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US-POLITICS-BIDEN

A new study found that many<b> </b>period products may be less absorbent than advertised. The reason: Laboratory testing methods fail to mimic the experience of real periods.

Researchers from Oregon Health &amp; Science University began studying the issue when they noticed more of their patients using menstrual cups. But it was difficult to compare their experiences with those of people who used other period products, because most measures of normal or heavy menstrual bleeding are based on how many pads or tampons are needed.

As the doctors looked at prior research for equivalencies among the period products, they saw that testing of period products was typically conducted with saline.

The lack of industry testing standards makes it more difficult for doctors to identify patients with heavy menstrual bleeding, which can affect quality of life and lead to further health issues such as iron deficiency and anemia, said Bethany Samuelson Bannow, a hematologist and one of the study’s co-authors.

Recognizing that saline is a poor substitute for menstrual blood, the researchers decided to conduct their own study to compare the maximum absorbency of menstrual products using human blood instead.

The study, published in August in the <a href="https://srh.bmj.com/content/early/2023/07/03/bmjsrh-2023-201895.full" target=_blank>BMJ Sexual &amp; Reproductive Health Journal</a>, used expired human packed red blood cells from the hospital’s blood bank. The researchers tested 21 products from 11 different brands, including menstrual discs and cups, which are worn internally and collect period blood, as well as 13 tampons, pads and menstrual underwear, which absorb it.

The tests showed that menstrual discs typically carried the most blood, and menstrual underwear usually soaked up the least when also compared with pads, tampons and menstrual cups.

They found that a majority of the products underperformed compared with their absorbency claims, probably because they had been tested with non-blood liquids.

The findings could be medically relevant to those who experience heavy periods and count on labels and advertising claims to help them choose the right product.

Actual menstrual blood wasn’t available in the volume necessary for the research. The expired human red blood cells the team used also had limitations. In addition to red blood cells, menstrual blood contains cells from the uterine lining and other secretions, making it more viscous than what researchers used. They also couldn’t emulate period flooding and clotting, or the angling or pressure on products when they’re worn, Samuelson Bannow said.

The team hopes additional research of heavy menstrual bleeding will offer additional insights.

“The reality is, in women’s health, we don’t have that knowledge about the uterus that we do about all of the other organs,” Samuelson Bannow said. “And as a hematologist who studies bleeding disorders, it’s absolutely shocking to me that we have an organ that’s literally designed to bleed and stop bleeding every month, and we really haven’t delved into exactly how that works.”

Tampons are regulated by the Food and Drug Administration as medical devices. In the 1980s, after many women developed the life-threatening illness <a href="https://www.washingtonpost.com/news/speaking-of-science/wp/2016/03/21/women-are-still-getting-toxic-shock-syndrome-and-no-one-quite-knows-why/" target="_blank">toxic shock syndrome</a> after using super absorbent tampons, a task force proposed standardized testing methods for the products.

The task force members settled on using a saline solution through laboratory machinery known as the synthetic vagina, which mimicked vaginal pressure and flow rates to simulate a period. The FDA later required standardized tampon labels such as regular or super plus based on the Tampon Task Force’s work.

There aren’t similar regulations for pads, period underwear or menstrual cups and discs.

Makers of period products have embarked on their own testing methods.

Karla Welch and Sasha Markov, co-founders of The Period Company, say the brand’s period underwear undergoes laboratory fabric testing, but they believe their best way of testing is with real people.

In response to the OHSU study, the brand <a href="https://www.tiktok.com/@periodaisle/video/7267723602315824390?lang=en" target=_blank>Aisle</a>, which sells period underwear and reusable pads, posted a TikTok to let customers know they test with a synthetic menses that mimics the viscosity and texture of real menstrual blood.

Aisle partners with the global testing facility SGS to verify how much its products can absorb and for <a href="https://www.washingtonpost.com/wellness/2023/08/10/forever-chemicals-pfas-period-underwear-tampons/" target=_blank>PFAS testing</a>, said Suzanne Siemens, Aisle co-founder and chief executive.

“We don’t want to be making claims about our products that can’t be substantiated,” Siemens said. “I’m hoping that consumers are just more aware that they should look behind the claims that brands are making and hold them to account. And I would also say that I’m hopeful that this study makes brands more aware and conscious that they need to stand behind their claims.”

Saalt, which makes period underwear, times the release of synthetic blood and applies weights to test the absorbency of its period underwear, menstrual cups and menstrual discs, said Danna Hall, the company’s director of product development.

Saalt chief executive Cherie Hoeger says she hopes increased awareness of the study will help normalize talking about periods and subsequently allow people to find the menstrual products that make them the most comfortable.

Samuelson Bannow said her focus is not on specific products, but helping women seek help for heavy menstrual bleeding.

“We’re not recommending that anybody change the menstrual products they use,” said Samuelson Bannow.

But if “their quality of life is being impacted by how often they have to change their products, then really the answer is to manage the bleeding,” she said. The goal is to encourage patients “to go to a doctor and get a strategy to reduce the bleeding more than it is to change product or use a product that’s more absorbent.”

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University of Florida, BS in Journalism

Samantha Chery is a breaking news reporter in Features. Previously, she was a multiplatform editor for The Washington Post's gender and identity team. She joined The Post in 2022 as a reporting intern for the Features desk.

Samantha Chery

Doctors finally used blood to test how much period products could absorb

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Elizabeth von Oehsen/The Washington Post; iStock

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Period products are tested with saline. A study found many underperform

Period products tested with saline underperform 

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