Comparing Different Menstrual Products: Pads, Tampons, Menstrual Cups, and Period Underwear

Choosing the right menstrual products is going to be a personal choice, that should always reflect and honour your own comfort. In the western world, we are privileged to have access to a variety of options when it comes to menstrual products, which can satisfy a diverse set of needs and requirements that prioritize ease, safety and comfort. The four main products on the scene are tampons, pads, menstrual cups/discs, and period underwear. Here’s our comprehensive low down on these options in regards to their safety, comfort, economic and environmental impact. Hopefully these specs can support you in creating the best period practices for your unique body and flow. 

Mess Friendly 

Reusable Period Underwear and Reusable Pads: Period underwear and reusable pads are both excellent low-mess options for managing your menstrual flow. While these products do require washing after use, they offer significant benefits in terms of absorbency and convenience. For instance, washable menstrual pads like Aisle Cloth Pads absorb 8x as much as the average disposable, which means fewer changes throughout the day and less maintenance overall. 

Period underwear is another great alternative that combines the comfort of regular underwear with built-in absorbent layers, capable of holding a substantial amount of fluid. This makes period underwear a discreet and low-maintenance option, particularly on lighter days or when paired with other menstrual products for added protection. Both options not only reduce waste but also provide reliable, mess-free protection throughout your cycle.

Menstrual Cups and Discs: Overall, this may be the messiest option. While you can change and empty a menstrual cup in a bathroom stall, you aren’t always able to rinse it and wash it, meaning you will need a sink nearby, which is preferably in private or at home. In my clumsiest moments, there has been spillage with removing the cup, which can leave a mess on your skin and clothes, and that single ply toilet paper at work doesn’t do the best job at dealing with. That being said, some individuals who use disks are able to “autodump”. When you use the bathroom, the position of when you are sitting on the toilet coupled with the push to urinate and deficate, tilts the disc downwards and it releases some (not all) of the menstrual fluid that has collected. The ability to autodump really depends on the size of your disc and how snug it is inside your vagina. The less snug, the easier it is to autodump. Therefore, this method may not work for everyone. All mess considered, Aisle Menstrual Cups, hold up to 30 ml or 6 tampons worth, meaning that you may not even have to change the cup throughout the day. 

Pad and Tampons: Due to their disposable, one time nature, pads and tampons leave little to no mess, if there is no leakage and they are changed within a reasonable amount of time depending on your flow. 

Budget Friendly 

Menstrual Cups and Reusable Underwear/Pads: Whilst it may seem like an expensive initial payment, by switching to reusable period products such as menstrual cups, reusable period underwear and pads, you can expect to save around 750 dollars over a five year period!  

Disposable Pads and Tampons: A lot of the times this may seem like and in many cases be the more affordable and accessible option, due to the lower cost, albeit more frequent. It is estimated that people who menstruate in Canada spend up to $6,000 dollars on menstrual products in their lifetime, and this cost can double to $12,000 for people living in rural communities. 

That being said, in Canada, federally regulated workplaces are required to offer free period products in workplace washrooms. Canadian provinces such as Ontario, BC, Manitoba, Newfoundland and Labrador and others have initiatives to make period products within school systems. This could make disposable pads and tampons are more economic choice however, this is not a workplace wide recognized initiative and relying on these initiatives may limit your choice of brand, and absorbency of products. 

IUD Friendly 

Pads, Tampons, Reusable Period Underwear and Pads, and Menstrual Discs:  All of these products are 100 percent safe to use with an intrauterine device. Menstrual discs, which sit back into your vaginal fornix - where your vaginal canal meets your cervix- don’t rely on suction and are safe to use with an IUD.

Menstrual Cups: Since an IUD sits in the uterine cavity and a menstrual cup sits inside the vagina, in theory the cup should not interfere with the placement of your IUD. However, an April 2020 study published in Obstetrics and Gynecology found that menstruators who used a menstrual cup had a higher rate of dislodging their IUD. That isn’t to say you can’t use a cup if you have an IUD. IUD expulsion and dislodgement is common (occuring in one in 20 people) and commonly occurs during a period, so it is sometimes hard to confirm that menstrual cups are a direct cause of explusion. Here are some best practices: 

• Make sure you break the seal of your cup before you take it out. If you don’t, that may cause pressure that can dislodge your IUD. Try pressing your cup into C-shape before you take it out instead of pulling on the base. 
• Get the right size cup! Period Aisle Menstrual Cups come in several sizes depending on whether you have given birth, or the strength of your pelvic floor.  
• Ask your doctor for shorter strings on your IUD, to reduce the risk of tugging on them during cup removal. 

Bacterially Friendly 

Bacterial risks and how that can impact your body are important things to consider when using various period products. As many of us know, the vaginal canal and vulva area are sensitive ecosystems that when healthy, will remain bacterially balanced and happy. However, these sensitive environments can be easily disrupted by a variety of factors. A healthy vagina has a pH of 4.5, which is fairly acidic. Menstrual blood has a pH of 7.4, and being in contact with blood raises the pH level of your vagina during menstruation which can increase the risk of infections if proper care practices aren’t followed. Depending on your own bacterial balance and specificities, choosing a period product that works best for your bacterial situation can be a smart move. 

Menstrual Discs and Cups: Menstrual cups are regarded as very safe within the medical community and are made with medical grade materials such as silicone, rubber or latex. The biggest risk of infection from using a menstrual cup is not properly washing your hands before inserting or removing your cup. To be safe, make sure that your cup or discs are cleaned as recommended by the manufacturer with warm water and a fragrance free, oil-free soap before insertion. 

Reusable Period Underwear and Pads: With proper care practices - changing your period underwear/reusable pad every 8-12 hours, and washing and drying your products after use- reusable period underwear and pads are safe and bacterially friendly period products. If you are prone to yeast infections, there is know correlation between damp vulvar regions and an overgrowth of candida albicans, and it may be wise to change your period underwear and pads more regularly/when they get damp to the touch. 

Disposable Pads: Similarly to reusable period underwear and pads, pads should be changed frequently (every 3-4 hours)  to avoid any unnecessary bacterial growth and any odor. 

Tampons: We’ve all shuddered and set timers in fear of the rare yet very serious Toxic Shock Syndrome that is associated with a tampon that has been left in for too long. This syndrome is caused by staphylococcus bacteria that can accumulate when a tampon has been left in the vagina for too long. However the odds of menstruators suffering from TSS are 1 in 100,000. TSS aside, tampons absorb the natural lubricant and bacteria inside your vaginal canal, which can disrupt your vagina’s natural pH balance. Good tampon practices are changing your tampon at least every 4 to 8 hours, opting for a lower absorbency tampon when possible and avoiding tampons if you have a skin infection near your genitals. 

Toxin Friendly 

Menstrual Cups and Discs: Most cups and discs are made with medical grade silicone which is considered chemically stable, and likely not toxic in its plastic form. 

Reusable Period Underwear and Pads: PFAS are “forever chemicals” that have been found in certain brands of period underwear and reusable pads to make the material more absorbent and stain resistant. The good news is, many companies are taking serious measures to make sure that their products are PFAS free through thorough lab testing and internationally recognized certifications. 

Disposable Pads and Tampons: There are many gaps in research around how the various chemicals found in pads and tampons impact individuals. In this 2023 study, phthalates, volatile organic compounds, parabens, environmental phenols, fragrance chemicals, dioxins and dioxin-like compounds were detected in disposable pads and tampons, which could suggest that pads and tampons could act as endocrine disruptors and impact reproductive health. However, future research is needed to clarify any concrete conclusions. 

Environmentally Friendly 

Period Underwear, Reusable Pads, and Cups/Discs: Using these reusable period products reduces your monthly waste significantly and can in many cases be more convenient since you aren’t having to constantly stock up. Period underwear and reusable, depending on the quality and the care, can last up to two years. Menstrual cups and discs can last up to several years as well. 

Disposable Pads and Tampons: An estimated 20 billion pads, tampons and applicators are sent to North American landfills each year. Plastic can take up to 500 years to decompose, meaning that all disposable menstrual products ever used are sitting in landfill to this day. While disposable pads and tampons are many peoples' choice for comfort and convenience, it is important to consider the environmental impacts of these products. 

The period products you choose should be based on what you feel best suits your menstruating needs and comforts, which may change over your menstruating life. I have experienced all of the products above and currently use all of them in combination, depending on my flow, my pain, and my schedule. Whatever choices you make when it comes to menstrual products, make sure it’s an informed one that prioritizes your comfort and well being. 

Much love. 

Ella Adkins is a writer, teacher and occupier on the ancestral homelands of the Sḵwx̱wú7mesh, Stó:lō and Səl̓ílwətaʔ/Selilwitulh and xʷməθkʷəy̓əm Nations. Her work has been featured in Femme Art Review, Peripheral Review, SAD Mag, ReIssue and Public Parking.