Period Positivity Defined The 2010s. Did It Deliver?

In January, the period underwear brand Thinx settled a class-action lawsuit which alleged that Thinx products contain harmful chemicals, specifically PFAS (per- and polyfluoroalkyl substances), also known as 'forever chemicals'. The decision came a decade after Thinx launched and built a reputation for providing an "organic, sustainable and nontoxic" alternative to disposable period products. The discovery of potentially harmful chemicals (first tracked in 2020 by environmental publication Sierra magazine) felt like a betrayal. 

Consumers were outraged. A viral tweet in all caps called for people to "stop using them now", while other users said it was making them furious, "giving them trust issues" and was their "worst nightmare".

The lawsuit soon became part of a wider cultural conversation, with headlines drawing attention to other concerns about menstrual products. Claims about menstrual cups causing prolapse (the bulging of one or more of the pelvic organs into the vagina) resurfaced online before spreading into group chats. The worries about period tracking apps and data privacy returned, and with them the demands on social media that everyone delete their apps. Thinx was seen as interchangeable with any brand of period underwear, with worried customers either asking questions of their preferred brand of pants or dismissing reusable undergarments entirely.

These trackers, pads, pants and cups gained popularity in the 2010s. They coincided with the wider movement for period positivity, which called for destigmatisation and better access to better products for both people and planet. NPR dubbed 2015 "The Year Of The Period". It felt as though the products and the politics finally were in step, enabling individual consumers to make choices that aligned with wider asks. Today that sense of empowerment and positivity feels invalidated. Instead of being the solution many had hoped for, one step forward has turned into two steps back, leaving many of us thinking, What am I supposed to use now?

Concerns have been raised around the health impacts of PFAS in general but particularly on women. In 2017 the International Agency for Research on Cancer classed PFOA (perfluorooctanoic acid, one of the most widely detected PFAS chemicals) as a potential carcinogen. In particular, PFOA is a suspected hormone disruptor and PFOS (perfluorooctanesulfonic acid, another widely detected PFAS chemical) has been linked to fertility problems.

In the case of Thinx, concern arose because PFAS were found in the crotch area of the underwear, which is positioned close to the sensitive vulva. As Thinx had previously stressed its environmental credentials, the presence of these chemicals (though the research did not state whether the PFAS found included those mentioned in the previous paragraph) felt deceitful. 

In a statement to Refinery29, Thinx said: "Consumer health and product safety are top priorities for Thinx, and we stand by the quality, efficacy and safety of our products. The lawsuit is related to how products were marketed, and was not about injuries or harm caused by the products. PFAS is not included in our product design."

The brand added that the settlement "included no admission of wrongdoing by Thinx".

The questions surrounding period tracking apps aren’t new either and have focused on data privacy. That focus has sharpened following a series of lawsuits and the changes to abortion laws in the United States. 

When the US Supreme Court overturned Roe v. Wade in 2022, many women chose to delete their digital period trackers. They feared data collected by the apps could be used in the future against individuals being prosecuted for illegal abortions. Speaking to The Guardian, Texas-based criminal defence attorney Sara Spector said: "If they are trying to prosecute a woman for getting an illegal abortion, they can subpoena any app on their device, including period trackers."

A 2019 survey found that period trackers are used by a third of women in the US, with the app Flo being the most popular. Trackers collect, retain and sometimes even share their users’ data. A 2020 study by UK-based charity Privacy International found some menstrual tracking apps hold intimate information from users "including answers to questions about when they have yeast infections and how often they have sex or see a gynaecologist". 

An investigation by the Wall Street Journal in 2019 found the app Flo had informed Facebook when a user was menstruating or pregnant; the Federal Trade Commission (FTC) reached a settlement with Flo two years later. Flo didn’t admit any wrongdoing and had to undergo an independent review of its privacy policy as well as obtaining user permissions before sharing personal health information. The result was the rollout of its Anonymous Mode. Cath Everett, VP of Product at Flo, tells R29: "This means, should Flo receive an official request to identify a user by name or email, Anonymous Mode will prevent us from connecting data to an individual, meaning we wouldn’t be able to satisfy the request. It’s a way of taking Flo’s commitment to protecting the users’ privacy to a whole new level, not yet implemented by any other company." Other US-based apps do not specify what information is shared with third parties, while EU-based apps like Clue benefit from stronger data privacy laws and do specify what data is shared.

The concerns about menstrual cups are less clear cut. The link between cups and prolapse stems from a call issued by the Chartered Society of Physiotherapy (CSP) in 2020 for better guidance around the use of menstrual products, citing the potential for prolapse with improper use.

Kate Lough is the physiotherapist from the CSP who was asked by the weekday BBC current affairs programme Victoria Derbyshire to talk about the possibility that menstrual cups can cause prolapse. While she emphasised to R29 that women with a functioning and healthy pelvic floor have far less to worry about, those who have signs of pelvic floor dysfunction (particularly around pregnancy and childbirth) may be more vulnerable. 

"If you're somebody that's using a menstrual cup five days out of your seven days, you're doing it once a month and you are otherwise in good nick, it shouldn't really cause a problem. But if you're really having to push to release the suction, it's not a good habit to get into. Some women with existing pelvic floor problems such as vaginal heaviness [a dragging discomfort that feels like there is something descending] may struggle to comfortably keep a tampon in, and turn to menstrual cups. But ideally it would be a moment to seek help from a healthcare professional."

She highlights that the lack of consistency in the guidance leads to confusion and the development of bad habits such as "bearing down" to "break the suction". The act of bearing down (increasing pressure in the abdomen in order to push downward, as in labour) is not in itself dangerous but if you are susceptible to pelvic floor dysfunction, it can encourage downward movement in the vagina, potentially leading to prolapse (though this is unlikely).

Advertising from different brands pushed at the boundaries of acceptability in order to throw off stigma and make noise. It was largely successful. A 2015 Thinx campaign was banned from the New York subway for being "inappropriate" and in 2019, one of its TV ads was rejected for showing a visible tampon string. In 2020, the Australian absorbent apparel company Modibodi had a Facebook ad banned for showing blood. Norms around bodies and gender were also pushed. In 2018, subscription service Pink Parcel ran the first ad for period products to feature a trans man, and many brands created product shots and campaigns featuring women and menstruators with a diversity of shapes and sizes.

In contrast, the advertisers of earlier eras sold single-use menstrual products with a message that depicted the body as dirty and shameful and alluded to menstruation in veiled, sanitised ways, whether that meant calling single-use pads Whisper or subbing in blue liquid for menstrual blood when demonstrating absorbency. Comparatively, the campaigns of the 2010s felt truly refreshing. 

But when it comes to better products and better access, private companies can’t help but fall short. In 2018, for example, Greenpeace Laboratories found that tampon applicators sold as "plant-based plastic" in fact contained polyethylene, the same material used to make oil-based plastic tampon applicators. And in 2021, UK high street retailer Primark introduced £6 period pants as "the perfect replacement for single use period products" before quietly withdrawing them in 2022 to "review the labelling to ensure that it is fully in line with UK requirements".

Ruby Raut is the founder of period underwear brand WUKA, which works with factories with certified ethical manufacturing credentials to produce period underwear made from OEKO-Tex-certified, GOTS organic cotton and recycled nylon. She tells Refinery29: "When people started seeing period pants, most of the brands didn't think about doing further due diligence other than just creating period pants. At the end of the day, they replace X amount of disposable pads or tampons going to landfill and they think that that is good enough credentials for them to become a sustainable brand. But it's more than that."

Similarly, menstrual cup brand Mooncup UK attributes the issues surrounding menstrual cup guidance to the rapid growth in the market for sustainable period products. In a statement to R29, Mooncup UK said: "Unfortunately, the growth in the menstrual cup market has seen misleading information around using a menstrual cup circulating, with some products even being sold without any instructions for use." This was echoed in the 2020 BBC investigation, which found that menstrual cups aren’t currently regulated in the UK and that the printed guidance can be "hard to understand".

These failings, while disappointing, are not catastrophic. There is more general awareness and normalising of periods than there has ever been, thanks in part to these companies. Simultaneously, campaigners have taken this momentum, fought valiantly and made some major strides, from renaming 'feminine hygiene aisles' as 'period products' to campaigning government bodies to supply period products for free in schools.

If anything, the current situation should act as a reminder not to put absolute faith in private companies. It is a public health issue – one that affects women and menstruators for the majority of their lives.  

As Dr Sharra L. Vostral, professor of history at Purdue University and author of Under Wraps: A History of Menstrual Hygiene Technology, explains to Refinery29, this shift in perspective may be slow but it is cause for hope, not despair about menstrual health.

"That [periods are] a public health concern is really the core of what's changing – it's shifting from an individual's problem to a greater social issue about acceptance. And so to me, destigmatisation is just the absolutely critical thing that's happening right now. And we're in the middle of it, we're not through it yet. And so that's why it sort of pops up in different moments and we thought we dealt with it, but we're not done.

"I think we're anxious and impatient for us to be through with this but social change takes a while. This is a really embedded belief system about periods being dirty, filthy, inappropriate, changing women's behaviours.

"That's why it's also a very exciting time because you can see it in lots of different sectors. It's two steps forward, one step back, but there is change and so I think that is the hopeful thing that's happening right now."