruation persist (Elledge et al., 2018). Investment in research and development for innovative waste management systems could help significantly reduce the environmental footprint of menstrual products and mitigate the stigma associated with their disposal. Implementation of effective menstrual waste management strategies requires coordinated cross-sector efforts, and collaboration between ministries typically involved in menstrual health policies – such as those focused on education, gender and health – with environmental and waste management authorities is essential for effective implementation.
Menstrual health and justice are deeply intertwined with environmental and climate change processes, as climate and environmental changes exacerbate challenges within menstrual health practices. For instance, water is fundamental for maintaining menstrual hygiene. Washing reusable products becomes inadequate and unsafe in areas where clean water is scarce, even if the products are available. Decrease or unreliability in water supply affects socioeconomically vulnerable individuals disproportionately, since poverty limits accessibility and affordability of menstrual management options. Many reusable options require access to clean water and suitable – hygienic and private – drying spaces, and the effectiveness of reusable menstrual products in the face of climate change remains inadequately assessed.
Water is a particularly important issue affecting the choices and health of menstruating mothers, who need additional safe water for drinking to sustain breastfeeding and for maintaining hygiene for themselves and their children. In these situations, individuals are forced to make difficult decisions, prioritizing their family’s health over their own menstrual health needs. These trade-offs are particularly acute in situations of violent conflict – whose frequency and intensity are also fueled by water scarcity related to extreme weather events and climate change.
Access to menstrual products remains a significant challenge in many countries, often due to market shortcomings. Supply chain inefficiencies, limited availability of products, and uneven demand contribute to the scarcity of these essential items, particularly in low- and middle-income countries (LMICs). The availability of certain menstrual products like tampons or environmentally friendly reusable menstrual cups is still low in many LMICs markets (Rossouw & Ross, 2021). In regions where supply chains are weak or underdeveloped, menstrual products may be unavailable or prohibitively expensive, leaving many menstruating individuals without access to safe and reliable options.
While efforts are being made to understand and enable the complex market ecosystem of menstrual products (The Sanitation & Hygiene Fund, n.d.), more research is needed to identify the strategies required to create viable and sustainable markets, especially for hard-to-reach areas. This research could help strengthen menstrual health markets globally, providing a foundation for developing solutions that ensure menstrual products are available to all who need them.
Menstrual experiences are unique and shaped by numerous factors such as gender, ethnicity, cultural practices, socio-economic conditions, personal health and age. It is thus crucial to understand how these factors intersect to shape unhealthy attitudes and behaviours towards menstrual practices which perpetuate stigma and limit product and disposal choices, and address these in menstrual policymaking.
Menstrual policies can also create and exacerbate stigma and further marginalize individuals experiencing socio-economic vulnerability. For example, policies that denounce disposable products commonly fail to address that despite their significant environmental impact, these products remain the only choice for many menstruators because they are generally the cheapest and most accessible. Norm-responsive and contextual menstrual policies can instead empower menstruators to make informed choices without fear of judgment for decisions associated with structural inequalities, promoting menstrual justice for all.
Acknowledgements
Initial ideas on menstrual waste were developed in connection to the Complicated Plastics project (Formas 2021-00864). Funding support for this brief was provided by the SEI Initiative on Gender Equality, Social Equity and Poverty, funded by Sida as part of the core funding to Stockholm Environment Institute.
Amery, F., Channon, M., Puri, M. C., & Thomson, J. (2023). Developing the menstrual justice agenda: Insights from a mixed method study in the mid-western region of Nepal. Sexual and Reproductive Health Matters, 31(1), 2204025. https://doi.org/10.1080/26410397.2023.2204025
Elledge, M. F., Muralidharan, A., Parker, A., Ravndal, K. T., Siddiqui, M., Toolaram, A. P., & Woodward, K. P. (2018). Menstrual hygiene management and waste disposal in low and middle income countries – a review of the literature. International Journal of Environmental Research and Public Health, 15(11), 2562. https://doi.org/10.3390/ijerph15112562
Fourcassier, S., Douziech, M., Pérez-López, P., & Schiebinger, L. (2022). Menstrual products: A comparable Life Cycle Assessment. Cleaner Environmental Systems, 7, 100096. https://doi.org/10.1016/j.cesys.2022.100096
Johnson, M. (2019). Menstrual justice. U.C. Davis Law Review, 53, 1.
Koskenniemi, A. (2023). Say no to shame, waste, inequality—And leaks! Menstrual activism in the market for alternative period products. Feminist Media Studies, 23(1), 19–36. https://doi.org/10.1080/14680777.2021.1948885
Rossouw, L., & Ross, H. (2021). Understanding period poverty: Socio-economic inequalities in menstrual hygiene management in eight low- and middle-income countries. International Journal of Environmental Research and Public Health, 18(5), 2571. https://doi.org/10.3390/ijerph18052571
The Sanitation & Hygiene Fund. (n.d.). The menstrual health market. SHFund. Retrieved August 19, 2024, fromhttps://www.shfund.org/media/global-standards-menstrual-products-and-why-they-matter
The Sanitation & Hygiene Fund. (2024, June 25). Global standards for menstrual products and why they matter. SHFund. https://www.shfund.org/media/global-standards-menstrual-products-and-why-they-matter
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