The Perpetuation of Health Inequalities by Period Product Research

Foreword
Up until 2017, menstrual products had never been depicted with realistic period blood. For decades, menstrual products such as pads and tampons were tested with saline instead of real blood. While this may not seem like a pressing issue, these representations falsely reflect how these products perform in real life. To understand this discovery and how it is changing the way that researchers, doctors, and consumers view menstrual health as a whole, we must first examine the history of using saline as a substitute for blood.

Cultural Stigma around Period Blood
Every month, 1.8 billion people globally menstruate. Although it is a completely natural and recurring process, many women face stigma, shame, and social exclusion during menstruation. Even now, the topic of periods is still considered taboo in many parts of the world.

The primary reason companies use the liquid blue saline solution is the long-standing taboo surrounding menstruation. Public beliefs often associate menstruation with sex, impurity, and an issue that should only concern women.

Dr. Bethany Samuelson Bannow, an associate professor of medicine at OHSU (Oregon Health and Science University) who conducts blood-based testing on menstrual products, stated in an interview that “the taboos, stigma and shame surrounding menstruation are deeply damaging.”

A recent study in Kerala, India, on the attitudes of adolescent girls towards menstruation, shows that over 51% still report a negative attitude towards the topic of menstruation. This clearly emphasizes the struggle of companies to switch and depict their products using real menstrual blood. Though with the way menstruation is represented, it has slowly evolved over time. In 2017, the first-ever advertisement showing realistic period blood aired, challenging the long-standing use of blue liquid in period product commercials.

Although this moment marked an important shift towards normalizing the menstrual cycle and reshaping how it is viewed as a natural process, the scientific testing method has largely stayed the same, well until now that is.

The Issue with Saline in Research and Development
In 1982, under the direction of the FDA, companies began to focus heavily on research and development to create menstrual products with a wide range of absorbencies.

“So somebody can pick the least absorbent product they manage their period, and hopefully, that will reduce the risk of toxic shock.” Said Dr. Bethany Samuelson Bannow.

Toxic shock syndrome is a serious medical condition resulting from infection with certain toxin-producing bacteria, in women, sometimes associated with the use of tampons or vaginal contraceptive devices.

“[A company’s] goal isn’t really to tell you how many millimeters of blood you lost. Their goal is to get you through your day without having a leak,” Samuelson added. The golden standard set by The Tampon Task Force, established by the FDA to analyze the absorbency of period products, is the use of saline. Saline is a more easily standardized liquid in laboratories. However, it lacks cells and tissues and differs in viscosity from menstrual blood, which causes discrepancies in the behaviour of laboratory theories and real-life usage.

With this information, the practicality of menstrual products comes into question. Theoretically, the absorbency level printed on the packaging product may differ from the actual absorption of a tampon or pad.

Ongoing Scientific Research
Dr. Bethany Samuelson Bannow has highlighted a growing scientific interest in quantifying how much blood a person loses during their cycle. Her research has contributed to a more comprehensive understanding of medical understanding of heavy menstrual bleeding– excessive menstrual blood loss can heavily affect a person emotionally, physically, and socially.

Dr. Bannow led the first-ever study to evaluate the performance of menstrual products using actual blood rather than a saline solution. Utilizing her university medical center’s extensive blood bank, she used samples of expired blood units in her experiment.

Drawing on resources that are not commonly available, Dr. Bannow found that most menstrual products, including pads and tampons, absorb more blood than their claimed absorptive rates. Her findings challenge industry claims about absorbency and indicate current product ratings may have been misunderstood or overlooked.

A Bright Step towards Health Equality
Beyond consumer convenience, this clinical research has transformed how medical professionals assess heavy menstrual bleeding. Doctors have traditionally relied on how frequently a patient changes menstrual products estimate blood loss. This new understanding allows for more accurate diagnoses to be found.

With real blood being used, we are slowly bridging the gap between controlled, laboratory data and everyday experience. Ultimately, this marks a shift in consumer and healthcare benefits, leading to improved medical care. The increased attention being directed towards basic healthcare signals a future with stronger healthcare systems, greater scientific accuracy, and more equitable care.