Period product comparison…

Headline News- menstrual cups are number 1!

Want to know which period product comes out on top? For those of you too busy to read the whole article, just know this: Menstrual cups performed best across all of the evaulation categories- health, performance, cost, environmental impact, marketing methods, and impact on self-esteem!

After cups, we have more new entries in the form of reusable products such as washable pads, and period underwear… and then, sliding down the charts, we have tampons and disposable pads…

  • 1st Menstrual cups – 94%
  • 2nd Washable pads/ liners – 80%
  • 3rd Washable underwear – 78%
  • 4th Tampons – 59%
  • 5th Disposable pads – 58%

Notes: We compared ‘average’ products of each type e.g. the average menstrual cup, the average washable pad, the average period underwear, the average disposable pad, and the average tampon. Although specific brands will perform slightly better or worse than the average, we wanted to be able to compare the different ‘types’ of period product overall.

So, for example, organic disposable pads- whilst they might have slightly better health, performance, and marketing scores than major pad brands, they remain unlikely to score more than organic tampons, or even the least ‘ethical’ menstrual cup, or washable pads/underwear brands…

We also tried to be as objective as possible, by examining positives and negatives for each product, and selecting a wide range of criteria with which to compare products. Of course, even disposable products are good at their job, and much better than using dirty rags, newspaper, or any other non-specific period products, as sadly too many people around the world are forced to do.

1. Health

  • 1st Menstrual cups
  • 2nd Washable pads/ liners
  • 3rd Washable period underwear
  • 4th Disposable pads/ liners
  • 5th Tampons

Vaginal dryness – Only tampons increase vaginal dryness, since they are absorbent internal products.

Infections – UTI’s, bacterial vaginosis, and vulval skin infections can occur if users forget to wash and rinse their hands (remove all traces of soap!) before inserting/removing internal products such as cups, or tampons. Pads and, to a certain extent, the string from a tampon, can also transfer faecal bacteria to the vagina or urethra, potentially causing infection.

Toxic Shock Syndrome (TSS) – Whilst it is not known exactly why some people are more likely than others to develop TSS (although there is a genetic component), it is thought that vaginal dryness (possibly causing vaginal cuts and abrasions) and the length of time that a tampon is inserted are factors in the development of TSS. There is one known case of TSS developing in a menstrual cup user, and several thousands of cases in tampon users. Always use the least absorbent tampon possible, and do not leave internal products inserted for longer than the recommended length of time (e.g. 8 hours for most tampons).

Blood loss measurement – How much is too much? Anything over 80ml blood (160ml fluid) per period counts as ‘heavy bleeding’. With a translucent menstrual cup with marked levels, you can easily and accurately record blood loss. People who use other products are forced to estimate blood loss e.g. a fully soaked ‘super’ tampon or pad= approx. 10ml blood, each regular soaked tampon or pad = approx. 5ml blood. This is slightly easier to do with tampons than pads, and both disposable options may be easier to inspect than washable pads or underwear.

Chafing/ discomfort– The main offenders are disposable pads, since they can rub against skin, stick to pubic hairs, and get hot and sweaty… Tampons can cause discomfort if flow is light, or if the string gets wet. Reusable pads are breathable and more comfortable to wear than the disposable kind. Inserting and removing cups can take a bit of getting used to, but once inserted correctly the user shouldn’t feel anything.

Length of period – Tampons can prolong a period (by up to 2 days), probably because they ‘stop the flow’ rather than ‘collect’ it, like cups and external products do.

2. Performance

  • 1st Menstrual cups
  • 2nd Tampons
  • 3rd Washable pads/ liners
  • 4th Washable period underwear
  • 5th Disposable pads/ liners

Leakage protection – Alas, heavy bleeding, user error, and the fact that life can sometimes get in the way of changing/ emptying menstrual products when needed, mean that leaks are always possible… However, menstrual cups, tampons, and disposable pads have a slight edge over washable pads, or underwear- simply because cups have a large capacity and so require less frequent emptying, and tampons and disposable pads are currently better able to handle ‘peak flow’ moments… But, for most people all of these methods provide good leakage protection, it is only when heavy bleeding is involved that washable products may be more likely to leak.

Ease of use – Internal products (menstrual cups and tampons) do usually require some patience and practice with insertion/ removal. However, this tends to happen within 3 periods, so definitely worth the short term effort. Pads and period underwear are usually pretty easy to use for the first time.

Accessibility – Disposable products are everywhere! Sadly, not so for reusable products, although the Mooncup is available in Boots, the Divacup in Superdrug, and the Femmecup in Holland and Barrett, and health stores may stock other menstrual cup brands. Washable products are easily available online, and are now stocked in a few shops, too.

Comfort – As mentioned in the health section above, reusable products are more comfortable in general. Tampons tend to be more comfortable to use than disposable pads (once insertion/ removal has been mastered).

Capacity – The cup wins yet again- with an average capacity of around 25-30ml, compared to 10-15ml for tampons or disposable pads, and 5-10ml for washable products.

Frequency of changing – This is related to capacity, but also covers other factors such as ‘smell’ (e.g. as found with disposable pads)… Cups can be left in for up to 12 hours, tampons up to 8 hrs, and pads for as long as comfortable (usually less than 8 hrs). Washable pads/ underwear are less likely to smell than disposable pads.

Length of life – Cups are stated to last 5-10 years, but can last even longer than this… Washable pads tend to last longer than period underwear, simply because of the ‘wear and tear’ factor (pads approx. 5yrs, underwear approx. 2-3 yrs.). Disposable products only last until usage, and can be damaged if kept in humid conditions before use e.g. a bathroom.

Land sports– Internal products are the best for active sports, since pads and underwear can become smelly once sweat is added to the menstrual mix! Gentle exercise is fine for all products.

Swimming – Internal products are the best options for swimming and other water-based activities during menstruation. Both tampons and cups perform very well, although make sure you change/empty them soon after you get out of the water.

3. Cost

  • 1st Menstrual cup (£2 per year)
  • 2nd Washable pads/ liners (£8 per year)
  • 3rd Washable period underwear (£20 per year)
  • Joint 4th Disposable pads/ liners, and tampons (£30 and £38 per year- every year!)

Cost per item obviously works in the favour of disposable products, but as soon as costs over time are taken into consideration, reusable products reveal much higher value for money. Disposable options also create far greater waste management costs (not included in the annual cost calculation, but reflected in the scores).

Since you only have to buy reusable products once every few years, you also don’t waste time and money purchasing fresh supplies every month…

4. Environment

  • 1st Menstrual cup
  • 2nd Washable pads/ liners
  • 3rd Washable period underwear
  • Joint 4th Disposable pads/ liners, and tampons

Sustainability/ landfill waste/ pollution – This relates to the materials and processes involved in the manufacture, distribution, and disposal of these products.

Menstrual cups are usually made from silicon polymers- the main environmental impacts derive from silicon mining, which releases carbon monoxide into the atmosphere, and can cause silicosis (lung disease) in those who mine it. However, the environmental/ social impact caused by the manufacture of menstrual cups, specifically, is almost negligible, especially when compared to those of other menstrual products. Also, the fact that one cup can last more than 10 years, makes it the most environmentally sustainable option, by far.

Washable textile items (pads, liners, or period underwear) – the main environmental impacts derive from the textile industry, which is highly polluting, and typically involves unethical supply chains; especially in regard to workers’ health, pay, and rights. Organic, undyed, natural fabrics, or those that ‘up-cycle’ existing fabric, are better than those that do not. Pads last longer and are more likely to be upcycled than period underwear, so they score slightly higher on average.

Disposable products (pads, liners, or tampons) – the main environmental impacts derive from the manufacture, distribution and disposal of large amounts of chemically treated, non-bio-degradable products that are commonly sent to landfill, or flushed into the water system. Organic non-bleached biodegradable products are better than those that are full of chemicals, and do not readily degrade over time. The disposal of so-called ‘disposable’ menstrual products is a big issue, both in terms of landfill and waste water management. They are estimated to create over 200,000 tonnes of waste each year in the UK.

CO2 footprint – This is an estimated rating based on the average manufacturing process, ‘air miles’ or shipping distance, and disposal methods for each product. Washable pads are scored more highly than washable period underwear because they are more likely to be made from existing fabrics, rather than from fabric produced to order (usually from overseas).

5. Marketing

  • 5 stars – (all reusable products)
  • 1 star – (all disposable products)

We have included ‘marketing’ because, historically, this has played an important part in influencing the way in which we view menstruation in the UK (which in turn has an effect on menstruators’ self-esteem, health, and wellbeing).

By framing menstruation as something dirty, unhygienic, and shameful, (i.e. something that must be hidden from others) disposable ‘sanitary hygiene’ companies were able to sell more products. Thankfully, in recent years, this approach has been disrupted by the increase in availability of reusable products, and greater consumer awareness.

Despite their relative lack of marketing budget, reusable product brands are now at least able to produce shame-busting YouTube adverts- check out this particularly relevant ad from Mooncup;

6. Self-esteem

  • 5 stars – Menstrual cups
  • 4 stars – Washable pads/ liners, period underwear, and tampons
  • 3 stars – Disposable pads/ liners

Regular readers of Menstrual Matters will know that good self-esteem is a critical component of improved health and wellbeing. What you may not know, is that different menstrual products can help, or hinder, self-esteem?

For example, a menstrual cup can really boost self-esteem as you get to know your body better, and menstruation becomes less mysterious once you can really see what’s happening. Similarly, other reusable products can boost self-esteem by allowing the user to feel positive about protecting the environment, and choosing a more stylish or natural option than those offered by disposable products. Even Tampons can enable users to swim, play active sports, and generally carry on as usual- even if they do ultimately result in landfill waste… Pads may be less intimidating than other products, but the fact that they can rub, or become smelly, can be bad for self-esteem.

Can you think of any more aspects of menstrual management that we should add to this list? Please let us know

Please cite this article as: King, S. (2017) “Period product comparison…” Menstrual Matters, [Date accessed],

Categories: No pain, Period products and The basics.