The photos went instantly viral: A young woman, focused and athletic, running the London marathon with a crimson stain across her inner thighs.
The marathoner was musician and feminist Kiran Gandhi, and she was menstruating.
Gandhi decided to run the marathon without a tampon or pad at first because using menstrual products during such an arduous run felt uncomfortable. As the photos went viral, they also became an expression of power for all menstruators: There is no shame in our periods.
The history of menstrual hygiene has been characterized with much more shame than pride. Across cultures, menstruation has been considered impure or taboo, and it unfortunately often remains so today. Even when it comes to menstrual hygiene products like tampons, advertisers have regularly chosen to market our periods as something we should be ashamed of or hide.
Yet modern tampons have also proven a deeply empowering invention, allowing people with periods the option of greater mobility and convenience. The history of the tampon reveals how far we’ve come—and the progress we still need to make to smash menstrual stigma.
A Time Before Tampons?
Records of how historical people stemmed their menstrual flows are sparse. That’s because most people who menstruate are women, who have traditionally lacked access to literacy, and whose concerns male physicians were less likely to take seriously in medical treatises.
Medical documents from ancient Rome reveal a view of menstruation as powerful but polluting. Ancient Roman historian Pliny wrote that menstrual blood could kill crops, but also that it could cure diseases. He wrote about cloths stained with menstrual blood, indicating the Roman women likely used rags to catch their menstrual flow. Women in Ancient Rome are also said to have used wool inside their vaginas, while women in other societies may have used natural fibers vaginally.
In 17th and 18th century England, menstruators used homemade pads fashioned from rags, often linen, which they pinned to their clothing and called “clouts.” Peasant women and others living in poverty may have simply bled on their clothes. Around the same time, in Qing era China, women may have used paper. Chinese commentators also wrote about the sight of women laboring in fields with “bloodstained crotches,” suggesting that in China, too, peasant women often didn’t use menstrual products.
The Making of the Modern Tampon
The modern tampon was a product of industrialization and increasing commercialization. Up until the late 19th century, the vast majority of people who menstruated made their own pads out of rags.
Starting in the 1840s in the United States, however, magazines began publishing ads targeted at women which advertised sanitary products like “trusses” or “bandages” that users could suspend on belts between their legs when menstruating.
There were also advertisements for menstrual cups, which unlike modern menstrual cups were held in place with elaborate (and frankly uncomfortable-looking) belts.
By the 1920s, consumers were buying disposable sanitary napkins from drugstores, department stores, or mail-order catalogues. That set the stage for the invention of the modern tampon.
The First Tampon Patent
In the 1920s, nurses sometimes made tampons out of cotton and gauze in medical settings. The absorbent wads were more commonly used to soak up blood from wounds in World War One, or to administer medicine vaginally.
That changed in 1929, when Denver-based physician Dr. Earle Hass patented a design for the first modern day tampon. It consisted of a tight wad of cotton attached to a string, with a telescoping cardboard applicator, similar to what we use today.
Hass invented the applicator because he believed it was more sanitary than users touching their own vaginas. That also, likely, had to do with deeply held fears that women shouldn’t experience sexual pleasure or be too connected with their own bodies. (Indeed, some scientists of the time worried that sanitary napkins rubbed too much on the clitoris, causing impure thoughts.)
Hass named his new product Tampax, a name he arrived at by combining “tampon” and “vaginal pack.” He sold the Tampax company name and patent in 1934 to Gertrude Tenderich, who became the founder of the modern-day Tampax company.
We can trace the cultural use and reception of tampons through the 20th century by following tampon ads: the good, the bad, and the sexist. These ads reveal that tampons helped women become more mobile during their periods, but also that advertisers tried to tie tampon use to antiquated ideas that periods should be hidden or kept “discreet.”
The very first tampon ads in the 1930s included advertising for deodorizing tampons, which perpetuated the false and harmful notion that our vaginas need to be perfumed. (In fact, perfumes can be very harmful to the vagina’s natural microbiome.)
In the 40s, 50s, and 60s, tampon ads focused on discretion and confidence. They showed images of sad girls, worried they wouldn’t be as “alluring,” who became happy and able to socially impress boys with the use of tampons. They emphasized how stealthy tampon boxes were, and addressed fears that using tampons would “take a woman’s virginity.” (In fact, tampons can be used whether or not you have a hymen, and the presence or absence of a hymen doesn’t reflect on whether or not you’ve had sex.)
Ads in the 70s and 80s pivoted more toward emphasizing how physically active women could be when they were using tampons, though they still promoted traditional ideals like marriage. Tampon ads were banned on television until the early 1970s, and it wasn’t until 1985 that the word “period” could be used on TV; the first use of the word was in an advertisement featuring Courtney Cox.
Raising the TSS Alarm
For the first 50 years of the tampon’s life, the design remained pretty much the same: a thin cylinder of cotton and nylon, with either a cardboard applicator or no applicator. That changed in the 1970s, when manufacturers began experimenting with super-absorbent synthetic materials, like carboxymethylcellulose, or CMC. This resulted in the invention of Procter and Gamble’s “Rely,” a super-absorbent tampon that hit the market in 1975.
At first, users and the company both touted Rely as a great achievement. But soon, the experiment turned south.
Hundreds of cases of a mysterious illness whose symptoms included very high fever, dizziness, and chills began showing up in hospitals. Doctors discovered that many of these cases were linked to the use of Rely. The tampon’s high-absorbency synthetic ingredients promoted the growth of Staphylococcus aureus in the vagina—a bacteria that secreted a toxin leading to the disease.
Dozens of young women died as a result of tampon-associated Toxic Shock Syndrome, leading to a recall of Rely and deep concern for women across the United States. Feminists and environmental activists agitated the US government to hold tampon manufacturers to a higher level of safety. As a result of their work, the FDA released guidelines requiring tampon manufacturers to label products notifying customers of TSS risk and advise that customers use the lowest required absorbency for their flow.
The Future of the Tampon
Today, tampons are safer and come in more varieties than ever. Still, advocates continue to push the menstrual hygiene industry to reject harmful materials, to create more environmentally sustainable products, and to reject harmful advertising.
The Menstrual Movement
Thanks, in part, to the activism of Kiran Gandhi, commentators labelled 2015 the “year of the period.” Menstrual activism had been an important part of the feminist movement since the 1970s, but in the early 2010s, this activism broke through to mainstream.
The same year Gandhi completed her bold marathon run, poet Rupi Kaur put out a lovely photo series showing her own experience of menstruation. When Instagram censored the photo for being too graphic, Kaur and her supporters fought back, arguing that this censorship was a sexist form of stigma; they won the battle and got the images reinstated on Instagram.
The same year, activists in India launched several bold, high-profile campaigns to normalize menstruation in a social context where girls and women often have to miss school or work due to period stigma. Activists also launched campaigns against tampon taxes all over the world, arguing it was sexist for governments to tax an essential health product.
Meanwhile, tampon companies also began engaging in more frank, and less stigmatizing ways with periods. The Libresse brand’s “Blood Normal” campaign was one of the frankest displays of menstruation in advertising. It used red, blood-like liquid to showcase its product, a departure from the euphemistic “blue liquid” that tampon companies had typically used as a stand-in for menstrual blood.
Cutting Down on Chemicals
While menstrual activists have pushed the FDA to regulate tampons more in the past few decades, these regulations remain incomplete, posing a potential risk to both our bodies and the environments. Tampons have historically been made of a mixture of cotton and synthetics, and manufacturers used chlorine to bleach them.
There was a dangerous catch to this product: chlorine bleaching processes produce dioxin as a byproduct. And dioxin is a toxic chemical that has been linked to reproductive damage, including endometriosis.
As a result of pressure from activists, today the FDA advises that tampons be free of dioxin, and pesticide and herbicide residues. It also requires tampon manufacturers to disclose the presence of dioxin. Yet these rules don’t guarantee dioxin-free tampons, and they don’t account for other potentially harmful chemicals found in tampons as a result of agricultural chemical use. For this reason, some environmental health advocates prefer 100% cotton tampons.
A More Eco-Friendly Period
Menstrual activists haven’t just raised concerns about the stigma and negative health effects associated with conventional menstrual products: They have also challenged the environmental impact. Tampons are single-use, disposable products, meaning they generate a lot of garbage. A menstruator who uses twenty tampons a month for thirty years will generate approximately 7,000 used tampons in their lifetimes. Tampons with applicators can create even more waste.
Many of these products are improperly disposed of: While you should never flush tampons down the toilet, menstruators in the U.K. alone flush more than 2.5 million each day. These applicators can enter our waterways and even wash up on beaches; during just one summer of beach cleanups in New Jersey, volunteers found 3,000 plastic tampon applicators washed up on shores.
Beyond the Tampon
The best choice to cut down on waste from tampons, however, is to use tampons less—or not at all. While tampons remain a convenient choice for many menstruators, a new wave of reusable menstrual products is focusing on increasing sustainability while stomping out menstrual stigma for good.
More Choices Than Ever
Today, it seems that menstrual product choice has, in some way, come full circle. The rise of period panties—underwear specifically designed to absorb a day’s worth of menstrual blood—is a throwback to the reusable cotton and linen rags that women used in premodern times, though they’re far cuter. Reusable menstrual pads are also increasing in popularity.
Meanwhile, menstrual cups, first patented in the 1930s, are now gaining in popularity thanks to this emphasis on sustainability. Menstrual cups are reusable, made of medical-grade silicone or rubber latex, and can last years. Many menstruators have written rave reviews about their happiness in making the switch, and as a result, the menstrual cup industry grew by over 200 million dollars between 2017 and 2019.
There has also been increasing public conversation about free bleeding: Not using any menstrual product at all, similar to many of our ancestors and to Kiran Gandhi’s famous marathon run.
From Menstrual Stigma to Period Pride
Sometimes, progress can feel halting. Nearly a hundred years ago, tampon ads emphasized that a lady should never let others know she’s menstruating. Today, manufacturers continue to run ads touting their products’ discreet packaging, and often still use that euphemistic blue liquid in ads.
At the same time, the rise of the period-positive movement, from Instagram campaigns smashing menstrual stigma to the repeal of the tampon tax, represents real progress. Just like Kiran Gandhi running the London marathon without shame, our society has come a long way toward a society without menstrual stigma—and we can all work together to cross the finish line.
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