Pads, Rags or Menstrual Cups?

Women line up at a pharmacy in Cuba for menstrual supplies. (Video Screen Capture)

14ymedio bigger14ymedio, Luz Escobar, Havana, 26 March 2018 — Marta María Ramírez was given her first tampons in 1991, when she got her first period at age 15. The country was experiencing the deepest days of its economic crisis and sanitary pads were not available. Some 27 years later the situation is little changed and Ramírez, now a journalist and producer, promotes the use of alternatives among Cuban women affected by the shortage and poor quality of sanitary napkins.

Each woman between 10 and 55 years old receives, through the rationed market, a monthly package with 10 “intimates,” as samitary pads are popularly called. The product, manufactured by the state monopoly Mathisa under the brand name ’Mariposas’ (butterflies), is sold at a subsidized price of 1.20 CUP a package, about 5¢ US, but has an impressive record of negative opinions among its users.

The poor quality of the pads, their poor ability to absorb, the defective glue that prevents them from being firmly fixed to the underwear, in addition to the irregularity in their supply, are some of the most common complaints heard when women are asked about ‘intimates’ on the streets of the country.

Alternatives are available in stores that sell products in hard currency, where several types of pads are sold, from the thinnest for light days to others for days of greater menstrual flow. But at more than 25 CUP a package, which for some can be the equivalent of a full day’s wages, the price is prohibitive for many pockets.

Ed. Note: Apologies for not having subtitles for this video.

“A woman’s menstrual cycle last three to seven days,” gynecologist Niurka Rodríguez tells this newspaper. “I recommend that my patients change their pad, at a minimum, every six hours, but most of them tell me that in the days of greatest menstrual flow they can use up to eight pads” on a single day.

“If you have a period for four days, taking the average, and you change every six hours, then you will need 16 ‘intimates’ for one cycle and the package that is distributed in the ration-market pharmacies only supplies 10 a month, which is not enough,” laments the physician.

However, “very few women who come to my practice use another alternative, such as tampons or a silicone cup that is inserted inside the vagina and manages to collect the flow,” adds Rodriguez, who works from a clinic in the 10 de Octubre municipality. “The cup can be worn for a longer time without great risks and lasts for years.”

The cups are made with medical silicone or TPE (thermoplastic elastomer) and are designed to be used also by those who have allergies, because they do not contain any chemical additives. They do not hurt, nor do they dry out the vaginal walls and they do not leave behind any bits of fibers, as traditional tampons can do.

In none of the more than 20 stores, pharmacies and supermarkets in Havana visited by this newspaper that sell feminine hygiene products in hard currency, were menstrual cups available, and there was only one pharmacy where tampons were available, for a price of 8 convertible pesos (CUC– roughly $8 US) for a box of 20.

Gynecologist Niurka Rodríguez believes that the limited use of these other options among Cuban women is due to several reasons. “The lack of information is vital, because many do not know that these products exist, but also the high prices at which tampons are sold in some pharmacies in CUC prevent them from becoming popular.”

“There is also a lack of information among us, health professionals, because most of my colleagues have never seen a menstrual cup and can not recommend something they know nothing about,” she says. “I am informed because I have a sister who lives in Sweden, where it is very popular.”

“When I use all the pads from the pharmacy I turn to rags,” says Mariela, a 23-year-old Havana woman who learned that habit from her mother, who “lived through very diffcult times, like the crises of the 70s and the 90s.”

“She taught me how to cut a towel into pieces, that I wrap and fill with a bit of cotton, which helps me replace the pads,” she explains to 14ymedio. “The problem is that afterwards you have to wash them very well and hang them in the sun to dry so there is no residue on them  that could affect your health.”

This method is very widespread among Cuban women and became practically obligatory during the most critical years of the so-called Special Period. “At that time everyone went around with their rags in their bags and the worst partwas when you removed one it had to be carefully stored, to take it home and wash it.”

Prejudices also contribute to “the pad remaining the first and most widespread choice among women” on the island, says Dr. Niurka Rodríguez. “There are many popular legends that using a tampon is dirty because the woman has to touch her genitals or that it may end up stuck in the vagina, but these are the result of ignorance.”

“With the tampon I felt liberated,” Marta María Ramírez tells 14ymedio. “Despite the risks (toxic shock syndrome and other longer-term ones that I heard of), I enjoyed being free,” she says.

Toxic shock syndrome is caused by a toxin produced by some types of Staphylococcus bacteria. Although its prevalence is very low (from 1 to 9 cases per 100,000 people) it is estimated that around half of the cases are associated with the use of tampons, particularly among women who leave the product in their vagina for a long time.

Other than that risk, that is explained in every tampon container, women interviewed insist that it is a better option than sanitary pads, because it performs better with regards to “how long it works, cleanliness, mobility and safety,” according to opinions collected by this newspaper.

On March 8, for Women’s Day, Ramírez published 42 demands of Cuban women on her Facebook account. These included the promotion and sale of tampons and menstrual cups in the country at prices that any woman can afford.

A few years ago, Ramírez learned about the work of Feminist Economics, a space that promotes “on this side of the Atlantic, the MenstruAcción campaign, asking the Argentine Congress to pass a law to provide menstrual products free of charge and tax exempt,” she said.

“There I found out about the battles of women in other parts of the planet and I decided to include the mentrual cup in my first book “SurvivalKitForWomen,” which lists objects that all women must carry in their purses.

Ramírez tested the menstrual cup thanks to a friend who bought it for her abroad. “It is safe, hygienic and more economical, having a useful life of up to three years. And in addition, it’s better for the environment,” she explains.

Now, she is disseminating her experiences because “Cuban women need access to information” on these issues “in order to be able to choose and to demand that the government set aside the absurd paternalism that ignores issues that would make us happier.”


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