Menstrual periods are something that most women between puberty and menopause deal with every month. But everyone’s period varies, and the choices for period products are vast.

Choosing the right product depends on factors like lifestyle, flow, and personal preference, according to Dr. Holli Jakalow, a gynecologist at NewYork-Presbyterian/Columbia University Irving Medical Center.

But with headlines questioning the safety of the materials and dyes in period products, as well as the emergence of new products, there’s lots to consider when it comes to safety, convenience, and more.

“Everyone is different, and it might take some trial and error before you find the period product that works best for you,” says Dr. Jakalow. “Your preferences and needs may change at stages of your life, and from cycle to cycle, and day to day.”

The Types of Period Products

The main types of period products are pads, tampons, menstrual cups, menstrual discs, and period underwear. You should always wash your hands before using or inserting any menstrual product.

Pads

A pad, also called a sanitary napkin, is a piece of absorbent material that sticks to your underwear to soak up menstrual blood. Pads come in different lenghts and absorbency-levels based on your flow and should be changed every few hours and thrown out in the garbage.

“While rare, some people experience an allergic reaction to the material used in pads,” says Dr. Jakalow. “If you notice any rash or irritation of your vulva, consider switching to another brand or type of period product.

Tampons

Tampons are small tubes of cotton attached to a string that are inserted into the vagina to absorb menstrual blood. They also come in various sizes and absorbency-levels.

“If inserting or removing tampons feels painful, it may help to switch to a smaller size,” says Dr. Jakalow. “If the pain persists, stop using tampons until you speak with your physician.”

Tampons should be changed every four to eight hours and should never stay in for more than eight hours. Keeping a tampon in for too long can lead to a rare but serious infection called toxic shock syndrome (TSS). The best way to prevent TSS is to use the smallest-sized tampon that works for your cycle, and to always change your tampon every four to six hours. “If you are using a tampon and experience sudden fever, dizziness, weakness, nausea, vomiting, sore throat, or a sunburn-like rash, immediately remove the tampon and go to the emergency room,” says Dr. Jakalow.

Menstrual cups

Menstrual cups are small, flexible cups (usually made from medical-grade silicone) that are inserted into the vagina to hold menstrual blood. They come in a variety of shapes — most commonly V-shaped or bell-shaped — and sizes, based on level of flow and a person’s anatomy.

A menstrual cup can hold more blood than a tampon and can be worn for eight to 12 hours or until full. 

With proper care, menstrual cups can last years before needing to be replaced. It’s recommended that you sterilize your menstrual cup at the beginning and end of your period by boiling it in plain water for about five minutes.

“It’s safe to use a menstrual cup if you have an intrauterine device (IUD) or contraceptive ring in place,” says Dr. Jakalow. “Always make sure to break the seal of the cup prior to removal to reduce the likelihood of displacing the IUD, and make sure you are familiar with where your IUD strings are located so that you will notice any signs that it has become displaced — for example, if the strings feel longer than usual.”

Like tampons, menstrual cups also pose the rare but serious risk of toxic shock syndrome. Again, it’s important to remove your menstrual cup at the appropriate intervals, and to seek immediate medical attention if you experience any symptoms of TSS.

Menstrual discs

Menstrual discs are shallow, round reusable discs (usually made from medical-grade silicone) that holds menstrual blood. Similar to the menstrual cup, the menstrual disc can hold more blood and stay in for longer than a tampon — but it sits higher up in the vaginal canal, just at the base of the cervix.

A menstrual disc can be worn for 12 hours or until full. With proper care, menstrual cups can last years before needing to be replaced. It’s recommended that you sterilize your menstrual disc at the beginning and end of your period by boiling it in plain water for about five minutes.

Similar to the menstrual cup, it’s safe to wear a disc with an IUD or contraceptive ring in place, as long as you are familiar with where your IUD strings are located.

If inserting or removing menstrual dics feels painful for you, switch to a different size or shape. However, if pain still occurs, stop using menstrual cups until you speak with your physician.

As with a tampon and menstrual cup, there is a small, but serious risk of TSS.

Period underwear

Period underwear, another reusable option, can be worn instead of regular underwear while you’re menstruating. They are made from special absorbent material (usually including a moisture-wicking layer to ensure dryness) and come in different absorbency-levels and styles.

Depending on the type of period underwear and your menstrual flow, you may be able to wear them for up to 12 hours. If they feel damp or uncomfortable, it’s time to change pairs.

Most period underwear should come with cleaning instructions, but for the most part, can be cleaned in the washing machine just like regular laundry.

How to Choose

When choosing a period product, it comes down to your flow, personal preference, and your goals for menstrual care.

For example, if you’re an athlete or have a very active lifestyle, you may prefer internal products such as menstrual cups, menstrual discs, or tampons over pads and period underwear, which can be a bit bulkier. If you want the most sustainable option, then you might choose to avoid disposable products and opt for reusable options.

Some people are allergic to certain substances found in some period products, such as dyes, fragrances, or other materials. “Everyone’s body and skin, including the skin of their vulva, has different sensitivities,” says Dr. Jakalow. “Generally speaking, I recommend using products that are free of dyes and fragrances, as they are less likely to cause contact dermatitis, eczema, or irritation.”

Recent reports have found that some period products (certain period underwear, tampons, and pads) contain potentially harmful “forever chemicals,” or PFAS. According to the U.S. Environmental Protection Agency, exposure to certain amounts of PFAS may cause reproductive effects such as decreased fertility, increased risk of certain cancers (including prostate, kidney, and testicular), obstruction of the body’s natural hormones, among other health risks.

“While there’s no way to entirely eliminate the risk, you can look for tampons and pads that use organic cotton, are labeled chlorine-free, and do not contain any fragrances or dyes,” says Dr. Jakalow.

Finally, Dr. Jakalow recommends paying close attention to your period. “It’s important to note that if your period feels particularly heavy to you (for example, if you bleed through a pad within an hour) you should call your doctor right away,” she says. “Your period should not be something that’s holding you back from living your life. If your period is something that significantly bothers you, you should talk to your doctor. You can safely take medication that also works as contraception to have a cycle that feels better for you.”