THEY COME with or without wings, ultra-thin or maxi, regular, extra long, or g-string. One can also have them unscented, but some brands tout scents like lavender and baby powder. There are sanitary napkins with green tea, while others boast of additives such as aloe vera and vitamin E. Recently, a Chinese company launched a sanitary pad that it says contains anions, which purportedly decrease bacteria and even gradually eliminate dysmenorrhea.

Modern sanitary napkins have come a long way since the days when women would try to contain their monthly flow with thick pads of cloth. Yet for all the innovations manufacturers of sanitary napkins have come up with to ease women’s discomfort during "those days" of the month, they seem to be stumped by this challenge: producing a practical yet eco-friendly sanitary pad.

Environmental groups like Bangon Kalikasan Movement (BKM) say the mountains of trash in dumpsites like Payatas in Quezon City contain a very hefty share of soiled baby diapers and used sanitary napkins. The trash in Payatas has piled up to a towering 50 feet, equivalent to five stories. Seven years ago, a thousand people were killed when the trash came tumbling down on scavengers and those living in huts near the steaming mounds of garbage.

BKM convenor Annette Papa believes that the first environment is the person, and that people need to take care of themselves so that they can take care of the environment outside their personal space. Yet while women are usually active participants in green movements, few of them seem to realize that a product they buy month after month isn’t eco-friendly at all.

It’s bad enough that the disposable sanitary pad is for single use, which means more pressure on resources that are vital to its manufacture, aside from more waste headed for the dumpsite. The cover of the modern sanitary napkin, whether net-like or nonwoven, is also made of plastic, as are the bottom layers. Most napkins these days are packed individually in plastic, too, and then sold in multiples, which are, yes, in plastic packs. Plastic is nonbiodegradable. In dumpsites, says Papa, it contributes to toxic emissions, especially when mixed with heavy metals like lead, cadmium, and mercury. These emissions, which are mostly dioxins and furans, are carcinogenic, and can also cause tuberculosis and other respiratory diseases.

Mixed garbage produces methane gas as well, which Papa says contributes to global warming. In addition, plastic trash often clogs canals and waterways, thereby contributing to floods.

Its plastic components and no-fuss application are what make the modern sanitary napkin so convenient for today’s multi-tasking woman. But women’s studies professor Dr. Sylvia Estrada-Claudio says that once she became aware each time she threw away a sanitary napkin, she was generating nonrecyclable trash, she ceased to see disposable sanitary napkins as "convenient."

Environmental lawyer Ipat Luna also points out that it isn’t only the plastic in disposable sanitary napkins that’s harmful to the environment. "All the energy that would go into production, not just the pad itself, but the plastic, the waste material from the production process, the delivery – it’s a very wasteful cycle altogether," she says. "And it’s unnecessary. And when there is something to replace something that is unnecessary and that replacement is easy, it’s a no-brainer."

The most common "replacement" for the disposable sanitary napkin, of course, is the pasador, or those folded pieces of cloth that women a generation or two ago used whenever they had their monthlies. Luna says she began using a commercial version of the pasador – ordering a set of washable, 100-percent cotton napkins from the Internet – when she started to become irritated over the fact that she needed to throw away her sanitary pads. Six and half years later, her washable napkins are still in service.

"I hardly throw anything out, so ‘pag ganyan na araw-araw may tinatapon ka, nakakasama ng loob eh (when there’s something you have to throw out every day, you feel bad)," she explains. "And then you know that other people are grossed out by what you throw away, you have to wrap it up. It just wasn’t jibing with the rest of my lifestyle."

Besides, she says, it wasn’t as if she was satisfied with her disposables. "There are environmental choices where it’s harder to make compromises on, but this one for me was easy, because to begin with, the product is horrible to me," says Luna. "(Disposable sanitary napkins are) just badly designed – they bunched up, they leaked, they scratched. And even this wings thing, they don’t help. They don’t conform to the contour of your private parts, so they just don’t work."

Gynecologist Dr. Elsie Dancel herself says the fibers in disposable sanitary napkins can cause itchiness and irritation for women who have hypersensitive vulvar skin. Thirty to 40 percent of her patients, she says, complain of irritation due to sanitary pads. A few have gotten urinary tract infections (UTIs) that Dancel believes may have been caused by pressure elicited on the urethra as a result of using sanitary napkins. Other health experts, meanwhile, worry that the scents and gels in some pads – plus the chlorine bleach used to whiten the napkins and enhance their appearance – can cause skin irritations, among other things.

Dancel, 58, grew up in Cagayan de Oro. She says she used a pasador until she graduated from high school. She never felt any itchiness or irritation when she was using cloth napkins, which were secured in place with safety pins, says Dancel. When she came to Manila, however, the convenience of using disposable sanitary pads proved too difficult to resist. After all, using a pasador means having to wash a blood-soaked piece of cloth again and again. And while the pasador is arguably kinder to the skin compared to its disposable cousin, it is prone to leaks.

Dancel doubts that her own daughters would switch to reusable napkins. "They don’t want to see the blood and everything," she says. All of her patients use disposable sanitary napkins.

For sure, a disposable product means its manufacturers are guaranteed to have their cash registers regularly going ka-ching. Last year, the global sales of the women’s health franchise of Johnson & Johnson, maker of the popular Modess brand, grew by 6.3 percent to $1.7 billion, partly because of the solid sales of one of the company’s sanitary napkin brands. Other multinationals such as Procter & Gamble and Kimberly-Clark are also behind local market favorites Whisper and Kotex.

The sanitary napkin market cannot be anything but lucrative. Better nutrition has resulted in the earlier arrival of menarche (a girl’s first menstruation) and the later onset of menopause, says Dancel. These days a girl could be menstruating as early as eight years old, she says, and some women continue to menstruate up until the age of 56. Assuming that the average woman would go through at least three eight-napkin packs per cycle, that means a total of some 14,000 sanitary pads for just one woman in the 50 or so years that she has a period every month.

The cheapest local brand costs around P19.50 per pack of eight. The most expensive brand can cost some P200 for a pack of 10. The last two decades has also seen a rise in the popularity of panty shields, which are essentially just shorter and thinner versions of sanitary napkins. A pack of 20 scented panty shields can leave a shopper about P41 poorer.

Some women’s issues advocates rue the fact that a generous share of those pesos goes to advertising that, they say, often portrays what is very much a natural part of a woman’s life as something to be embarrassed about. Luna says that in some cultures, menstruation is celebrated, citing an American Indian tribe in which a mother and daughter go for a run on the beach in celebration of the daughter’s menarche.

Then again, Luna admits that there really are societies in which menstruating women are considered unclean and are made to live separately from the rest of the community whenever they have their period. She offers the theory as well that colonizers imposed a taboo on sex, and the corresponding private parts of the body, hence the stigma often associated with menstruation and sanitary napkins.

In any case, academic Estrada-Claudio says modern Filipino society is apparently not that comfortable with menstruation. "The message that society’s giving you is that (the) very mark which ushers you into being a woman is also the very threshold that you’re suddenly becoming sinful, which also has something to do with being sexual," she says. "You have this whole norm of sexuality, particularly women’s sexuality, women’s libido, and women’s bodies, being stigmatized as something unclean, something unholy, something unsacred, something difficult."

For all Estrada-Claudio’s concerns about what her used napkins are doing to the environment, though, she still cannot bear to swear them off completely. So she has compromised – sort of.

"I tear my napkins apart," she says. "I take the cotton and put it in the nabubulok (biodegradable), wash the (plastic), which makes my maids think I’m extremely crazy, and I try to tell them they should do it, too."

But she doesn’t think many women would be willing to do the same. "It’s pretty icky to tear it apart," she concedes, "and you kind of in fact lose the convenience – because it’s so convenient to just wrap it up and throw it away, so it’s not convenient for me anymore. Because I have to tear it apart, it takes me longer."

BKM’s Papa also resorted to this method to segregate her used sanitary napkins. "I would just wet the whole napkin," she says. "It’s easier to tear the side, separate cotton from plastic." She cleans the plastic while the bloodied cotton is turned into compost by adding cocodust and water. The plastic is pulverized with a simple shredder. It can then be used as a filling for hollow blocks, or as pillow stuffing.

Papa has also learned how to use the pasador. But Luna says there’s another alternative to the disposable napkin: a washable silicone cup.

"You insert it folded," she says. "And then when it gets into the opening, it opens up and it makes up a vacuum." Luna says that once there’s a vacuum, there’s no leak. She takes her cup out every half day, depending on how heavy her period is. But she says she still prefers to use washable sanitary pads at night, so that she can still feel the flow.

Inserting the cup is tricky, Luna confesses. "You have to twist it a little bit so that plok! It makes a sound like that," she says. "When it does that, it hits you, it’s like rubber bouncing on your uterus a bit, so it hurts. Plok! You feel its suction. Also, it’s hard to pull out because the stem is quite small."

Several companies actually make contraptions similar to the one used by Luna. Hers is being marketed under the brand "Diva Cup." It comes with its own flowered pouch and a little silver pin, which is for proudly announcing that the wearer is using a washable cup. According to Luna, her cup has leaked only twice so far. She says she may have inserted it wrong or perhaps her period was too heavy. Most of the time, however, it has stayed where it is supposed to be. "So you could swim, go to the gym, do anything with the cup in there," she says.

One major problem with the menstrual cup, which has been around for decades, is its price. Luna bought hers for $34, which in these days of the supposedly stronger peso comes to almost P1,600. Even with a guarantee that it can be used for up to 10 years, perhaps only divas and diehard environmentalists would be willing to fork over that much for one. And in a country where the tampon has never made much of a headway, a cup that has to be inserted up one’s private parts may not be much of a hit.

Still, people like Luna and Papa wish that more women would at least become aware of the downside of the modern convenience called the disposable sanitary pad.

Says Papa: "It would be really hard to ask other women to shift, but when they come to understand it is something they can do to help mitigate the global trend of global warming, maybe they can do it." Or perhaps they can start pressuring the major feminine-hygiene product makers to go green.