Posters of the film Padman, with Akshay Kumar clutching a sanitary pad like a Wimbledon Trophy have made the sanitary napkin far more visible than ever before. While it remains to be seen whether the movie will stop chemists across India from handing sanitary napkins to women without first wrapping them in a newspaper or a black polythene bag, urban women have moved on to using more convenient products to deal with their monthly period.

For 26-year-old Purvi Gupta, using a menstrual cup was a life-changing experience. “When I first used the cup last year, I realised I almost forgot I was having my period. It works best at night when I can sleep without worrying about staining,” she said.

It lowers the risk of rashes too. “I had read about it but products like menstrual cups and menstrual panties were not readily available in India a few years ago. Now you can choose from a wide range of products on online retail websites, with good quality cups costing as little as Rs 200 to Rs 300,” said Gupta.

Pads vs Cloth

In India, nearly 58 per cent of women between the ages of 15 and 24 used hygienic methods of menstrual protection, found National Family Health Survey (NFHS) 2015-16.

“This means around 42 per cent of the women were still using unhygienic methods, which lead to infections. Our first aim is to ensure women use hygienic products and since disposable sanitary pads are the cheapest and the most readily available, most organisations promote their use,” said Dr Surbhi Singh, a Delhi-based gynaecologist who runs a non-profit organisation called Sacchi Saheli to promote menstrual awareness and health among adolescents.

Of the people who use hygienic menstrual protection, 42 per cent use commercially available sanitary napkins, according to the NFHS data.

Disposable sanitary pads, which contain chemicals, gels and plastic sheets to make them more absorbent and leak-proof, create a lot of waste that is poorly managed. India generates an estimated 13 tonnes of menstrual waste annually in the form of 12.3 billion disposed sanitary pads, according to a report by PATH, Water Aid and Water Supply and Sanitation Collaborative Council.

“This is just an estimate. If 121 million women in India use two pads for four days a month, one billion pads are discarded every month,” said Arundhati Muralidharan, who works in the policy team of WaterAid India.

Going Green

“To manage menstrual waste and promote menstrual hygiene, people can opt for reusable products,” said Muralidharan, who uses cloth pads to lower her carbon footprint.

Priyanka Jain, 32, the founder of the Hygiene and You website dedicated to promoting the use of sustainable menstrual products, first used a cup when she was in the UK more than a decade ago.

“I was 19 and had used only disposable sanitary pads till then. The only problem was I couldn’t go swimming. So I started looking for alternatives and discovered menstrual cups on Google,” she said.

Three years ago, she thought of promoting it in India. “I realised that most people had the same set of queries, so I started the website that answers 15 or 20 basic queries and creates awareness through articles and videos,” she said.

She switched to cloth pads when she introduced it on her website. “I needed to try it first to persuade people to use it. Cloth pads are easily washable, much more comfortable than the disposable sanitary napkins, does not cause rash and does not smell awful,” she said. Now, she has a line of cloth pads too.

“In the last year or so, more and more people have moved to these sustainable options, but it is still a minuscule percentage,” she said.

Downside

Using cloth, say gynaecologists, is not the best solution. “The pH of the vagina becomes alkaline during the menstrual cycle and cannot stop bacterial growth as effectively as the acidic vaginal fluid. This means that if it is not cleaned properly, the cloth can become a source of infection,” said Dr Jyotsna Suri, professor of gynaecology, Safdarjung hospital.

“The cloth pads have to be washed and dried in the sun, and I don’t see many women doing that,” said Dr Singh.

Many women don’t like products that need to be inserted. “From the years of experience, I have learned that women in India are not comfortable with manipulating something in their genitalia. They do not like products that have to be inserted, especially before marriage. This is the reason tampons never took off in India and why menstrual cups are difficult to promote,” said Dr Suri.

Commercial products like silicone cups, padded panties, cloth and jute pads are alternatives that cost more than the ubiquitous pad. “In the longer run, the reusable products are economical, but for the poor, it is impossible for many to shell out Rs 300 to Rs 1,000 in one go. A pack of pads for ₹25 is affordable,” said Dr Singh.

A Clean Change: Alternatives to disposable sanitary napkins

Menstrual Cups: A silicone cup that needs to be inserted in the vagina. Reusable. Has to be washed every 12 hours. May last up to 10 years.Price: Rs 200 – Rs 3,000

Menstrual Panty: A panty with layers of fabric and leak-proof patch. Can be worn like a normal panty during periods. Reusable. Price: Rs 200 – Rs 700

Reusable pads: Pads made of cloth or cotton, which can be washed and reused. Have to be changed like normal pads. Price: Rs 200 - Rs 900

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