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.
Table of contents – report overview
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.
Are single-use menstrual products a problem?
Single-use menstrual products such as tampons and pads are a significant contributor globally to single-use plastic waste.
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 menstrual products and sustainable alternatives report findings
The reusable menstrual cup
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
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.
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).
Related questions about menstrual products and our findings
According to our report, although shown to be environmentally preferred by a considerable margin, the reusable menstrual cup cannot be considered a viable alternative unless the wider social and economic system is able to accommodate it. For example, cultural and religious taboos will need to be overcome. Sufficient infrastructure, such as access to running water, and privacy in the home, schools and places of work will need to be ensured. The importance of the social and economic aspects is touched upon here but socio-economic aspects are not the focus of the report, which is on the environmental aspects of single-use menstrual products and their alternatives, specifically on insights obtained from taking a life cycle perspective.
In one of the studies in our report, the environmental impacts of the reusable pads 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.
According to our report, the tampon without applicator is the best possible preference among single-use products.
Our study concludes that reusable menstrual cups have the lowest environmental impacts relative to all other alternatives and should be chosen whenever practicable. In some societies, however, when considering social and religious norms – in addition to environmentally sound practices, the reusable pad is found to be the preferred option. This is the case for instance in India where reusable pads are locally produced. When produced abroad and shipped via airfreight, reusable pads, however, have the highest environmental impacts, even against single-use options. So, purchasing locally is key. Therefore, menstrual cups are better than reusable pads, from an environmental perspective, although in practice, one should not necessarily exclude the use of the other, depending on context.
About the menstrual products and sustainable alternatives report
This report provides insights from Life Cycle Assessments (LCA) to inform decisions on single-use menstrual products and their alternatives. The report is based on the review and analysis (meta-analysis) of selected existing LCA studies that compare single-use menstrual products and their alternatives. The different solutions for providing women with protection during menstruation considered in this report thus only include those options that have been covered in the LCA literature. The following single-use (disposable) and reusable options are considered:
- Single-use tampon (with and without applicator)
- Single-use pad
- Reusable pad
- Reusable menstrual cup
LCA studies were evaluated according to the following criteria:
Type of product: Studies that covered single-use (disposable) and reusable products designed to provide women with a sufficient level of protection during menstruation so that they are not prevented from carrying out their usual daily activities were included.
Completeness of the study: Full LCA studies were selected over preliminary or screening LCA studies.
Transparency of the study: Only studies that included sufficient details in the publication were shortlisted, particularly on methodological assumptions, sources of data and impact assessment methods.
Geographic coverage: Electricity grid mix, available waste management technologies and efficiencies, and recycling rates differ significantly by geographic region. Thus, selecting studies to cover as many regions as possible was important for the meta-analysis. This report is intended to have global applicability, which provides further rationale for selecting studies for broad geographic coverage.
Publication date: Technologies improve over time and so although the original screening considered publications from 2000 onwards, more recent studies were given preference in the final selection.
Language: The meta-analysis only included studies published in English.
Peer-reviewed studies: Preference was given to studies that have been through a peer review process. Compliance with international standards is not a selection criterion, as this is often not explicitly stated in publications. Furthermore, it is assumed that the peer review process would focus on compliance with relevant standards.
Life cycle assessments studies considered
Comparative Life cycle assessment of menstrual products: Vilabrille Paz, C., Ciroth, A., Mitra, A., Birnbach, M. and Wunsch, N (2020)
References in the menstrual products and sustainable alternatives report
ANSES (2018) Opion of the French Agency for Environmental and Occupational Health and Safety on the safety of feminne hygien products. Available at: https://www.anses.fr/en/system/files/CONSO2016SA0108EN.pdf
Arena, U., Ardolino, F. and Di Gregorio, F. (2016) ‘Technological, environmental and social aspects of a recycling process of post-consumer absorbent hygiene products’, Journal of Cleaner Production, 127, pp. 289–301.
Borowski, A. M. (2011) Are American women turning to reusable and greener menstrual products due to health and environmental pollution concerns? Rochester Institute of Technology.
Available at: https://scholarworks.rit.edu/theses/544/.
Cabrera, A. and Garcia, R. (2019) The Environmental & Economic Costs of Single-use Menstrual Products, Baby Nappies & Wet Wipes: Investigating the impact of these single-use items across Europe.
Available at: https://zerowasteeurope.eu/wp-content/uploads/2019/12/bffp_single_use_menstrual_products_baby_nappies_and_wet_wipes.pdf .
Cooper, K. (2018) The people fighting pollution with plastic- free periods’, BBC News, 30 April.
Available at: https://www.bbc.com/news/world-43879789.
Cordella, M., Bauer, I., Lehmann, A., Schulz, M. and Wolf, O. (2015) Evolution of disposable baby diapers in Europe: Life cycle assessment of environmental impacts and identification of key areas of improvement’, Journal of Cleaner Production, 95, pp. 322–331.
Danish Consumer Council THINK Chemicals (2018) Test: Menstrual cups.
Available at: https://kemi.taenk.dk/bliv-groennere/test-menstrual-cups
EDANA (2020) 2019 Nonwoven Statistics Released.
Available at: https://www.edana.org/about-us/news/2019edana-nonwoven-statistics-released.
Hait, A. and Powers, S. E. (2019) The value of reusable feminine hygiene products evaluated by comparative environmental life cycle assessment’, Resources Conservation and Recycling, 150.
Jamieson, A. J. et al. (2019) Microplastics and synthetic particles ingested by deep-sea amphipods in six of the deepest marine ecosystems on Earth’, Royal Society Open Science. Royal Society Publishing, 6(2).
KEMI (2018) Survey of hazardous chemical substances in feminine hygiene products.
Available at: https://www.kemi.se/publikationer/rapporter/2018/report-8-18-survey-of-hazardous-chemical-substances-in-femininehygiene-products.
Leroy, Y., Yannou, B., Murthy, L., Lallmahomed, A. and Yannou-Le Bris, G (2016) ‘Which hygienic products for which continent? Design for usage and sustainability’, Proceedings of International Design Conference, DESIGN, DS 84, pp. 311–320.
Mazgaj, M., Yaramenka, K. and Oleksandra, M. (2006) Comparative Life Cycle Assessment of Sanitary Pads and Tampons, Royal Institute of Technology Stockholm.
Available at: https://docplayer.net/39797321-Comparative-life-cycle-assessment-of-sanitary-pads-andtampons.html.
Musaazi, M. K. et al. (2015) Quantification of social equity in life cycle assessment for increased sustainable production of sanitary products in Uganda’, Journal of Cleaner Production, 96(SI), pp. 569–579. Peberdy, E., Jones, A. and Green, D. (2019) ‘A Study into Public Awareness of the Environmental Impact of Menstrual Products and Product Choice’, sustainability, 11(2).
Roos, S., Jönsson, C., Posner, S., Arvidsson, R. and Svanström, M. (2019) An inventory framework for inclusion of textile chemicals in life cycle assessment’, International Journal of Life Cycle Assessment. The International Journal of Life Cycle Assessment, 24(5), pp. 838–847. SCBD (2020) Global Biodiversity Outlook 5. Montreal.
Available at: https://www.cbd.int/gbo/gbo5/publication/gbo-5-ar.pdf.
Scranton, A. (2013) Chem Fatale.
Available at: http://www.womensvoices.org/wp-content/uploads/2013/11/Chem-Fatale-Report.pdf.
de Souza Machado, A., Kloas, W., Zarfl, C., Hempel, S. and Rillig, M. (2018) Microplastics as an emerging threat to terrestrial ecosystems’, Global Change Biology. John Wiley & Sons, Ltd (10.1111), 24(4), pp. 1405–1416.
Specia, M. (2020) Tackling “Period Poverty,” Scotland Is 1st Nation to Make Sanitary Products Free’, The New York Times, 24 November.
Available at: https://www.nytimes. com/2020/11/24/world/europe/scotland-free-period-products.html.
Tingle, C. and Vora, S. (2018) Break the Barriers : Girls ’ Experiences of Menstruation in the UK.
Available at: https://plan-uk.org/file/plan-uk-break-the-barriers-report-032018pdf/download?token=Fs-HYP3v.
UNEP (2021) United Nations Environment Programme (2021). Single-use nappies and their alternatives: Recommendations from Life Cycle Assessments.
Available at: https://www.lifecycleinitiative.org/library/single-use-nappies-and-their-alternatives/
Vilabrille Paz, C., Ciroth, A., Mitra, A., Birnbach, M. and Wunsch, N. (2020) Comparative Life cycle assessment of menstrual products. GreenDelta GmbH, commissioned by einhorn products GmbH. WECF International (2020) Toxic Free Periods: Eco-friendly healthy plastic free periods.
Available at: https://www.wecf.org/toxic-free-periods/.
Weir, C. S. (2015) In The Red : A private economic cost and qualitative analysis of environmental and health implications for five menstrual products.
Available at: https://cdn.dal.ca/content/dam/dalhousie/pdf/science/environmental-science-program/Honours Theses/2015/ThesisWeir.pdf.
Wen (no date) ‘Environmenstrual fact sheet’.
Available at: https://www.wen.org.uk/wp-content/uploads/Fact-Sheet-Environmenstrual.pdf.
Zero Waste Europe (2020a) Policy recommendations to make menstrual products, nappies and wet wipes circular.
Available at: https://zerowasteeurope.eu/library/policy-briefing-on-menstrual-products-nappies-wet-wipes/.
Zero Waste Europe (2020b) Single-use menstrual products, nappies and wet wipes: Assessing existing measures and providing policy recommendations to minimise the impact of these singleuse items across Europe.
Available at: https://zerowasteeurope.eu/library/existing-measures-policy-recommendations-to-minimise-the-impact-of-menstrual-products-nappies-wet-wipes/.
Zero Waste Europe (2020c) The Bloody Manifesto.
Available at: https://zerowasteeurope.eu/library/the-bloodymanifesto/.
Copyright © United Nations Environment Programme, 2021
Credit © Photos: www.shutterstock.com