Credit AJ Duncan

Bloody hell: period products tested with blood

A recent study was the first to test period products using blood, concluding with interesting revelations for women’s health. Why wasn’t this done sooner?

Jo’s monologue in Little Women, The Hot Priest saying “it’ll pass”, Tom Holland’s Lip Sync Battle performance: all credible answers to the tired question, “What’s the female version of the Roman Empire?”. For the uninitiated, the “Roman Empire” phenomenon refers to a TikTok trend in which women surveyed their boyfriends, husbands, brothers and male friends as to how frequently they thought about the Roman Empire, with an overwhelming majority claiming to have a bizarre preoccupation, thinking about it at least several times a week. However, there’s only one thing that has continually flooded my mind: the first study to test period products using blood published in June 2023. Centred around the assessment of heavy menstrual bleeding (HMB), the study, conducted by researchers at the Oregon Health & Science University, affirmed a high likelihood that the menstrual blood loss in those with HMB is being underestimated. Additionally, there are significant discrepancies in the amount of blood held or absorbed by products used by menstruating individuals – period underwear can hold just 2mL of blood on average – so what happens if you need to, say, stand up quickly? Menstrual disks on the other hand, despite sounding like something Gwenyth Paltrow has invented, can hold up to 65mL of blood. What is more, when testing the capacity of products, with the exception of tampons (due to toxic shock syndrome), “no industry standard exists”. The fact that blood had not been used to test menstrual products prior to this study, where previously water or saline was seen as an acceptable replacement, has considerable implications for women and others who menstruate, and raises questions about why it’s taken so long to do so.

The NHS website- the only website to relieve my hypochondria induced panics – contains a heavy period self-assessment test. Many of us who have periods will have taken this test or been asked similar questions for a history. In a survey carried out in 2018 by Public Health England 31% of women experienced reproductive health symptoms including HMB. The very first question posed in the self-assessment reads “Do you have to change your pad or tampon every hour or 2, or empty your menstrual cup more often than it recommends to prevent leakage?” The 2023 study found that over a complete cycle saturation of two heavy-flow pads, or three heavy tampons, or filling a menstrual cup 3-4 times, all indicate blood loss of over 80mL and therefore meet the diagnostic criteria for HMB. The study concluded that HMB is likely to be underdiagnosed, and more likely so in users of menstrual cups and disks – which hold a lot of blood. HMB, or menorrhagia, is common, however, it can be indicative of more serious or chronic causes such as PCOS or endometriosis for which “1 in 10 women and those assigned female of birth of reproductive age in the UK suffer”. Interestingly, menorrhagia can be caused by stress and depression, maybe opening a wider diagnostic use for periods.

So how on earth are we in a situation where menstrual products are only now being tested using blood? The answer is certainly complex, but I can imagine it’s related to the fact there simply isn’t enough gender diversity in STEM fields. In the physical sciences’ 22/23 cohort, 44% of students were female or non-binary. There’s a minority at undergraduate level, but barely. The real problem, I suspect, is the “leaky pipeline”, a term for the pretty striking fallout of women pursuing STEM careers. As a stark reminder that water can’t fix the leaks in the pipeline, a 2019 study placed an onus on biases in hiring, noting in labs that have a male PI and that therefore in the majority of labs female grad students and researchers are less likely to be employed. In 2018, the Royal Society of Chemistry (RSC) set about addressing the haemorrhage of women from the discipline: going from women making up 44% of undergraduate chemists to only 9% of chemistry professors. At the University of Glasgow’s School of Chemistry, as of 2018, female students made up:  54% of undergraduates, 40% of postgraduate taught students, and 22% of academic research staff. In 2018, Serena Cussen became the school’s first female professor. However, currently, there is no such representation. An almost textbook demonstration of the fallout of women in research, and I do wonder whether we’d be in this situation if the gender imbalance in academia wasn’t quite this dramatic.

Naturally, the leaky pipeline has sparked some interesting conversations. The RSC’s Equality and Diversity fund has supported PERIODically, a podcast from the University of Oxford featuring undergraduates and postdocs alike, discussing the impact of periods on their studies and other gendered issues. Significantly, the students have published an article detailing the impact of periods on student’s studies, claiming that “periods are a practical barrier that can impact the academic progression of those who experience them”, qualifying yet another faucet to the leaky pipeline, placing particular emphasis on the physical nature of a chemistry degree. The article goes on to suggest policies to provide free menstrual products to those who need it, with an especially innovative idea involving a sign-up system to receive a free menstrual cup and serving to potentially alleviate the need for reminders to not “hoard” products, as is frequently seen. The PERIODically podcast recently won the Bright Network Women Who Inspire award, demonstrating the need for conversations around periods in science fields.

In a way, Scotland is far above the rest of the UK as the first country ever to provide free period products. However, I can’t say I know a soul who would voluntarily use the free-sandpaper-esque pads, when a friend or a quick run to Boots can give you both comfort and dignity. I don’t think throwing some Tampax into science faculty buildings is going to set students on a straight trajectory to becoming professors and academics, but it might render the Mojo Dojo Casa House a little more accessible. Rarely have I felt like a minority as white, female STEM student, though I’ll leave you with this: in the UK in 2016-17, across all academia, of 19,000 professors, 25 were black and female.

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