How women manage periods around the world

Posted in Postpartum Advice.

Periods around the world

Cow patties, goatskin skirts, a hole in the ground – they’re all used to manage periods around the world. While most of us are used to the modern luxury of using sanitary pads, a new photo project lifts the lid on how other women deal with their periods.

WaterAid’s project highlights how so many women don’t have access to basic sanitation during their periods, and still deal with an outdated stigma. The organisation is working with communities around the world to help women learn more about their periods, and in turn, has discovered the unique ways some cultures deal with menstruation.

Here are how nine women from different corners of the globe manage their periods.


Cow patties used during periods in Zambia

WaterAid/ Chileshe Chanda

Limpo, 22, uses dry cow patties. 

“I use cow patties to manage my period. I started using them a long time ago just from the time I started having my period. I collect cow patties from the grazing areas for cattle in the plain and they are readily available. Sometimes I collect dry ones and other times I collect semi-dry ones depending on the season. If it is the wet season, I collect cow patties and stock them somewhere to make sure they are completely dry before use. In a dry and hot season like now, I find them already dry and all I do is pick and use.

“I spend a little time shaping cow patties into sizable pieces that can fit in my underwear comfortably. This is a very simple task for me each time I need to. I do not put the cow patties directly on my skin, I wrap it in a cloth and place it nicely to capture the flow without staining other clothes. I like this method because cow patties soak up a lot of blood before they are completely soaked. I go about doing all sorts of things without any trouble. Once soaked, I carefully dispose of it privately. I usually dig a small hole in the ground and bury it. In our culture, it is not allowed that men see such things.

“I use cow patties to manage my period because I don’t have money to buy the pads. These cow patties are free and readily available. Yes, I have used a pad before. I have only used it once when I was given one at school. I don’t have much experience with pads. I have been using this method most of the time.

“I cannot say that I am completely comfortable and happy using these materials to manage my periods. If I had an alternative, I would use other stuff. It is just that I don’t have an option, so I keep using this anyway. I have never seen or experienced any complications with cow patties. From my single experience with the pad, I think it works very well just like cow patties they both work effectively.”

Cow patty sanitary pads

WaterAid/ Chileshe Chanda

Nowana, 45, uses powdered cow patties.

“I mainly use cow patties to manage my periods, occasionally I use a piece cut from an old blanket. I only use a blanket if am home and not intending to go anywhere. But the cow patties I use at any time whether I am just home or I am traveling to different places.

“I don’t like using a piece of blanket because it gets soaked quickly compared to the cow patties. The other reason is that it is not easy to wash off all the blood from the blanket and many times I end up just disposing of it. I pick cow patties from the kraal and other times I just walk about in the fields where we cultivate and pick the cow patties as dropped by cattle while grazing. I pick the dry cow dung and pound it into powder using a mortal. After making the powder I then pack it into a pouch and it will be ready to use in managing my period.

“The dry cow patties do not have a smell and no one would notice that there is something I am putting on of this sort. This is why we have been able to use this method for a long time. Our parents taught us about the use of cow patties a long time ago before we even heard about pads. I was shown this method by my grandmother and I have been using it since that time.

“Money is scarce and I cannot afford to buy pads, they are expensive and that’s why I use this method. I have children who are of age who also need pads and if you put all of us together, you will agree that it’s a lot of money that will be required and we cannot afford that. My daughters have been shown the same method; we have passed this onto them because it is easy, cheap and readily available.

“I feel just fine to use the cow patties in managing my periods so far, but I can’t stop thinking about pads since I know about them and cannot just have them. In my entire life of using cow patties, I have not seen anything worrying or dangerous. They are fine and harmless as far as I know. People started using them from a long time ago.

“There is not a task I fail to do when am on period. I manage to do all the work as expected of me with or without periods. I would prefer pads to cow patties if I had a choice. They are easy and already made, they are disposable and don’t require a lengthy process like the one I go through when using cow patties. Nowadays whenever I use cow patties to manage my periods, the feeling of lack is in my heart since I know that something better exists.”

Cotton used for sanitary pads

WaterAid/ Chileshe Chanda

Doris, 19, uses cotton wool. 

“I use pieces of chitenge material and cotton wool to manage my periods. [A chitenge is a wrap originally designed for women to cover themselves from the waist downwards.] I get my pieces of cloth from my mother’s old and worn out chitenge. As for the cotton wool, I pick it from the cotton fields and stock it up for use when need arises.

“It is not very comfortable to use chitenge materials for managing the period. It gets soaked very easily and heats up when am walking. Lint cotton is much more comfortable to use but too many insects are attracted to it and sometimes it is itchy when using it. Also, cotton lint has become scarce due to the bad rainfall we had.

“I don’t use pads because they are very expensive here. A pack has 10 pieces and if I have to change three to four times a day, then its way beyond what I can afford. My mother first taught me about how to manage my period. She taught me also how to prepare these materials so that I am not embarrassed by staining my clothes or the chair where am sitting.

“Washing off your blood from the pieces of cloth after use is not the easiest of things. Even if all the material staining the pieces of cloth is yours and from your body, the idea of touching it and washing it off so you can dry the clothe and reuse is not a good experience. It takes a lot. When am on my period, I stop playing soccer or any other sporting activities. I can’t run or play games with my friends.

“During my period, I don’t feel confident enough. Mostly I hang around home and engage in less activity. I come to school sometimes and other times I just stay home if my period pains are too much. The materials I use during my period are not 100 per cent safe that’s why I need to be careful all the time.”


Menstrual cup for period

WaterAid/ David Severn

Claire, 40, uses a menstrual cup.

“I use sanitary pads, tampons and a Mooncup when I’m on my period. I buy them from a vegan cooperative near me. The tampons and pads are made of 100 per cent cotton and are perfume and chlorine free, as well as being biodegradable. The Mooncup is made out of silicon and is plastic-free. You insert the moon cup into your vagina and the little head sticks out, so that you can pull it out again.

“My main consideration is that these products are better for the environment. I made a lifestyle choice to reduce waste. Before becoming more environmentally conscious I used regular supermarket brands. With the Mooncup, a side benefit is that it saves me having to but much of the normal products, as the cup is reusable. I like using it because I can leave it in longer than a tampon, it’s safer for the body.

“The one thing with the Mooncup is that it is more hassle. It needs boiling to clean it properly. We have a ‘Mooncup pan’ in which I boil it and sometimes I have to rush into the kitchen to stop someone from boiling an egg in it. I don’t find the Mooncup as convenient to empty when I am out and about. I’d only be able to do that if adequate facilities are available, since you do end up with blood on your hands. It’s a choice I have made though, like we use reusable nappies for the kids to reduce waste. I don’t use the Mooncup on the first day of my period, as it leaks a bit more than other products.

“With tampons, I am a bit concerned that I forget to take it out, as that has happened before. I don’t have that with the Mooncup. The little head that sticks out though, compared to the small thread of a tampon, can be a bit more uncomfortable. I’d consider using reusable sanitary pads in the future, or perhaps anything new that might come out. My period doesn’t affect my confidence, but I do permit myself to rest more and I am more gentle with myself.”

Reusable sanitary pads

WaterAid/ Billy Barraclough

Hilary, 27, uses reusable sanitary pads

“I use a combination of different reusable sanitary pads, cotton or bamboo when I am on my period. A group of women in India makes some of them as a means of sustainable income. It is important to me that they are made of natural materials because I find it most comfortable and eco-friendly. Fortunately, I am in a privileged position to think of comfort when it comes to sanitary towels.

“They do stain and since they are made of cotton or bamboo, they usually last about as long as a regular piece of clothing. Some of the ones I have are now two years old. The environment is a big factor for why I use reusable sanitary pads. It’s about reducing waste. There is no way to recycle or properly dispose of regular sanitary pads, so with up to half the world’s population using those, it has a huge impact on the environment yet nobody discusses it.

“I am also concerned about the materials that go into tampons, such as lots of chemicals and rayon that leave trace fibers in the vagina and can cause small cuts and thus infections. Reusable pads are also cost-effective and I always have them, so I never find myself without when my period starts.

“The downside about reusable sanitary pads is that it can be inconvenient in terms of washing. I live in a house share, so finding somewhere with privacy to clean them can be challenging. You are supposed to soak, scrub and then cold wash them. I don’t want to cause any embarrassment or discomfort to my housemates. They do see them drying, they don’t mind that. In the future, I could see myself trying period pants though they are more expensive, or period swimwear.

“When I am on my period I take more care with myself: I take a bath to relieve cramps, relax a bit more to avoid getting tired or grumpy. I am just generally a bit gentler with myself and listen to my body. While I do get period pain, for me my period is a sign that my body is doing what it is supposed to do.”



Cloth sanitary pad in Pakistan

WaterAid/ Sibtain Haider

Saba, 18, uses cloth. 

“I use a cotton cloth to manage my periods. I get the cloth from home, from the clothes that we used to wear earlier and are now old and rough. In school, I used to face difficulty during my periods because I use cloth, I don’t feel comfortable with it. Use of cloth hampers my work as I cannot work properly, for example, while sweeping or walking.”

“My mum told me to use cloth during my periods. I cannot afford to use sanitary pads. Sometimes I do use sanitary pads when I have to go somewhere but not very often. I find the use of cloth difficult and it makes me uncomfortable. I can’t use it properly and I feel irritated. I keep worrying because I do not want others to know when I am menstruating.”


Goat skin used for periods in Uganda

WaterAid/ James Kiyimba

Lepera Joyce, 23, uses a goatskin skirt.

“I have this special skirt made out of goat’s skin that I wear during my period. The skirt is made in such a way that it has a thick folded bottom ending, which we locally call ‘Abwo’ – the tail of the skirt. When I have my period I wear this skirt, I find a comfortable place to sit, I fold the tail of the skirt ‘Abwo’ in between my thighs and wait for the blood to drain in the tail of the skirt.

“I use this goatskin skirt because it’s always available; it’s our traditional sanitary pad. I don’t pay anyone to use the skin, other pads are expensive, even if my skirt gets old, I make another one since we have many goats. My grandmother taught me how to make and use the goatskin skirt during menstruation. Even now my four-year-old daughter Angella has her own skin skirt, she has to get used to wearing the skirt.

“When the blood flow stops, I clean my goatskin skirt with cow ghee. I look for a private place, probably inside a hut that’s where cleaning takes place because no one is supposed to look at your blood. The process of cleaning the goatskin skirt involves smearing cow ghee in all the areas with blood – on the side of the goatskin without fur – this is the part that absorbs blood. I do the smearing with bare hands since the blood is mine. I keep squeezing the blood out of the skin, it’s like I am washing clothes, through this process all blood is removed from the goatskin skirt.

“I am happy and comfortable wearing the goatskin skirt during menstruation because it’s cost effective and easy to clean – I just have to use ghee only. After using ghee to clean, I don’t even need to dry it in the sunshine. Once I bought a pack of sanitary pads from the shop but I did not like them because if one has heavy blood flow she can use more than three pads in a day yet they are expensive. Also, they are small, they do not absorb all blood, yet the goatskin skirt works for the whole day.

“There are no specific taboos associated with using the goatskin skirt during menstruation but in our culture, we have some taboos around menstruation: menstruating women are not allowed to milk cows or even cross the kraal due to fear of cows dying or getting stolen. During menstruation, I stay home all the time, because I am considered unclean. I usually take three days and after I am very free to do all my duties including milking cows.

“In case I have blood flows at night, when I am in my bed, I don’t use the skirt. This time I use a small soft skin from a calf. Another alternative is using four pairs of pants. I fold one pair of pants in a shape of a pad to absorb blood and then wear the other three pants to prevent blood flow.

“When I am on my period I am always shy and I fear to move outside my home. My biggest fear is if my skirt falls off and people get to know that I am on my period.”

Digging hole for periods in Uganda

WaterAid/ James Kiyimba

Munyes, 44, digs a hole in the ground to sit over.

“During my period I find it easy and very normal to make a hole in the ground and sit on top of it for blood to drain in it. As a woman, when I am on my period, I can tell that blood is coming. I make a small hole in the ground in a private place – sometimes under a tree or in the garden. I sit on top of the hole targeting blood to flow into it. I sit comfortably spreading my skirt, even if someone is passing by they cannot know what I am doing. It’s like I am resting.

“When I am done I cover the hole very well with soil. In our Karamoja culture when a woman is on her period, other people should never get to know. I find managing my period using this method very convenient because buying sanitary pads is costly and sometimes when blood comes there is no time to run to the shop to buy sanitary pads. I can’t run, letting people see my blood; I would rather make a hole in the ground to sit. Some people think they are allergic to modern sanitary pads.

“Whilst growing up, the mature women including my mum taught us the different methods of managing our periods, but I preferred this method of making a hole in the ground. No man, not even your husband should see your blood. Even me, I have taught all my daughters how to use this method.

“I am happy and confident when using this method because I always find a private place where no man will see me. This gives me confidence that I am safe. I have to sit on top of this hole until I stop bleeding; thereafter I cover the hole with soil to the extent that no one can ever notice any blood.

“When I have my period for three or four days, it means each day I have to make a hole. In case the blood flow starts at night, I have a piece of old cloth I use. In the morning I go to the river to wash it in a certain type of mud, which removes blood and smell.

“When I am sitting on the hole there is no any other activity I do but if there are other women nearby we can converse. During menstruation I don’t do anything, not even milking cows or going to the garden until the blood stops flowing. In most cases when I am on my period, I feel out of place because I don’t want anyone to know what’s happening. I am always shy, thinking that someone may notice what I am going through. Even when I am eating food with other people I eat first so that no one gets to know that I am on my period.”


Cloth used for periods in Malawi

WaterAid/ Dennis Lupenga

Tamala, 23, uses a piece of cloth called nyanda.

“During our menstruation period, we use nyanda – a rag or a piece of cloth cut off from an old chitenge wrap [traditional African fabric]. We place it in a piece of underwear. However, some among us cannot afford underwear, so in that case, we secure the nyanda in place by tearing a long and thin piece of the rag and tie it around the waist to hold the fabric tight in place.

“We also know of women who are very poor that they can’t even afford the chitenge wrap, so they cut off a piece of their blanket and use that; it is less sanitary than the chitenge but then, they have no other option. Sometimes, a piece of cloth from our husband’s old shirt comes in handy, if a chitenge wrap is not available

“If married, our husband is not supposed to see any piece of cloth that we are using, so the rags are carefully secured in a small plastic bag which we hang on a top corner close to the ceiling in the bedroom; this we do to ensure that our men do not have any close contact with that plastic bag, even when we are not on our period; and mostly they know that they cannot touch it because it’s for the ‘woman’ in the house.

“Even when we are not on our period, we keep the plastic bag hidden. After washing, we can dry the nyanda only in the bedroom despite the foul smell which appears if the soap has not been used. Drying it in the bedroom is also another way of telling the husband that ‘I am in that time of the month’ and he then knows he must keep away from you sexually.”

Read next …

Find out more fascinating facts and information about periods (including if you can still get your period when you’re pregnant?):

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