The impact of disposable sanitary napkins on human health and the environment is not often discussed publicly, because of the social taboo associated with menstruation (despite the fact that nearly 50% of the world’s population are women). However, the fact remains that it is a major problem and the practice of using such non-biodegradable napkins is unsustainable, in the long run. We cannot pretend like it isn’t a serious environmental issue, just because of the taboo surrounding it.
We have gotten accustomed to using these napkins because of their convenience: we simply need to use them, wrap them up in a newspaper and then throw them into the garbage bin. But there is no awareness of the impact of disposable napkins on the planet and human beings, through the entire product life cycle — from manufacturing and use to final disposal. Let us look at the adverse effects of these napkins from two main perspectives: health and environment.
Disposable sanitary napkins have been linked to various health problems, ranging from mild to serious, due to the toxic ingredients contained in the product. Independent studies by women’s health organizations have found chemicals of concern like dioxin, carcinogens and reproductive toxins in tampons and pads. 
The skin in the vaginal and labial walls is highly vascular with a tendency for greater absorbency. Hence, on prolonged usage of disposable sanitary napkins, these toxic chemicals can be absorbed by the body.
Chemicals like dioxins are highly toxic, even in trace quantities. Such chemicals cannot be metabolized by the body. They accumulate in the body with a potential cumulative effect. Dioxins can cause reproductive and developmental problems, damage the immune system, interfere with hormones and also cause cancer.
Doctors and medical institutions approve of the use of these disposable napkins and hence women assume that the safety of such products have been looked into. This is incorrect. Feminine hygiene products need to be thoroughly researched by experts. There needs to be investigation into their long term effects on health. Complete and accurate information must be made readily available.
A single sanitary napkin is equivalent to 4 plastic bags.  Since they are non-biodegradable, the soiled napkins would stay in the landfills for about 800 years! A woman’s impact on the planet by her choice of products extends well beyond her lifetime!
Only 12 per cent of the 355 million women of menstruating age in India can afford disposable sanitary napkins. But, conservatively, these 42.6 million women will throw 21.3 billion sanitary napkins into a landfill in their lives. 
The Indian Government’s interim solution to the problem of disposal of the sanitary waste is to burn them in incinerators.  Incineration in simple, low-temperature incinerators are now being promoted in India as a method of disposal. But the toxic dioxins present in sanitary napkins are released into the air and soil when used napkins are burnt under temperatures lower than 800 degrees Celsius.
Hence, we see that these disposable sanitary napkins are not really ‘disposable’ in the true sense of the word!
Solid waste management
An average woman throws away about 150 kg of mostly non-biodegradable absorbents every year,” according to period of change, a campaign started under The Kachra project. Disposal soiled sanitary napkins is a major challenge in our country. Women, both rural and urban, face this question every month while government authorities struggle to find a way to handle the staggering amount of sanitary waste generated every month.
Some women wrap it in plastic or paper and throw it along with domestic garbage, while some flush them down toilets or throw them into water bodies. 
When we throw out our waste, it may have vanished from our house, but it does not mean that it has vanished from the face of the earth. There are human beings involved, whose livelihood is segregating the wastes that we throw away.
So what happens to the sanitary napkin after we wrap and throw them into the dustbin? The napkins are collected as household waste by garbage collectors and later segregated, often manually.
Waste pickers separate out soiled napkins from recyclable items by hand, exposing themselves to dangerous pathogens that cause diseases like hepatitis and tetanus.  After this, the sanitary waste is driven out of the city and buried in a landfill on the outskirts of a city. At times they are shredded before being buried.
Most commercially produced napkins contain a chemical component called super-absorbent-gel that is designed to absorb fluids. When flushed down the toilet, the napkin continues to bloat as it makes its way through the underground drains, open channels and clogs up the sewers.
Conservancy workers then have to risk their health and even their lives to dive into manholes to remove the napkin by hand.
Each of these pads has an environmental impact of the waste of not only the product itself, but the packaging, plastic or cardboard applicators, as well as the less visible costs of transportation and production.
The Royal Institute of Technology in Stockholm carried out a life cycle assessment (LCA) comparison of the environmental impact of tampons and sanitary pads. Their “cradle to grave” assessment of the raw material extraction, transportation, production, use and waste management stages took three main impact categories into consideration: human health, ecosystem quality and resource use.
They found that the main environmental impact of the products was in fact caused by the processing of raw materials, particularly LDPE (low density polyethelene) – or the plastics used in the backing of pads and tampon applicators, and cellulose production. As production of these plastics requires a lot of energy and creates long lasting waste, the main impact from the life cycle of these products is fossil fuel use, though the waste produced is significant in its own right. Between pads and tampons, pads have more of an environmental impact due to their plastic components since almost 90% of a sanitary napkin is plastic. 
At every stage of manufacturing and use, disposable sanitary napkins use up precious resources like crude oil and trees (for cellulose in the napkins), contaminate water and the atmosphere, and finally end up in a landfill since there is no option to dispose of them safely. Hence, the use of such a product by a large population in the long run is unsustainable.
At Anaadi, we are constantly exploring and experimenting with creative ideas for a sustainable future. We try to bring in sustainability in all spheres of activity. Since sustainability has always been the core of the Indian tradition, we look for ideas from the rich ancient culture of India and see how we can re-apply them in the modern context.
Hence, given this problem of wide usage of an unsustainable menstrual product, we explored several alternatives that reduced the ecological footprint and arrived at the best one: Reusable cloth napkins. All the problems described above, such as health problems, air and soil pollution, high energy consumption and waste management would vanish, if women made the switch to using reusable cloth napkins.
There is nothing new in this. Women have been doing it for thousands of years. However this does not mean that it is old-fashioned or outdated. It is a time-tested practice that has several benefits:
It is completely environment-friendly.
There are no solid wastes.
Cost is reduced, as cloth napkins last much longer if maintained well.
There are no adverse health effects.
The internet has several stories of women who are very happy about making the switch to reusable cloth napkins. They report feeling more connected to the earth, to themselves and to their cycle. 
Through personal experimentation, we developed a modern, up-to-date technique of implementing this age-old practice. The steps are given as follows:
We have modeled the napkins after the Carefree brand of pads. The Carefree pack comes with the waist band, which is used to hold up the napkin.
Take two pieces of cloth – one for the covering (the red cloth in the figure) and one for the absorbent (the grey cloth in the figure).
The absorbent cloth can be of cotton or banian material. T shirts (dark colored) made of banian material were found to be good at absorbing the flow. Old cotton sari can also be used.
Fold the absorbent cloth to the thickness that is comfortable for you and cover it with the covering cloth as shown.
Fix this to the waistband.
The reusable cloth napkin is ready.
Make about 12–15 such napkins for your cycle. (You need to have sufficient dry napkins ready for use.) This number may vary from person to person of course. It also depends on the climatic conditions. If your napkins dry quickly, you can keep washing and reusing them. If your napkins take a long time to dry (say, in rainy season), you will need to have more napkins ready for use.
The number of napkins you use per day depends on the intensity of your flow. In case of heavy flow, you will need to change your napkins more frequently.
Get a medium sized tub with a lid. This will be used for soaking and washing.
Soaking the napkins soon after use is necessary to prevent stains from blood setting in.
Soak the napkins in cold water for 30 minutes. Add a dash of vinegar to the water. Vinegar prevents musty bad smells and is a gentle but effective antibacterial. It is not harmful to the environment.
Good quality essential oils such as tea-tree oil and lavender oil also have good disinfectant properties and they have good fragrance.
After 30 minutes, pour the soaking water down the drain and wash the napkin using natural soap. Do not use detergents or soaps which contain chemicals as they are not environment friendly.
Washing can be done in 2 ways:
o Tub washing : Fill the tub with water and immerse the napkins into it. Squeeze and wring the napkin to remove all the blood. Wash the napkin with natural soap and rinse it. This method can be followed when you are away from home, or when you have to use common bathrooms.
o Stomping: If you are at home, you can follow this method while bathing. Put the napkin on the floor and as you pour water, stomp it with your feet to remove the blood. Then wash the napkin with natural soap and rinse it.
While washing, if you need to scrub, you can use a brush or a rough stone. To remove tough stains, a paste of baking soda (Baking soda + water) can be used.
Washing takes just 10 minutes. You will need to wash twice a day, in the morning and evening. So 20 minutes per day is all that it takes to wash and maintain your napkins!
While on the go
When you are travelling and will be back home at the end of the day, carry a plastic Ziploc bag (shown in the figure above) or a wet bag to put the soiled napkins. You can wash them after coming back home. The Ziploc bag can be turned inside out, washed and reused.
If you are travelling and are staying outside your house, carry a small jar or plastic container with an air tight lid for soaking and washing the soiled napkins.
Drying the napkins
Dry your napkins on your terrace or wherever it is convenient, in direct sunlight. Sunlight is best for drying as the UV rays kill germs. Also, sunlight helps to fade stains.
During the rainy season, dry your napkins on a clothes horse kept indoors.
Making the switch!
The problem with this taboo around menstruation is that it prevents women from publicly discussing issues related to menstrual health and hygiene and sharing creative and innovative ideas on this topic. Open dialogue is the first step in changing the way women deal with menstruation and only this can create awareness around the need to make a switch to reusable cloth napkins.
The thought of switching completely to reusable sanitary napkins may seem daunting at first. Why should go through such inconvenience when we have an easy “use and throw” method? It might seem repulsive to wash bloodied napkins with our own hands. In fact, this could be a major reason why young people especially, might feel reluctant to go for reusable napkins, having grown up with the comfort and convenience offered by the disposable napkins. We need to remember that women have been doing this for thousands of years before us. It is just that, having gotten used to disposable napkins right from the onset of menstruation and not having followed any other method, our mind has been conditioned to think of washing and reusing a napkin as “repulsive”. But this is not so. Many women who were initially averse to this idea found that they could get accustomed to it very easily. They One woman even mentioned that the process of washing her cloth napkins became like a morning ritual for her!
We just need to integrate this routine of using, washing, drying and reusing napkins into our lifestyle and we will be surprised to see that it is no big deal at all! Soon, this routine will become the new “convenient”!
Also, when we look at it as our very own personal step towards living in harmony with Mother Nature, who is the one who nourishes us and provides everything for our sustenance, we would not mind sacrificing a bit of our comfort, would we? (Just 20 minutes a day after all 🙂 )
 Shreya — The Ecological Impact of Feminine Hygiene Products (2016)