The report reviews several Life Cycle Assessments (LCA) of single-use menstrual products – pads and tampons – and their alternatives like menstrual cups, reusable pads and period underwear.

The report finds that reusable menstrual products have a lower environmental impact than single-use menstrual products.

Especially the reusable menstrual cup is substantively better for the environment than other product options.

Also, the report covers the critical parameters influencing the environmental impacts of single-use menstrual products and their alternatives.

The report is in response to a request by Member States at the Fourth session of the UN Environment Assembly in March 2019.

What you need to know about the menstrual products and sustainable alternatives report

Below is a summary of the main conclusions on the menstrual products and sustainable alternatives report:

• Reusable menstrual products have a lower environmental impact than single-use menstrual products.
• The menstrual cup is substantively better for the environment than other product options.
• Consumer behaviour is a key determinant of environmental impacts for both single-use menstrual products and reusable products although consumers have far more leverage over their impacts with reusable products.
• The use phase of the menstrual cup and specifically how it is washed and sterilised, constitutes its most significant environmental impacts.
• For single-use products, the environmental impacts lie mainly in the production of materials used in tampon and pad manufacture and in the waste disposal practices of the user and the municipality.
• Depending on geographical context, reusable pads and period underwear, when washed in an energy-efficient manner, have lower environmental impacts than single-use alternatives.
• When comparing the two most widely used single-use products – tampons and pads – they were found to have similar environmental impacts, with consumer behaviour being as much of an impact driver (number of products utilized, hand-washing, and disposal behaviour), as the particular product features.

Read the full conclusion here

They can contain up to 90% plastic and are often individually wrapped. In recent decades, use of single-use menstrual products continues to rise, especially in developed countries.

While it is difficult to quantify their global use, some 49 billion and 19 billion single-use menstrual products are consumed each year in the EU and USA, respectively. While tampons are the preferred choice in Western Europe and the US, the global numbers for single-use pads are anticipated to be even higher due to cultural taboo around tampons. The varied composition of single-use menstrual products, together with the presence of organic matter after use, makes their recycling technically and economically expensive. As a result, the vast majority of these products are landfilled or incinerated.

In Europe and in the USA approximately 87% and 80% respectively ends up in landfills where the plastic components can take up to 500 years to break down, potentially releasing toxic chemicals into the environment as they degrade and generating microplastics that threaten the health of ecosystems.

In addition, single-use menstrual products are at times disposed of carelessly and incorrectly, for example, flushed down the toilet. Hence, they block sewers, cause flooding, and pollute freshwater and marine environments.

Not surprisingly, single-use menstrual products are one of the most frequently collected items in beach clean-ups in the UK, with an average of 5 pieces of menstrual products waste picked up every 100 m on UK beaches. All of this makes for a pressing need to consider alternatives to single-use menstrual products such as reusable menstrual cups, reusable pads and period underwear.

The reusable menstrual cup has substantially lower environmental impacts than single-use menstrual products. This was shown to be the case across all impact categories and regardless of the material from which the menstrual cup was produced (Weir, 2015; Leroy et al., 2016; Hait and Powers, 2019; Vilabrille Paz et al., 2020).

The significantly lower impacts of the reusable cup relative to the single-use products – with the reusable cup having less than 1% of the impacts of the single-use options over a year of use in Hait and Powers (2019) and Leroy et al (2016) – is due in part to its long life span (assumed to be 10 years in these studies).

Nonetheless, the cup needs to be used only for one or two months for its environmental benefits relative to single-use tampons and pads to be realised. The “breakeven” point of the reusable cup made from silicone is between 12 (Weir, 2015) and 20 tampons (Hait and Powers, 2019).

These studies didn’t include sterilising the cups monthly, as recommended by manufacturers, only including rinsing between uses. However, even when full use-phase impacts are considered (rinsing between uses and sterilising with boiling water monthly), the menstrual cup has a better environmental performance than singleuse options, even when used for just one year (Vilabrille Paz et al., 2020).

The use phase of the menstrual cup constitutes its most significant environmental impacts, which are likely to vary with different consumer habits. This is apparent even in the two studies covered in the meta-analysis that assumed the cup only to be rinsed in cold water between uses.

Periodic sterilisation in boiling water, as recommended by the manufacturers, was not included in either study, nor was soap used in washing. The study by Vilabrille Paz et al (2020) addresses this limitation, and finds the cup still to be strongly preferred to single-use pads and tampons, albeit with the use phase playing an even more important role in the life cycle impacts of the cup.

The packaging of the menstrual cup, typically a cardboard box, was found to be a significant contributor to the cradleto- gate life cycle impacts of the menstrual cup for certain impact categories. Many manufacturers include a fabric bag to store the cup in when it’s not in use, which adds to the packaging impacts.

Other reusable menstrual products are not well represented in the LCA literature, with only one of the studies considering a locally produced reusable pad in India. In this study the environmental impacts of the reusable pad were found to be strongly dependent on the geographical context, and in particular on how the pad is washed during its use phase (Leroy et al., 2016).

Although there is a lack of LCA studies on reusable pads and period underwear, it is reasonable to draw comparisons with the wider literature on baby nappies and adult incontinence products, as these are made of very similar absorbent materials (both the single-use and the reusable alternatives).

A conclusion from a meta-analysis on nappy LCA studies is that reusable nappies washed in a water and energy-efficient manner have lower environmental impacts than single-use nappies (UNEP, 2021), and this finding is likely to be true also of reusable menstrual pads and period underwear.

Consumer behaviour

An important insight that the above findings bring is that the environmental impacts of reusable menstrual products (both cups and pads) are driven by consumer behaviour to a much larger degree than single-use products.

Consumers using reusable pads have strong leverage to reduce the environmental impacts, for example, in their choice of washing machine and wash temperature and by washing full loads, in their choice of detergent, and by line-drying their reusable products.

Consumers using menstrual cups have strong leverage in whether they use a kettle or pot to sterilise the cup between uses (with the former having significantly lower energy use and associated emissions), and even just placing a lid on the pot can considerably reduce energy use (Vilabrille Paz et al., 2020).

Using renewable energy will also substantially decrease use-phase impacts. However, for single-use products, the environmental impacts fall largely outside of the influence of the consumer (in the raw materials used in tampon and pad manufacture and in the waste-disposal practices of their municipality). However, across all options (single-use and reusable) the amount of water and soap, and the water temperature used to wash hands before and after changing products, are influential (Vilabrille Paz et al., 2020).

Read the full conclusion here