Menstrual products in India have evolved. Women’s choices haven’t

Women—and women’s unique healthcare needs—have historically been given a second-tier status in society. In India, menstrual products like sanitary pads carried a 12 per cent Goods & Services Tax (GST) after being labelled “luxury” items by the government until 2018. Campaigns and petitions eventually forced the withdrawal of this so-called ‘pink tax’. 

But a tax cut doesn’t fix the deeper issue: menstruation itself remains a largely hush-hush subject, best left unspoken in India. 

A 2024 survey conducted in Chennai revealed that 39.8 per cent of adolescent girls weren’t aware of menstruation before their first period. And, among those who were, mothers (53.6 per cent) were the primary source of information, followed by friends (23.6 per cent), and schools at a lamentable 8.2 per cent. Nationwide awareness remains lower in rural areas compared to urban ones. 

While period literacy and period poverty remain pressing challenges, paradoxically, the availability of menstrual products in India such as tampons, menstrual cups, period panties and reusable cotton pads has surged. Homegrown brands like Nushu, Nua, My Mahina, Sirona, Pee Safe and Carmesi are expanding the market, valued at $1.56 billion in 2025 to a forecasted $3.15 billion in 2030. 

The progress, however, feels more like an illusion than reality.

In a country where the adoption of sanitary pads—a product synonymous with periods—hasn’t reached its potential, sustainable menstrual products like cups and period panties still have miles to go. Doctors and on-ground social workers point to the many reasons why menstrual products in India remain underused. 

Why period illiteracy is the biggest roadblock 

A comparison between the National Family Health Survey (NFHS)-4 and -5 highlights the slow shifts. In 2015-16, 62.5 per cent of women still used cloth pieces, 42.2 per cent used packaged sanitary pads, 2.4 per cent used tampons in India and data on menstrual cups was non-existent. By 2019-20, the cloth use dipped  by 13.2 per cent, sanitary pads use rose by 22.3 per cent, tampons saw a marginal dip and menstrual cups at just 0.3 per cent. 

Another survey confirms the pattern: only 1.4 per cent used modern menstrual methods (MMMs)—menstrual cups (1.3 per cent) and tampons (0.1 per cent). Sanitary pads continue to dominate, used by 96.3 per cent of women. 

“MISCONCEPTIONS LIKE USING INSERTABLES COULD WIDEN THE VAGINA OR THAT A TAMPON COULD GET LOST IN YOUR VAGINAL PASSAGE HAVE SWAYED WOMEN AWAY FROM CUPS AND TAMPONS” — Arun Gupta

According to Dr Taniya Kaul, director and educator at Myna Mahila Foundation, this is less  an agency issue and more an  awareness crisis. “While women's reproductive health, specifically menstruation, has entered social chatter via social organisations and government initiatives, the stigma associated with periods is deeply entrenched among Indians, irrespective of the socio-economic backgrounds.” She further notes that when advertising frames menstruation as a ‘problem’, normalisation becomes impossible. Pads are still positioned as a fix for an inconvenience rather than a physiological necessity.

Kaul adds that boxing menstruation as solely  a “women’s issue” deepens the taboo. “We once came across a case of an 18-year-old girl committing suicide simply because she was unable to bear the debilitating period pain every month. Better awareness and support could have saved her.” In schools, chapters on reproduction are still skipped, and boys are often  asked to leave the class. In such a controlled environment, expecting every girl to know the full range of menstrual products available for her is unrealistic. 

Social media has brought modern menstrual methods to digital audiences through educators like Dr Tanaya Narendra (or Dr Cuterus) and Leeza Mangaldas. Yet it can easily fuel misinformation, notes Kaul. “Many women—including urban women—still think that a menstrual cup could enter the body without really understanding the physiology of the body,” begins Arun Gupta, director at the Pinkishe Foundation. “Misconceptions like using insertables could widen the vagina or that a tampon could get lost in your vaginal passage have swayed women away from cups and tampons.”

Social, cultural and demographic barriers 

In sanitary pad advertisements, red has replaced blue; films like Padman(2018) have attempted to shift stigma and in 2022-23, the Supreme Court of India issued a notice directing the Central and State Governments to provide free sanitary pads and separate toilets to school-going adolescent girls in Government-aided schools. Yet, real empowerment remains stuck between intention and execution. 

Awareness is only the first barrier. Cultural norms continue to dictate how women perceive menstrual products in India. Periods are called everything but periods, blood is deemed “impure” and women are pushed into isolation for five days. Against this backdrop, period poverty in India is inevitable. 

“In a country where virginity is equal to sanctity, and so much emphasis is given to the risk of breaking the hymen, the mere thought of an insertable period care product is almost unthinkable for a rural girl,” says Gupta. “Even when we surveyed urban girls across 1,100 schools in India, the penetration of such items was just 3 per cent. I vividly remember a young school girl from a city telling me, “Mummy ne kaha shaadi nai hogi” in context to using insertables such as tampons and cups.” If insertables are unimaginable in metros, rural adoption is even more distant. 

Dr Tejal Kanwar, consulting gynaecologist at Ujaas, an initiative by Aditya Birla Education Trust, adds that the stigma cuts across demographics. Many women—urban and rural—struggle with the discomfort of insertion or even the sight of their own blood. “Modern options—tampons, cups, and period panties—are generally safe but require strict hygiene and correct knowledge for use. Improper use of tampons can lead to a rare but serious condition called Toxic Shock Syndrome (TSS). Similarly, not cleaning menstrual cups or period panties correctly can cause infections.” 

Bangalore-based writer Surina Sayal returned to sanitary pads after trying menstrual cups, explaining that several factors made switching to a cup difficult. “You have to be careful about hygiene while using a cup. Sterilise it before and after use, and clean it properly in between uses. So that’s one hurdle. Plus, wearing it is not the easiest; squatting and inserting a cup when you’re already achy and tired is tough.” 

Why affordable period products in India remain out of reach 

Ravi Ramachandran, founder and CEO of Nua, a brand offering a wide range of menstrual products in India, says, “The adoption of non-conventional period care products is mostly in the major metros, where there is more access to period product options as well as more understanding around pad alternatives—by everyone, not just women.”

“WOMEN IN RURAL AREAS DIG PITS A LITTLE FAR AWAY FROM THEIR HOUSE OR IN THE BACKYARDS, TO DUMP USED SANITARY PADS, WHICH ARE NON-BIODEGRADABLE IN NATURE” — Avisha Jhunjhunwala

He adds, “The difference in sales between various flow products boils down to familiarity. These alternatives are less known, and so they’re less sought, even where they’re available.”  Gupta agrees, noting, “There’s a reason why giants like Procter & Gamble or HUL haven’t gone big on cups and tampons yet.” 

Cost is another hurdle. In almost a quarter of districts, hygienic method use is under 30 per cent—and as low as 6-7 per cent in parts of Meghalaya and Uttar Pradesh. “Contemplating traditional versus sustainable period care solutions is a luxury many women can’t afford, especially in rural and remote areas,” says Gupta. “For a rural girl, who has just begun getting access to a pad priced at ₹2 to ₹3, spending ₹400 (and upwards) on a period care product is a very big luxury. Besides a few brands with funding, several cup-, tampon- or period panties-only brands have shut down and given their clearance stock to us for donation drives, simply because the costs of such products are too high for a price-sensitive market like India.”

For Avisha Jhunjhunwala, founder Nushu, period panties in India are a promising long-term solution. Their washability feels familiar to rural women used to cloth, while also bypassing issues of pad disposal. But barriers remain: lack of clean water, drying spaces, and upfront costs. “Women in rural areas dig pits a little far away from their house or in the backyards, to dump used sanitary pads, which are non-biodegradable in nature,” notes Jhunjhunwala.    

“For people who worry about survival daily, considering long-term benefits isn’t an option,” cites Gupta. 

Why India’s period care ecosystem keeps failing women

The Menstrual Hygiene Scheme (MHS), launched in 2011, by the National Health Mission was India’s first national programme for period health. It provided six subsidised pads at ₹6 in 107 districts across 17 states. But Kaul points out, “Oftentimes, sanitary pads vending machines aren’t refilled, while subsidised sanitary pads remain out of stock for as long as six months, forcing women to opt for commercialised pads from the private sector.” If basic pads face these gaps, how will menstrual cups or tampons scale? 

NGOs also face resource constraints. Gupta explains, “There’s a lot of heavy-lifting that needs to be done when it comes to educating women about menstruation. Doing so with disposable pads becomes slightly easier because of the widespread adoption. If I were to convince one group of women to try tampons or cups, it would take me multiple educational sessions, therefore, discounting the time I can allocate to many other women in need of it.” Moreover, “While disposable pads aren’t the best option, they are definitely the most viable option for women in rural areas because they’re tried-and-tested, and don’t entrust the burden of disposal and cleaning on women.” 

Urban women, even financially secure ones, still earn 31 per cent less disposable income than men, per Mintel Reports India, Feminine Hygiene, 2025. For many affordable period products remain out of reach—not due to awareness, but economics. 

Awareness is the key to ending period poverty in India

According to Mintel’s Feminine Hygiene India 2025 Report, 28 per cent of Indian women are open to trying newer formats, with period panties being the most popular choice because of their similarity to pads. Yet only 3 per cent of women use tampons, and another 3 per cent use menstrual cups.

Curiosity exists—but adoption falters under the weight of stigma, affordability, and awareness gaps. Real change requires campaigns, curriculum inclusion, affordable innovation, and 24x7 counselling support. Kaul adds, “Our chatbot helps women discuss their issues openly and freely without fearing judgment from another human, and it’s available around the clock. We still get similar questions from women in Tier-1 and Tier-2 or -3 cities, indicating the wide education gap that has to be filled.”

Ultimately, having menstrual products in India on shelves isn’t enough. Women need the awareness, affordability and agency to choose them. That begins not with sensitising menstruation but with democratising it.