In this 2017 photo a worker cuts locally made biodegradable sanitary pads known as Makapads, made from waste paper with papyrus as the absorbent, that sell for half the price of imported pads, at the factory in Kampala, Uganda. Menstrual hygiene has emerged as a serious, and often emotional, subject in Africa, where some experts say governments must supply free sanitary pads to girls who are often at risk of dropping out of school because of embarrassment. AP Photo/Stephen Wandera

Living with someone inherently brings you into closer personal quarters; traveling with someone brings you even closer—long layovers and cramped hotel rooms stripping away customary boundaries.

Walking into the bathroom of our hotel in Addis Ababa, Ethiopia, this truth hits me in the face like a slap.

“What are you doing?!” I ask, desperately covering my virgin eyes from the carnage of one of our most basic human functions. My travel companion, Andréa Paige casually shrugs, and goes back to hand-washing her reusable cloth menstrual pad.

My delicate male sensibilities had never witnessed such barbarism; our bodily functions are normally concealed in “fresh” scents and sterilized plastics. But my friend had lived in India for six years and despite growing up in America tries to tread lightly on the earth. Turning away from the red-tinged water flowing surprisingly unthreateningly down the drain, I hid outside the door and began to query her exotic practices.

This being new territory for me, and being aware that this intensely personal female subject may not be the domain for male writers who often pontificate on women’s issues, I was eager to learn more.

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According to the book Flow: The Cultural History of Menstruation, the average woman throws away 250 to 300 pounds of “pads, plugs, and applicators” in her lifetime. The average American woman will use approximately 11,000–14,000 tampons over her lifetime and overall 20 billion sanitary products are dumped into North American landfills every year (100 billion globally).

As with most waste from disposable products, the environmental impacts are considerable. Most conventional sanitary pads are made of 90% plastic and therefore will not biodegrade, and a Life Cycle Assessment of tampons conducted by the Royal Institute of Technology in Stockholm found that the processing of LDPE (low-density polyethylene thermoplastic) for tampon applicators and plastics in sanitary napkins requires very high amounts of fossil fuel generated energy. A year’s worth of a typical feminine hygiene product leaves a carbon footprint of 5.3 kg of CO2.

In 2010 during a UK beach cleaning, 23 sanitary pads and 9 tampon applicators we found per kilometre of British coastline. And according to the Center for Marine Conservation, over 170,000 tampon applicators were collected along US coastal areas in one year. From the plastic packaging, to the pesticides and bleaches and non-organic cotton, to the heavy metals used during production, the environmental impacts of having turned this monthly human ritual into something disposable are substantial.

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And then there are the potential health effects. The U.S. Food and Drug Administration doesn’t require that companies declare what their feminine care items are made of because they’re listed as medical devices and not personal care products, therefore keeping women in the dark about what they’re exposing their bodies to. From dioxins to pesticides, these links show the potential negative consequences of the current model.

There are alternatives out there, but thanks to our disposable culture and a $15 billion feminine care industry motivating businesses to keep things as they are, conversations about other options are still rare. The period, as witnessed by my own reaction, is still a taboo for men—many of whom believe it should be hidden away and neatly disposed of, no matter the cost.

Diving into this subject was a new experience, and the deeper I went the more I discovered how this basic human function can severely impact a woman’s life.

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According to this piece, 50% of school-age girls in certain Ugandan districts are forced to miss school during their periods, while in Kenya 65% of women cannot afford to buy pads. And, terribly, a number of 15-year-old girls admitted turning to prostitution for money to buy pads.

Alternatives to the current disposable model are not only important for the environment, but can also help empower women. Bana is a Ugandan startup that uses handmade banana fibres in their pads, offering affordable alternatives and employing local women in their production.

Eco Femme is a women-led social enterprise based in India, producing reusable cloth pads with a focus on education and empowerment.

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It seems like new conversations are finally being started, removing stigmas and helping give women options. There is even a new Bollywood film releasing this month, “Pad Man”, the story of an Indian man turned entrepreneur and activist for women’s access to safe and affordable menstruation products.

For Andréa Paige, my travel companion, it’s so clear why women should choose more natural options. “I can’t imagine my period any other way. I used to have to carry around and purchase incessant amounts of pads and tampons. Now it’s a pouch of useful tools that make me feel responsible about my impact upon the earth and my body. No TSS risk (Toxic Shock Syndrome) or suffocating plastic. Not many women know, but our menstruation is a form of detoxification. It’s our responsibility to be more engaged and check in with our bodies!”

I’ll leave the last words to her.