New Delhi: On June 5, the World Environment Day, eminent scientist Dr Soumya Swaminathan released a report on the use of menstrual cups, a method for managing menstrual hygiene. The report, ‘Why India needs to move beyond sanitary pads’, has been brought out by Action Research and Training for Health (ARTH) at a webinar titled ‘Sustainable Menstrual Hygiene Options’. The event was hosted by ARTH and Population Foundation of India.
Dr. Swaminathan said, “The report estimates that a woman generates around 14.1 kg of non-biodegradable waste in a lifetime if she uses commercially manufactured disposable sanitary pads. On the other hand, if she uses menstrual cups she will generate .06 kg of non-biodegradable waste. This reduces the generation of total non-biodegradable waste by 99% and is an example of a win-win intervention that is good for the environment and good for health and hygiene. Menstrual cups are practical, hygienic, and cost-effective. More and more women need to know about them and myths around their use need to be busted.” The webinar included voices of young champions who shared their experiences of leading Initiatives for menstrual hygiene and cloth pad accessibility in their respective communities.
As many as 77% of girls and women (89% in urban areas and 72% in rural areas) in the 15-24 years age group were using a hygienic method for managing their menstruation, according to NFHS-5 (2019-21). ARTH has successfully introduced menstrual cups in two districts of Rajasthan as part of a documented study, the findings of which were shared at the webinar. The study analyses the various methods available for menstrual hygiene management and the urgent need to expand to sustainable and reusable methods which benefit both women and the environment.
The ARTH report states that pads are the most used method as these have been widely promoted by the corporate sector and distributed free or subsidised by the government. It notes that pads consist of 49% polymers and disposal of used pads remains a problem- only two Indian cities – Pune and Bengaluru – separate menstrual waste during routine garbage collection. The recommended methods for treating and disposing used pads include use of incinerators, deep burial, composting and pit-burning. However, not doing this can lead to negative health and environmental impacts. The study also observes that tampons – with 10% non-biodegradable content –are not reusable.
Making a case for menstrual cups, the report states that cups have been available since the 1930s, and are sold under various brand names in the market and on e-commerce sites. Made of medical grade silicon, the cup does not break down into microplastics. “It is reusable, and has a far lower environmental impact than sanitary pads,” said Dr. Sharad Iyengar, CEO of ARTH.
Poonam Muttreja, Executive Director of Population Foundation of India, said the advantages of menstrual cups were that it offered longer duration of menstrual apart from cost-effectiveness. “However, it is important to undertake communication campaigns with communities that they support the use of menstrual cups. Evidence shows that women who transitioned from locally made cloth pads to cups experienced high levels of satisfaction. Promoting cups as a method of menstrual hygiene management along with other options like pads and tampons will offer choice to women and let them choose a method that they prefer to use.”
In July 2019, ARTH introduced menstrual cups, called RituCup, to rural women through a network of 630 trained community health entrepreneurs (CHEs). Named after Ritu Kaal, meaning menstruation in Sanskrit, the menstrual cups were promoted over three-and-a-half years. As many as 5,695 cups were purchased by women in Udaipur and Rajsamand districts till March 2023.
Sharing their experience of using the cup, most women found that the menstrual cup helped them “improve their work efficiency, ensure privacy, and greater mobility.” The report stated that ARTH field staff met with 784 women who had purchased cups between January 2022 and March 2023. Around 84.4% of them had used for all of the last three months, while a small number had used it for only one or two of the last three cycles. “The 784 women included 109 adolescent purchasers, of whom 83.5% used the cup, while the rest used pads, cloth, and a combination of the two,” said Dr. Iyengar.
Promoting alternative methods of menstrual hygiene management
The study has argued for the promotion of the menstrual cup as one of the options available to women. However, it says there are currently no global or national standards for the manufacturing of menstrual cups. “There is a need for national standards for menstrual cup manufacturing that cover quality, health, safety and performance aspects,” said Dr Iyengar.
Dr Iyegnar suggested government agencies and welfare-based organisations should promote this method by either subsidising it or providing it free of cost, especially to those from marginalised communities.