Disrupting Feminine Hygiene: Business Model Innovation in Period Products

The topic of menstruation remains taboo in many communities around the world. As a result, the awareness about and accessibility of feminine hygiene products, and rates of adoption of these health measures are low and grossly unequal between the developing and developed worlds. In addition, these “period products” are not traditionally designed to be environmentally-conscious and often use harmful ingredients. Creating sustainable period products would tackle three United Nations Sustainable Development goals: Good Health and Well Being (#3), Gender Equality (#5) and Sustainable Consumption and Production (#12).

  •  #3 Good Health and Well Being
    • 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
    • 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

 

  • #5 Gender Equality

 

    • 5.5 Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life
    • 5.6 Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences
    • 5.B Enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of women

 

  • #12 Sustainable Consumption and Production

 

    • 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
    • 12.6 Encourage companies, especially large and transnational companies, to adopt sustainable practices and to integrate sustainability information into their reporting cycle

We envision a world where women are able to menstruate with dignity and without shame. A business model innovation in this space would ideally address several key problem areas at once. The goal would be to create a low-cost, safe product that can be purchased by women around the world. More importantly, the innovation would not contribute to growing landfills and waste. Core to the success of this product, would be educational support that ensures women understand the biological process of menstruation (and female sexual and reproductive health broadly) and the potential for products to ease their monthly burden. Ideally, the innovation would tackle the challenge of distribution, including to remote locations, and discreetly, to cater to people who are uncomfortable with publicly acknowledging their menstrual cycle.

Needed innovations differ in two main markets, the developed and developing world. We examine each segment below.

 

Fair, Safe, and Sustainable:

Disrupting Feminine Hygiene in the Developed World

– Accessibility

Surprisingly, 35 of the 50 states in the US charge a consumption tax on period products. The reasoning is that the products are deemed to not be “necessary”. However, given that women cannot participate in economic or social life without them, access to feminine hygiene products is an absolute necessity if society is to achieve UN Sustainable Development Goal #5, Gender Equality and #3, Good Health & Well Being.

As a comparison, consumption tax is not levied on any sort of equivalent product or even products that should arguably be taxed more, if consumption tax is assumed to be a behavior control by the government. For example, products to treat non-life-threatening conditions for men, such as Viagra, do not have a consumption tax. In addition, unnecessary and unhealthy snack foods, like chocolate or soda, are not taxed in states that opt to tax feminine hygiene products. The “period tax” can then be seen to be discriminatory and limit women’s financial participation and success.

A campaign to end this tax called “Tax Free. Period.”, has been launched by the organization Period Equity and the startup period product company LOLA, but has not yet been successful in eliminating the period products tax. There are other organizations in the US that help provide these menstrual products to lower income populations where even if the tax were eliminated, the products are still too costly. There is a clear issue across the female population of accessibility and affordability.

 

– Safety

In addition to accessibility, there are serious safety concerns with feminine hygiene products. Period products are in prolonged close proximity with reproductive organs and can therefore have a significant impact on women’s health if they contain harmful chemicals. Meanwhile, product manufacturers are not required by law in most countries, including by the FDA in the US, to label period products with their manufacturing ingredients. Given this option, existing product incumbents like Tampax, Always, and Kotex choose to not include any information about ingredients, so consumers cannot be sure what the products may contain.

Unfortunately, period products have been found time and time again in independent studies to contain such chemicals. Products manufactured by major FMCG firms can contain formaldehyde-releasing preservatives as well as volatile organic compounds (VOCs) and phthalates, which are endocrine disruptors, and allergens. The presence of endocrine disruptors in period products is particularly worrisome, as endocrine disruptors directly affect reproductive health and can lead to infertility or fatal reproductive cancers.

In the US, because the products’ levels of these chemicals are below the FDA-mandated threshold for consumer product production, the products are deemed to be safe and put into the market. However, given that women will use 10,000 to 20,000 of these products over a lifetime, the effects of these harmful chemicals are compounded and may lead to many women’s health issues.

In South Korea in 2017, the low-cost sanitary pad brand Lilian was found to have extremely high levels of volatile organic compounds (VOCs) in a study by Korean Women’s Environmental Network (KWEN). The initial push for the study came after women in an online community began complaining of health issues after using the products. Following the results, women organized a class-action lawsuit for damages from the side effects arising after using the pads for even a short time. In a second survey by KWEN, 85% of women surveyed reported that their menstrual flow had shortened, some by up to five full days, while 68% reported severe cramps and 48% reported skin conditions. While Lilian was reported to have the highest levels of VOCs, all products surveyed contained some levels of VOCs and other harmful chemicals.

None of the products had exceeded the Korean Ministry of Food and Drug Safety regulations around nine types of chemical contaminants in pads, including formaldehyde and brightening agents. VOCs are not included in this list of nine and so are not even regulated, as they had not yet been verified to be harmful in a government study. As a result, consumers were furious that the government had failed to protect them.

Around the world, women are demanding that period products are regulated and sold to be 100% safe. In addition to safety concerns, companies that opt to not use harmful chemicals and materials in the production of period products will help contribute to SDG Goal #12, Sustainable Consumption and Production.

 

– Waste

Finally, the sheer volume of disposable period products used is contributing to the planet’s waste problems. It’s estimated that 45 billion disposable period products are thrown away each year

Pads are a “monstrous hybrid”, or a hybrid of organic/recyclable and inorganic/non-recyclable materials, the irreversible combination of which prevents the organic/recyclable components from decomposing naturally or having any other useful life. The adhesive wings and the perforated plastic layers in particular in commercial sanitary pads are not biodegradable. For tampons, while the cotton absorbent material can be biodegradable, the plastic applicator and packaging is made of polyethylene: one of the slowest-decomposing types of plastic.

Even if products are made of organic components like cotton, deodorised sanitary products contain chemicals used in bleaching such as organochlorines. These chemicals when released into the soil not only disturb soil microflora but also take a long time to decompose. Most commercially used products are therefore not fully biodegradable.

 

– Current Manufacturer Strategy

Procter & Gamble (P&G) has 25% of the global market share of feminine products and is the clear incumbent to be disrupted by innovation. According to the sustainability page on their website, P&G does not appear to be very motivated about these issues. They are committing to address various broad sustainability goals by 2030, but have none specifically related to developed-world concerns period products.

In South Korea, after the pad contaminants scandal of 2017, Procter & Gamble opted to pull out of the market rather than innovate its products.

 

– Disruptors in the Developed World

In response to consumer concerns and lack of action by large FMCG firms, startups have begun disrupting the period products industry with products that are safe, sustainable, and distributed differently. A few of these products are as follows, illustrating a highly competitive market to address the female hygiene issues that P&G and other incumbents won’t address.

Product type Model Companies
Subscription services Offer all-natural/organic disposable period products (pads, tampons, pantyliners) on a monthly subscription service. LOLA, kali, Blume
Menstrual cup Reusable silicone cup that collects menstruation Diva Cup, MoonCup, Intimia
Cloth pads Reusable pads made of all-natural cloth and offered in different sizes for different stages of menstruation. Luna Pads, TreeHugger, etc.
Period underwear Highly absorbent underwear that can be worn during menstruation instead of products separately attached to underwear Thinx, Dear Kate, Modibodi

 

– Disruption Strategies

The following business model innovations have made feminine hygiene disruption possible.

  • FOCUS: Disruptors focus specifically on period products and are therefore better able to provide for the industry’s needs. This differs from large FMCG conglomerates who are managing portfolios of hundreds of products that are evaluated mostly on ROI and other financial measures.
  • ALIGN INCENTIVES: Instead of solely focusing on making money, disruptors succeed by designing products by and for women. This aligns the incentives of the disruptor companies and their customers.
  • RESEQUENCING: By shifting sales online and creating a subscription service, disruptors can better determine the demand for which they must manufacture their products, thereby reducing information costs.

 

Accessible, Understandable, and Stigma-Free:

Disrupting Feminine Hygiene in the Developing World

While the feminine hygiene industry in the developed world is being disrupted based on product innovation, in the developing world, problems go much deeper. Menstrual hygiene management in the developing world is heavily intertwined with girls’ education, gender equality and social development.

The primary concern in developing countries is the access to good sanitary products and the alternatives used in the absence of said access. Commercially-produced sanitary pads are used commonly among girls in urban areas and with those who’ve received specific training in the use of these products. But girls in rural areas use tissue paper, old rags, pieces of cotton or wool, or some combination of these items to manage menstrual bleeding. Such options can be uncomfortable and ineffective, as well as unsanitary and unsafe. Studies have shown some relationship between the use of such poor alternatives and the risk of contracting urogenital infections. Desperate use of options such as newspapers or tissue papers have shown to even result in cancer from the contact of chemical ink with the reproductive area. Unfortunately, many rural women are not even aware of commercially available sanitary products. Even if they were, products are not affordable for those at the bottom of the pyramid. Disposal of the products can be uncertain or unsafe if social stigma exists. These problems hinder achievement of the goals under UN SDG #3, Good Health and Well Being.

Menstrual management also has a direct impact on girls’ education. Frequent school absences by girls from resource-poor countries is attributed to these girls’ inability to manage their menses. In a Ugandan study of rural schoolgirls, nearly two-thirds said they miss school at least once per month because of menstruation. In India, only 54% of girls reported attending school while menstruating. Even if girls manage to attend school during their period, they report being unable to concentrate, less willing to participate and often  uncomfortable throughout the school day. Providing girls with access to adequate sanitary products could improve their performance at school as well as give them the confidence to pursue opportunities on par with their male counterparts. These problems get in the way of UN SDG #5, Gender Equality.

The final piece of this wicked problem is waste management. Period products in the developing world face the same waste issues as the developed world in that they are made of a monstrous hybrid of cotton and plastic. However, the developing world’s problems are compounded as toilet facilities in developing countries lack bins for the disposal of sanitary pads. In urban areas, sanitary products are disposed in toilets or in garbage bins. In rural areas, these products or their alternatives are either burned, buried or simply trashed in dustbins. Sanitation systems are unable to cope with menstrual absorption materials as commercial sanitary pads and tampons are made up of ultra absorptive materials like polyacrylate. These items when flushed in toilets get saturated with liquid and swell up, resulting in sewage backflow, which is a serious health hazard. Blockage of sewage system from excess solid waste is a global problem and a major contributing factor is flushing of menstrual products in toilets. There are also reports of some women and girls wrapping their used menstrual cloths and packs in polythene bags before disposing of them in pit latrines, which stops decomposition. These problems hold back progress in UN SDG #13, Sustainable Production & Consumption.

 

Where is the innovation?

From a policy perspective, there have been a few heartening signs. Two emerging economies, India and Kenya, have moved to subsidize commercial sanitary products for rural girls and to remove the value-added tax on menstrual hygiene products, respectively. The subsidy plan faces potential pitfalls due to the lack of knowledge and awareness of family members, teachers, and health care providers; lack of water and sanitation facilities available in schools; and lack of sufficient solid-waste disposal in villages.

Women’s reproductive health is an interesting arena for innovation in the design of health systems. We’ve discussed in class about shifting risk to entities who are best prepared to handle the risk (think Uber drivers/customers). A parallel can be seen in “task shifting”, where specific tasks are moved from higher to lower levels of system in order to make more efficient use of human resources for health.

Self-care is the ultimate form of task shifting. Women receive needed training in the area of menstrual health and administer required interventions themselves. This frees up health workers to devote more time and resources to more critical medical interventions. The advent of smart devices has also helped. Phone-based applications for predicting menstrual cycles have had positive impact on the sexual and reproductive health of women in rural areas with higher mobile penetration.

 

What about the private sector?

The industry is ripe for innovation and none of the big private sector players seem to be making any significant investments in this area. The few studies that have tried to improve or change menstrual hygiene practices provide moderate to strong evidence that targeted interventions do improve menstrual hygiene knowledge and awareness. Overall, there is moderate evidence that education-based interventions can improve menstrual hygiene knowledge and practices among schoolgirls in poor countries. There is limited (but mixed) evidence to suggest that distribution of sanitary products may reduce school absenteeism among girls.

P&G is focusing on Indian schools to inform girls on why they should be using sanitary towels. In Rwanda, Kasha, a mobile-ready e-commerce and content platform supported by Unilever, sells and discreetly delivers women’s health and hygiene products, giving them an opportunity to access items such as sanitary pads and contraceptives without fear of social stigma. The platform doesn’t require internet connectivity to browse and pay, so it’s accessible with a basic mobile phone. Kasha’s purpose is to help women in urban and rural areas, of all socioeconomic levels, overcome issues of social stigma, so they can purchase the health products they need.

Social enterprises are very active in this space in Africa. Girls cannot easily obtain feminine products in the African country of Uganda. Paul Montgomery, an Oxford University professor, decided to bring reusable pads and feminine education to Uganda. The reusable pads were called AFRIpads. According to our research, these were made from polycotton blend fabric and impermeable materials, and because their manufacture does not rely on electricity, workshops could be located in rural settings. An Afripads menstrual kit is designed to last for a year. In a study conducted, school attendance improved for the girls who had received pads or education or both while a drop in attendance was recorded for those who received neither. Accessible hygiene products can be the difference between getting an education and being homebound.

A social enterprise in India called Eco Femme has brought about a so-called ‘Cloth Pad Revolution’. Eco Femme promotes eco-friendly menstrual practices and encourages women to make and pass on the baton of sustainable choice around. The organisation sells pads in India and across the world, and from the profits made from these sales, it conducts educational activities in menstrual hygiene and women’s well-being. Following the TOMS shoes business model, L Menstrual Products (founded by Talia Frenkel, a photojournalist who worked for the Red Cross and UN) donates a pack of pads to developing nations for every pack purchased by a customer.

 

Business Model Innovation:

Combining the Innovations of Developing & Developed World

For a way forward, we propose that the innovations of the developed world–those around chemical-free, low-waste, aligned-incentive products–can meet the innovations of the developing world–those around distribution, education, sanitation, and removal of social stigmas. In particular, if low-impact and easy-to-manage products like period underwear or silicone menstrual cups could be adopted by developing-world markets, it would go a long way to solving the UN SDGs of Good Health and Well Being, Gender Equality, and Sustainable Consumption and Production.

This business model would face many risks, many of which we have discussed above. A summary within this context is below.

1. How does this business model outperform existing business models both financially and environmentally/socially? Do financial growth and social/environmental impact form a feedback loop (i.e. the faster the growth, the larger the impact and vice-versa)? Financially: As period underwear and menstrual cups are reusable, the model would depend on non-frequent purchases at higher margins.

Environmentally: Reusable products will nearly-eliminate the significant waste caused by disposable products.

Socially: These products could empower women

Feedback loop: As more women were empowered to take control of their periods, more women would be educated, in leadership, and participating in social life, which could in turn lead them to help other women do the same.

2. Why could this innovation be game-changing (demand and/or supply point of view)? By switching from disposable to semi-durable period solutions in developing economies, women will be empowered to control their menstrual cycle at a cheaper cost. They will also not have to go through the development phase of using chemically unsafe products as the developed world has done.
3. What are the potential costs and risks of this innovation? What are the barriers to scaling this business model? The biggest risk and barrier is access to sanitation. For consumers to be able to use reusable period products safely, they must be able to wash and sanitize them regularly. If there is a lack of access to clean water or soap, then this solution should not be offered and cannot scale.

The second biggest risk is marketing and consumer education. Adoption of semi-durable period solutions is slow even in the developed world as consumers are unsure of how to use them and afraid of sanitation issues. In the developing world, women’s rights issues could make education and adoption even more challenging.

4. What are possible next steps to mitigate the risks associated with this business model and to allow it to scale? We must first ensure that communities have access to proper sanitation facilities. After that, we must find out where product adoption might be possible.
5. What are the potentially negative social/environmental impacts of this business model? Social: If the sanitation issue remains unsolved, incorrectly used products may cause health problems and disease.

Environmental: If products adoption lags or is impossible, products may be dumped en masse into the environment.

 

Many challenges remain before the issues faced by period product manufacturers and consumers can be solved in either the developed or the developing world. However, as awareness spreads of the importance of this industry to the world’s health, productivity, economy, and equality, we can expect that business model innovations will revolutionize what was once an unfairly ignored industry.

 

Authors

Sarah Sutter

Arjun Kumar

Sonia Hensley

Sneha Kalaivanan

 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5482567/

https://www.hindawi.com/journals/jeph/2018/1730964/

http://www.koreaherald.com/view.php?ud=20170824000747

http://www.koreatimes.co.kr/www/nation/2018/12/119_235351.html

https://www.bustle.com/p/tampon-disposal-other-period-habits-impact-the-environment-in-some-scary-ways-8823338

http://www.koreaherald.com/view.php?ud=20181207000350

https://www.forbes.com/sites/ashoka/2015/06/10/5-amazing-companies-working-in-menstrual-hygiene/#2a4e288c59bf

https://www.mylola.com/

https://www.periodequity.org/

https://www.taxfreeperiod.com/

https://edition.cnn.com/2015/11/13/health/whats-in-your-pad-or-tampon/index.html

Menstrual and Personal Care Products

4 Comments

  1. Thank you for the excellent post! I really appreciate this breakdown of the menstruation products market because it shows how the market is both clearly underdeveloped and yet key for equality in girls’ education. To me, this lack of focus on menstruation products stems from prejudices surrounding feminine hygiene in society as well as a high skew towards male representation in the boardroom. Savvy companies should overcome their squeamishness in discussing and addressing periods to reap this substantial business opportunity and have a wide-reaching positive social impact through improved girls’ education.

  2. Thanks for this post, such an important topic to talk about and for some reason we never talk about it. I like how you addressed both the developed and the developing countries separately – it reminded me that where we are facing issues with waste and possibly toxins, women in developing countries are facings much bigger problems on top of that. There is such a huge opportunity for social and for-profit companies to make an impact and make money – hopefully some companies will jump on it soon.

  3. Agree with Kila that part of the reason why innovative solutions for female products are falling behind is also because of gender inequality in top business management (my blog article is also happen to be related to gender equality). In the long-term, hopefully bridging this gender equality gap will also result in the injection of intellectual diversity in boardroom, which hopefully will lead to more solutions for female-related issues as well.

  4. Such an important topic to discuss – thank you for choosing it. Even in developed countries there is still more that can be done in this space to promote gender equality, e.g. tampon tax in the UK.

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