Menstruation is a natural process and a key sign of reproductive health ¹. The menstrual cycle in females is a naturally occurring physiological phenomenon after they reach of age. Females go through the natural phenomenon approximately 451.3 times (median number of their lifetimes), corresponding to 34.7 years of menstrual activity, considering an average of 13 cycles per year. The demand for effective feminine hygiene products is surging due to the increasing number of working women and changing socio-economic standards.

Sanitary napkins are absorbent materials worn in underwear to absorb blood during periods. Major categories include panty liners, tampons, menstrual cups, and feminine wipes.

Composition of Sanitary Napkins

• Fluid transfer layer: Transfers fluid from the top cover to the secondary layer. A dry surface is essential for comfort. Modern solutions include thermoplastic fiber, which provides sufficient capillary attraction.
• Acquisition and distributing layer: Distributes fluid laterally and holds it for absorption. Typically made of non-woven composites.
• Absorbent layer: Often composed of cellulosic pulp and Superabsorbent Polymer (SAP) to enhance absorbency.
• Barrier sheet: A polyethylene sheet that prevents leakage.
• Adhesive layer: Keeps the pad in place.

Superabsorbent Polymer (SAP)

Sodium polyacrylate, a common SAP, can absorb up to 300 times its weight in water. Its safety has been extensively studied, and it is generally considered safe by the FDA. However:

• Toxicity: Rare skin irritation or allergies may occur.
• Environmental Impact: Non-biodegradable, requiring proper disposal.

Alternatives to Sodium Polyacrylate

• Cotton: Natural, absorbent, and breathable.
• Bamboo: Sustainable and antimicrobial.
• Hemp: Durable, absorbent, and eco-friendly.

Menstrual Health Management in Nepal

In Nepal, MHM faces challenges in waste disposal, sustainability, and socio-economic disparities. The median age of first menstruation is 13.6 years. With over 10.9 million women in the menstruating age group and approximately 290,000 menstruating daily, Nepal produces about 900 million disposable pads annually, of which 202 million are exported to India.

Disposal Practices

• Urban areas: Flushing, dustbins, or solid waste systems.
• Rural areas: Burying, burning, or discarding in pits or latrines.

The use of cloth increases with age and in rural regions, while disposable pads dominate urban usage. Government initiatives include funding free sanitary pads for 1.3 million schoolgirls.

Menstrual Waste Disposal Practices and Challenges

Current practices include:

• Disposing in open spaces, dustbins, or garbage.
• Burying or burning menstrual waste.
• Using incinerators or flushing soiled napkins.

Challenges

• Non-biodegradable plastics and chemicals disrupt soil microflora and pose health risks.
• Improper handling exposes waste workers to pathogens and toxic chemicals.
• Incineration releases harmful gases like dioxins, necessitating emission controls.

Recommended Disposal Methods (Indian MHM Guidelines 2015)

• Separate disposal bins for menstrual waste.
• Controlled incinerators or eco-friendly disposal options.

Way Forward

1. Eco-Friendly Product Design
   • Transition to biodegradable and reusable products.
   • Mandate transparency in product composition.
2. Improved Waste Management Systems
   • Install labeled bins for menstrual waste.
   • Provide PPE for waste workers.
   • Use incinerators operating at 800°C to reduce emissions.
3. Infrastructure Development
   • Build women-friendly public toilets with water supply and covered bins.
4. Education and Awareness
   • Incorporate menstrual hygiene education in school curriculums.
5. Policy and Legal Framework
   • Establish guidelines for menstrual waste management.
   • Subsidize eco-friendly menstrual products.
6. Research and Innovation
   • Assess product sustainability.
   • Develop low-cost disposal technologies.

Ideal Disposal Processes

Comparison of Incineration and Composting

Low-Cost Incinerators

• Suitable for rural areas.
• Made from locally available materials.
• Can handle approximately 200 pads daily.

Electric Incinerators

• Ideal for community settings.
• Burns 150–200 pads daily, generating minimal ash.

Composting

• Suitable for biodegradable pads.
• Involves mixing waste with leaves and soil.

Deep Burial

• Practical for rural areas.
• Requires pits 5–7 meters away from water sources.

Facts and Figures

• Total menstruating-age women in Nepal: 10.9 million.
• Daily menstruating women in Nepal: 290,000.
• Annual pad usage in Nepal: 905 million.

Addressing menstrual waste disposal is crucial for achieving environmental sustainability and ensuring the health and dignity of all women.