Does the type of menstrual product we use affect our vaginal microbiome, and possibly symptoms such as menstrual pain or recurrent vaginal yeast infections? That is what the citizen science project LUNA is investigating, although researchers like Leonore Vander Donck are still urgently looking for additional funding.
In short
- People who menstruate use an average of 15 000 menstrual products over their lifetime. And yet, very little research has been done into the impact these products have on vaginal health.
- The parent project Isala found striking differences between menstrual products: menstrual cups appear to be associated more often with ‘good’ lactobacilli in the vagina, while some sanitary pads show greater bacterial diversity. The LUNA study is now examining this in detail.
- The LUNA study is unique worldwide: 88 women tested five menstrual products, resulting in 3000 samples, but the most expensive analyses are currently on hold due to a lack of funding.
No more vaginal yeast infections
Tampons, sanitary pads, menstrual cups or period underwear: we use them for around 2700 days of our lives. But can these products affect our vaginal microbiome – and thus the risk of vaginal yeast infections and other conditions? The short answer: yes, possibly. And for the first time, this is now being thoroughly investigated.
Within the LUNA project, a sub-study of the citizen science project Isala, bioengineer Leonore Vander Donck and an enthusiastic team of researchers are examining how different menstrual products affect the vagina. The first interim results are both promising and surprising. But to analyse all samples, an additional 150 000 euros is needed, which is why the University of Antwerp has launched a crowdfunding campaign.
15 000 menstrual products
Vander Donck first became involved with Isala during her master thesis and immediately felt that something socially relevant was happening. ‘Women use an average of 15,000 menstrual products over their lifetime. And yet we knew almost nothing about their impact on the vaginal microbiome. That simply doesn’t make sense.’
With LUNA, she aims to fill that gap. The study tests five types of products – tampons, menstrual cups, period underwear, and a scented versus an organic sanitary pad – each used by the same women. ‘This has never been done anywhere in the world before,’ she says.
Long live menstrual cups!
Although the most in-depth DNA analyses have yet to be carried out, the team is already seeing clear trends in survey and usage data from 600 women:
1. Menstrual cups stand out as beneficial
‘Within the LUNA population, 50% use a menstrual cup. That is five times higher than in other Western countries,’ says Vander Donck. ‘Earlier Isala research already showed that cups are more often associated with a higher presence of lactobacilli. These bacteria support a healthy vaginal environment and help protect against, for example, yeast infections.’
2. Greater diversity with sanitary pads
‘A high bacterial diversity isn’t necessarily a bad thing,’ Vander Donck explains, ‘but some patterns do overlap with profiles we commonly see in vaginal infections. It’s far too early to draw conclusions, but it does show why this research matters.’
3. Menstrual pain is seriously underestimated
‘Our data show that only two per cent of women experience no menstrual pain at all. Twenty per cent are unable to function for at least one day a month due to pain, fifty per cent have difficulty concentrating, and one in three has sought medical advice,’ says Vander Donck. ‘In addition, 44% of women say they never received any education about menstrual hygiene at school.’
Women use an average of 15,000 menstrual products over their lifetime. And yet we knew almost nothing about their impact on the vaginal microbiome. That simply doesn’t make sense.
Five menstrual cycles, five products
For the intervention study, 88 women were selected (aged 18–40, without serious reproductive conditions, non-smokers, with a stable menstrual cycle). ‘Each participant used a different product for five consecutive cycles,’ Vander Donck explains. ‘During each cycle, three samples were collected: before, during and after menstruation. This was very demanding for our participants. Normally, women use several products interchangeably. Here, they had to stick to just one per cycle. Even so, motivation was high. Some participants used a menstrual cup or period underwear for the first time during the study, and many continued using those products afterwards.’
Costly analyses
The LUNA samples are analysed using metagenomic shotgun sequencing, a highly detailed technique that maps the complete DNA of the bacteria present.
‘Where traditional research only looks at small fragments of DNA, we see the whole picture: which bacteria are present and what functions they have,’ Vander Donck explains. ‘But that level of detail is expensive. Additional funding is therefore crucial. At 150 euros per sample, with 1000 samples still to be analysed, we need another 150 000 euros. Without additional resources, an important part of the material cannot yet be examined.’
Lactobacillus vaginale for the win!
The university is therefore calling on everyone to support LUNA. ‘Every donation, no matter how small, brings the analyses one step closer,’ says Vander Donck. ‘We have a unique dataset. If we can analyse it in full, we will finally be able to offer scientifically supported advice: which product is healthiest for the vagina? And how can manufacturers improve their products? At present, there are no safety standards for menstrual products – and that needs to change.’
For Vander Donck, LUNA is about more than research alone: it’s about empowerment. ‘Women spoke remarkably openly in our questionnaires about their vulva, their menstruation and their symptoms. That shows just how great the need is.’
Support research into menstrual products
Help make history and bring this groundbreaking research to its next phase.
- You can donate directly via our crowdfunding platform or by bank transfer to IBAN BE42 7310 4624 7854, stating ‘Gift LUNA’.
- Want to know more about the parent project Isala? Read the interview with principal investigator Sarah Lebeer.