Menstrual cups are bell-shaped devices, typically made of medical-grade silicone, that are inserted into the vagina to collect rather than absorb menstrual blood. A single cup can be worn for up to twelve hours, then emptied, cleaned and reinserted, and with proper care a cup can last for as long as a decade. Compared with disposable pads and tampons, the economics are striking. One systematic review cited in the study calculated that if a woman used twelve pads per cycle, switching to a cup would represent roughly 0.4 percent of the waste and 5 percent of the cost; against twelve tampons per cycle, the cup would account for about 7 percent of the cost and 6 percent of the plastic waste. Research in Gujarat found that the average annual cost of sanitary pads is roughly twenty times that of a menstrual cup. Yet despite these advantages, usage among reproductive-age women in India has been reported at only around 5 percent.

The research team, led by Melisa Rudolph Menezes of Manipal Health Enterprises Limited, together with Swathi K S and Brayal D Souza of the Prasanna School of Public Health at Manipal Academy of Higher Education and Pallavi Upadhyaya of T A Pai Management Institute, grounded their investigation in three established behavioural frameworks: the Theory of Planned Behaviour, the Technology Acceptance Model and the Health Belief Model. This integrated approach allowed them to capture social influence, usability perceptions and health-related beliefs within a single model. The Theory of Planned Behaviour contributes the roles of attitude and subjective norms; the Technology Acceptance Model contributes perceived ease of use; and the Health Belief Model contributes safety perceptions, cost considerations and awareness as a cue to action. Because menstrual cups are inserted rather than worn externally, the researchers also hypothesised that safety perception would mediate the relationship between attitude and behavioural intention.

Data were collected through a cross-sectional online survey distributed via Google Forms and social media platforms, with voluntary participation and informed consent. The questionnaire contained 28 items measuring seven constructs: awareness, perceived ease of use, price value, attitude, safety perception, subjective norms and behavioural intention, all rated on five-point Likert scales. A priori power analysis using G*Power indicated a minimum sample of 103 for a medium effect size, so the achieved sample of 282 was comfortably adequate. Analyses were performed in SPSS for descriptive statistics and SmartPLS version 4 for structural equation modelling, following a two-step procedure that first validated the measurement model and then tested the structural paths.

The measurement model passed standard checks. Outer loadings exceeded the 0.7 threshold, Cronbach’s alpha and composite reliability met internal consistency criteria, average variance extracted surpassed 0.5 for convergent validity, and all heterotrait-monotrait ratios fell below 0.90, confirming discriminant validity. Variance inflation factors were all below 5, ruling out problematic multicollinearity. Most respondents were aged 18 to 30, about 91 percent had education at or above the 12th-standard level, roughly 30 percent were employed, and 73.4 percent were single, reflecting a largely young, educated, digitally connected sample.

The structural model delivered clear and statistically significant findings. Awareness, perceived ease of use and price value all significantly shaped attitudes towards menstrual cups, with price value showing the strongest path coefficient into attitude at 0.312. In turn, attitude, safety perception and subjective norms all significantly predicted behavioural intention. The coefficient of determination for behavioural intention was 0.424, indicating moderate predictive validity. Most strikingly, safety perception carried the highest path coefficient of any construct at 0.411, making it the single most powerful driver of intention in the model. All seven hypotheses were supported at the 5 percent significance level.

The mediation analysis added a crucial nuance. Without safety perception in the model, the direct effect of attitude on intention was 0.505; with the mediator included, it dropped to 0.246, an absorption of 0.259. The indirect effect through safety perception was 0.2558, and the variance accounted for statistic came to 0.5097, falling within the 20 to 80 percent range that indicates partial mediation. In practical terms, this means that even women who hold favourable attitudes towards menstrual cups may hesitate to adopt them unless they also believe the product is safe for their bodies. Safety beliefs about hygiene, insertion, sterilisation and leakage act as a cognitive filter through which positive attitudes must pass before converting into intention.

These findings align with, and help reconcile, a mixed international literature. Studies in Taiwan using the Theory of Planned Behaviour found attitude to be the largest predictor of cup intention, while research in the Philippines reported that subjective norms did not significantly influence intention, and work in Nepal suggested that positive peer exposure could increase adoption. The Indian results suggest that in a context where menstruation remains stigmatised and misconceptions about internal products persist, social endorsement matters, but it cannot fully override personal safety and comfort concerns. Prior Indian studies have reported that more than 80 percent of women in some populations are aware of menstrual cups and nearly half would be willing to try one if available, yet actual use remains low, evidence that knowledge alone is insufficient to change behaviour.

The authors argue that their results point to targeted, actionable interventions rather than generic promotion. To address safety perceptions and ease of use, policymakers and marketers could develop instructional workshops and video demonstrations on proper cup use and hygiene. Given the influence of subjective norms, peer-led campaigns and community ambassadors could normalise the product, while digital campaigns on popular social media platforms highlighting health benefits and cost-effectiveness could raise awareness. The study is not without limitations: its cross-sectional design cannot establish causality, convenience sampling through online channels may introduce self-selection bias and limit generalisability to women with less internet access or digital literacy, and measured intentions may not translate into actual behaviour where product availability, peer influence or personal comfort intervene. Even so, the research provides public health experts, policymakers and marketers with an evidence-based map of the psychological levers, above all safety, that must be pulled to make sustainable menstrual health choices genuinely accessible in India.

Subject of Research: Behavioral intentions of Indian women to adopt menstrual cups as sustainable menstrual hygiene products

Article Title: Shifting Preferences: Assessing Women’s Behavioral Intentions to Adopt Menstrual Cups

Article References: Menezes, M. R., K S, S., Upadhyaya, P., & Souza, B. D. (2026). Shifting Preferences: Assessing Women’s Behavioral Intentions to Adopt Menstrual Cups. Trends in Psychology. https://doi.org/10.1007/s43076-026-00533-8

Image Credits: AI Generated

DOI: 10.1007/s43076-026-00533-8

Keywords: menstrual cups, menstrual hygiene management, behavioral intentions, Theory of Planned Behaviour, Technology Acceptance Model, Health Belief Model, safety perception, PLS-SEM, India, sustainable menstrual products, consumer behavior, women's health

The study’s researchers, led by Prof. Alice Medeiros Lima, have conducted an extensive lifecycle assessment to explore the potential of biodegradable materials like polylactic acid (PLA), derived from cornstarch. Their meticulous analysis reveals that these biodegradable pads not only demonstrate remarkable reductions in environmental impact but also offer a solution to the pressing issues surrounding the disposal of plastic-based sanitary products. By utilizing PLA, a material that reflects a more sustainable production process than fossil-derived plastics, the environmental consequences of menstrual product disposal can be dramatically diminished.

The findings reveal a comprehensive view of the impact of menstrual products on the environment. Research indicates that the average menstruating individual uses around 120 kilograms of menstrual products throughout their lifetime, a statistic that emphasizes the urgent need for sustainable solutions. The stark reality is that traditional sanitary pads consist of up to 90 percent plastic, equating to the environmental footprint of approximately four plastic bags for each pad used. This statistic alone accentuates the alarming reality of plastic pollution caused directly by sanitary products.

In this context, cornstarch-based sanitary pads emerge as a beacon of hope. The team responsible for the research has discovered that the adoption of PLA not only presents a lower global warming potential but also significantly reduces toxic byproducts related to sanitary product manufacturing. Even considering factors such as increased land use required for PLA production, the overall ecological advantages render cornstarch pads a viable alternative to conventional plastic-based options.

While the benefits of utilizing cornstarch-based materials in sanitary products are profound, the market accessibility of these sustainable alternatives remains a critical barrier. Many large companies have been slow to integrate such innovations, largely due to production hurdles and the necessity for bulk quantities. Nevertheless, the high scalability of cornstarch-based products—a material that can be cultivated widely—serves as an undeniable advantage. Corn is one of the most abundantly produced crops globally, thus enabling manufacturers to secure ample quantities for production, making these eco-friendly options not only viable but also attractive for large-scale operations.

Alice Medeiros de Lima’s insights reflect a clear understanding of the complexities involved in the widespread adoption of sustainable sanitary products. The underlying message is clear: the path toward eco-friendly menstrual products is not just about developing innovations but also about addressing production efficiency, affordability, and scalability. Given the escalation of plastic pollution and the documented environmental hazards tied to conventional sanitary products, there is a compelling case for a transition toward cornstarch-based alternatives. This research stands as a call to action for both consumers and manufacturers to prioritize sustainability for the health of both people and the planet.

Moreover, the positive implications of adopting cornstarch-based sanitary solutions extend beyond just ecological concerns. These products also propose a novel paradigm in consumer behavior towards menstrual health, potentially fostering a broader acceptance of environmentally conscientious practices. As more consumers become aware of the negative impacts of plastic on the environment, the demand for sustainable options—such as those made from cornstarch—will likely rise. Companies that embrace this transition early on could position themselves as leaders within a competitive market, thereby tapping into the growing consumer base that prioritizes sustainability.

The urgency surrounding the need for sustainable menstrual products cannot be overstated. With global plastic pollution steadily escalating and its detrimental effects on marine ecosystems becoming increasingly apparent, the proposition of cornstarch sanitary pads is timely and critical. If embraced widely, these products have the potential to alleviate a significant fraction of the waste generated by traditional sanitary items while simultaneously promoting environmental stewardship among users.

The promise of cornstarch-derived sanitary pads is only beginning to resonate on the global stage. Institutions and industries should rally together to bolster research efforts and product development in this avenue of eco-friendly alternatives. With a concerted commitment from academia, industry, and consumers alike, the movement toward sustainable sanitary products can burgeon, facilitating a necessary shift in how society engages with menstrual health.

Looking forward, the research led by Prof. Lima not only contributes valuable insights into the viability of sustainable sanitary products but also charts a course for future studies centered on customizable biodegradable alternatives. As research in this field evolves, we can anticipate further innovation, potentially leading to a wide variety of products that cater to diverse consumer needs while aligning with environmental sustainability goals.

In summary, the evaluation of cornstarch-based sanitary pads presents a compelling case for the need to re-evaluate our current consumption patterns and materials used in everyday products. By prioritizing sustainable options such as these, society has the opportunity to embrace a transformative shift in hygiene products that aligns with ecological well-being and public health. The path to a greener future lies within the creative innovations of today, marking the beginning of a new era in menstrual product sustainability.

Subject of Research: Life Cycle Assessment of Sanitary Products
Article Title: Evaluation of the substitution of polyethylene for polylactic acid in sanitary pads through Life Cycle Assessment
News Publication Date: 1-May-2025
Web References: DOI Link
References: N/A
Image Credits: IOP Publishing

Keywords

Sustainability, Environment, Menstrual Health, Biodegradable Products, Plastic Pollution, Cornstarch, Polylactic Acid, Eco-Friendly Solutions.