Menstrual hygiene sounds simple — use a product, change it, wash up. But the sheer number of available products, conflicting advice, and pervasive myths can make what should be straightforward feel overwhelming. As a gynecologist, I see the consequences of hygiene misinformation regularly: recurring infections from douching, irritation from scented products, and TSS scares from forgotten tampons. Let's clear the air with practical, evidence-based guidance.
📦 Product Comparison: Finding Your Match
There's no single "best" menstrual product — the right choice depends on your flow, lifestyle, comfort, budget, and environmental priorities. Here's an honest comparison:
Disposable pads: The most widely used product globally. They sit in your underwear and absorb flow externally. Pros: easy to use, no insertion required, widely available in different absorbencies. Cons: can feel bulky, may shift during activity, generate significant waste (an average menstruating person uses 5,000 to 15,000 pads in their lifetime), and some women develop contact irritation from adhesives or fragrances. Choose unscented, unbleached pads whenever possible.
Tampons: Inserted into the vaginal canal to absorb flow internally. Pros: discreet, allow swimming and vigorous exercise, feel invisible when properly inserted. Cons: carry a small risk of Toxic Shock Syndrome (TSS), require comfort with insertion, and need regular changing (every 4–8 hours). Always use the lowest absorbency that manages your flow — a higher-absorbency tampon on a light day increases TSS risk because the dry tampon can create micro-abrasions.
Menstrual cups: Reusable medical-grade silicone cups inserted into the vagina to collect (not absorb) flow. Pros: can be worn up to 12 hours, reusable for 5 to 10 years (enormous cost and environmental savings), hold more than tampons, and are associated with a lower TSS risk. Cons: learning curve for insertion and removal (typically 2 to 3 cycles to master), need access to water for rinsing between uses, and require sterilization between cycles (boiling for 5 minutes).
Menstrual discs: Similar concept to cups but sit higher in the vaginal canal at the cervical fornix. Pros: can be worn during penetrative sex (unlike cups), hold a generous 60 to 70 ml, and auto-dump when you use the toilet. Available in disposable and reusable versions. Cons: same learning curve as cups, and some women find them more challenging to remove.
Period underwear: Underwear with built-in absorbent layers that wick moisture and prevent leaks. Pros: feel like normal underwear, excellent for overnight use, light-flow days, or as backup with a cup or tampon. Reusable and increasingly available in stylish designs. Cons: higher upfront cost, need rinsing and washing after each use, and heavier flow may require pairing with another product.
Many women find that combining products works best: a menstrual cup during the day, period underwear at night, pads for the first heavy day when cup changes would be frequent, or a disc for swimming. There's no rule that says you must use one product exclusively. Experiment until you find your ideal combination.
🦠 Toxic Shock Syndrome: Rare but Real
TSS is a rare, potentially life-threatening condition caused by toxins produced by Staphylococcus aureus or Streptococcus pyogenes bacteria. While TSS is associated with tampon use (particularly super-absorbent tampons left in too long), it can also occur with menstrual cups, contraceptive sponges, wound infections, and surgical sites. The incidence is approximately 1 in 100,000 menstruating women per year — very rare, but the consequences are severe enough that prevention knowledge is essential.
- Sudden high fever (39°C / 102°F or above)
- Sunburn-like rash, especially on palms and soles
- Rapid drop in blood pressure (dizziness, fainting)
- Vomiting or diarrhea
- Severe muscle aches
- Confusion or disorientation
Prevention: Change tampons every 4 to 8 hours (never sleep with one in longer than 8 hours). Use the lowest absorbency needed. Alternate between tampons and pads when possible. Wash hands before and after insertion. If using a menstrual cup, sterilize between cycles and don't wear for longer than 12 hours. If you've had TSS before, avoid tampon and cup use entirely.
⏰ Change Frequency Guidelines
🚿 Washing Routine: Less Is More
One of the most common mistakes in menstrual hygiene is over-cleaning. The vagina has a sophisticated self-cleaning ecosystem — a balanced community of Lactobacillus bacteria that maintain an acidic pH (3.8 to 4.5), protecting against infections. Disrupting this ecosystem causes more problems than the "cleanliness" it intends to achieve.
Do: Wash the external vulva (labia, perineum) with warm water. If you prefer soap, choose a gentle, unscented, pH-balanced cleanser specifically designed for intimate use. Pat dry with a clean towel — don't rub.
Don't: Douche (ever — this is associated with increased risk of bacterial vaginosis, yeast infections, pelvic inflammatory disease, and ectopic pregnancy). Don't use scented wipes, feminine deodorant sprays, or perfumed products near the vulva or vagina. Don't use antibacterial soap on genital tissue — it kills the protective bacteria you need.
🌙 Overnight Protection Strategies
Nighttime leaks are a common frustration. Here are strategies that work:
Overnight pads: These are longer (up to 40 cm) and wider than daytime pads, with extended back coverage. Position the pad slightly farther back than you would during the day to account for the lying-down angle.
Menstrual cup or disc + period underwear: This combination is the gold standard for overnight protection. The cup handles the bulk of the flow, while the period underwear catches any overflow or positional leaks. Most women can sleep a full 8 hours without issues.
Mattress protector: A waterproof mattress protector eliminates stress about ruining your bedding and is a worthwhile investment for anyone who menstruates.
🌿 Eco-Friendly Options
The environmental impact of disposable menstrual products is substantial. Over a lifetime, a single person may use 5,000 to 15,000 pads or tampons, generating over 100 kilograms of waste — most of which contains plastics that take centuries to decompose.
Sustainable alternatives include reusable menstrual cups (lasting 5–10 years), reusable cloth pads (lasting 3–5 years with proper care), period underwear (lasting 2–3 years), and menstrual discs (reusable versions lasting several years). Even switching to organic cotton disposables, which biodegrade faster and avoid pesticide-laden cotton, is a step in the right direction.
✈️ Travel Tips
Traveling during your period requires a bit of extra planning but shouldn't limit your adventures.
Good menstrual hygiene isn't about achieving sterile perfection — it's about keeping your body comfortable, preventing infections, and finding products that fit seamlessly into your life. When in doubt, keep it simple: change regularly, wash gently, skip the fragrances, and listen to your body.