Reusable menstrual products require fewer daily changes but result in more leaks, which could impact the clinical diagnosis of heavy menstrual bleeding (HMB), a new study suggests.
HMB is diagnosed based on patient-reported menstrual product usage, traditionally measured using pads and tampons. However, with the growing use of reusable options such as menstrual cups and period underwear, it is unclear whether these products provide comparable diagnostic reliability. A study aimed to evaluate whether the rate of product changes and leakage frequency differs between disposable and reusable menstrual products, which could influence the accuracy of HMB assessments.
A total of 20 regularly menstruating individuals with HMB (Pictorial Blood loss Assessment Chart [PBAC] score ≥100) participated in the study across two menstrual cycles. In the first cycle, participants used study-provided disposable pads and tampons. In the second cycle, they were randomised to use either a menstrual cup or period underwear and collected their menstrual fluid on their two heaviest flow days. The mean number of product changes per heaviest day was 5.5 for disposable products (range: 1.5–11), 3.6 for menstrual cups (range: 1.3–6.2), and 3.5 for period underwear (range: 2.7–6.9). While reusable product users reported fewer changes per day compared to those using disposable products, both menstrual cup and underwear users experienced a median of 3.5 leaks (range: 1–5) per heaviest day. These findings highlight a discrepancy in how menstrual blood loss is measured when using different product types.
In clinical practice, these results suggest that reliance on the frequency of product changes for diagnosing HMB may be less accurate for those using reusable products, as they require fewer changes but lead to more leaks. This could result in underdiagnosis of HMB in patients who rely on menstrual cups or underwear.
Jenna Lorge, EMJ
Reference
Bannow BS et al. Reusable menstrual hygiene products may lead to underdiagnosis of heavy menstrual bleeding: a randomised trial. BMJ SRH. 2025;DOI:10.1136/bmjsrh-2024-202541
