Menstruation is an unspoken taboo in American culture. Society silences the subject and depicts menstruation as if it were something to be experienced yet not discussed, except in private conversations. From the resulting ignorance, myths emerged, including the imagined impurity of menstrual products. By treating menstruation as a cultural taboo, American society imbues women with a shameful view of their bodies, all which contributed to the Toxic Shock Crisis in the 1980s. Perpetuation of shame and misinformation about menstruation and menstrual products ultimately endangers American women. Since the 1980s, the prevalence of Toxic Shock Syndrome has greatly decreased, yet the menstrual taboo and its cultural consequences persist.

Companies that manufacture and market menstrual products establish an artificial set of unwritten rules that frame our thinking on menstruation. In advertising, companies use specific etiquette that limits the extent and way American women can talk about menstruation. The language used, and not used, in menstrual product commercials reflects denial of menstruation. The first time the word “period” was used in a commercial was in 1985 (St.Vincent Editorial Staff Menstrual Cycles). By treating periods as something unspeakable, society acted as if menstruation was something shameful. In 1980, the “Rely” company used several slogans, which described menstruation in code words, such as: “It even absorbs the worry” and “You won’t know you’re wearing one, and neither will anyone else” (McDonough, John and Egolf, Karen The Advertising Age). Distorting reality further, commercials used blue color to depict menstrual blood, signaling that reality must be hidden and potentially confusing young women in the process. Scholars acknowledge the double standard in this fear of menstrual blood by stating: “Americans only need to turn on televisions to view graphic and typically violent depictions of blood, [however] it is considered too taboo… to simply make this watery liquid red" (Lapekas, Jenny M. Red moon rising). Menstruation, according to company advertisements, is a problem calling for secrecy.

Women themselves perpetuate the taboo of menstrual etiquette by conforming to the standards set by society. Mothers often teach their daughters that periods are “a private, girl-talk, family matter. Nice girls may talk about bleeding in the privacy of their fluffy, girlish bedrooms, but nice girls never talk about it elsewhere" (Houppert, Karen The Curse 71). Young girls hide their periods from public knowledge, which creates buried feelings of shame and embarrassment. Women hide their menstrual products in their pockets, using cute girly pouches or jamming them up their sleeves when walking to the restroom. According to this breed of etiquette, periods can only exist in privacy. (Lapekas, Jenny M. Red Moon Rising).

Commercials for menstrual products also advanced the culture of female sexualization. The women, in such commercials, are mostly white, slender females, many of whom wear dresses or bathing suits. Also, the actresses in the advertisements look ultra-clean, often dressed in white clothing. This implies that if a woman does not hide her menstruation with a product, she must be unclean or impure.
 

Ironically, menstruation is proof of a woman’s femininity and maturity, but society, specifically males, treats it immaturely. The CEOs of menstrual product companies are mostly male  (Lapekas, Jenny M. Red Moon Rising). In their depiction of women, the CEOs frequently objectify women and perpetuate the notion that women should conform to males’ beauty standards. The female body is attacked “as a site of menstrual codes and corporeal propriety” (Lapekas, Jenny M. Red Moon Rising). Sexualization of the female body even extends to the role of women in athletics. Women did not participate in sports until modern times, the early 1900s. Women often sat out of playing sports during their periods for fear that “menstrual blood would ‘stain’ the playing field” (Moreno-Black, Geraldine Young Women’s Experiences). After conducting a study, Moreno-Black found that women playing sports suffered from great shame during their menstruation. Consequently, women never discussed their fears or health concerns with their coaches. This fear and embarrassment lead young girls to use super-absorbent menstrual products to conceal their menstruation more effectively.

Far from merely being a modern commercial creation, the shunning of women for their periods dates back centuries. In Biblical Jewish society, periods were considered spiritually sinful. Jewish Women, both in biblical history and modern times, need to be cleansed from their periods before re-entering society. Beyond the purification of  women, all objects that menstrual blood touched were thrown out (St.Vincent Editorial Staff Menstrual Cycles Through the Ages). According to ancient Jewish laws, women were required to immerse themselves in the Mikveh, a bath designed for purification. After the destruction of the Jewish Temple, the separation from society for menstruating women increased from seven to twelve days (Wenger, Beth. Mikveh). Menstruation confined women to a specific lifestyle, limiting their participation in society. Because of  this confinement, Jewish society fostered the culture of menstrual shame. Although modern Jewish feminists have urged women to disregard mikveh baths, others still defend the practice as a celebration of female biology and spiritual renewal (Wenger, Beth. Mikveh).

Beyond Jewish culture, modern society as a whole continues to perpetuate menstrual myths, such as viewing periods as sinful. Although the menstrual cycle is part of the reproductive system, individual menstruating women are not sexually impure. Women need menstrual products, but are shamed for using them. Catholic priests objected to tampons, for many years, saying that they were erotic or stole a woman’s virginity.  In Ireland, Archbishop McQuaid gave homilies condemning the use of tampons because they destroyed purity (Seltman, Muriel What's Right? What's Left?). Religious men were condemning a product with which they could never have any experience. Research by Harvard scholar Jamie Kohen, in 2001, found that only two and four percent of women in Mexico and Italy, respectively, use tampons (Kohen, Jamie The History of the Regulation). Scholars discern that the reason behind these shocking statistics is the prevalence of Catholicism in the countries. Women in these countries continue to fear that tampons will destroy their virginity. Although 70% of American women use tampons, the stigma that tampons are sinful or sexual persists even in the United States.

The stigma of menstruation also impacts the physical health of women and eventually erupted with the Toxic Shock Crisis of 1980. Lack of research and regulations concerning the production of tampons put thousands of women at risk for developing a potentially fatal disease. The tampons found most responsible for the outbreak were “Rely” tampons made by Proctor & Gamble. Rely tampons appealed to women’s desire for concealment because they were of higher absorbency. This meant women could wear them for a longer amount of time without changing. In 1980, approximately 42% of women were using high absorbency tampons (U.S Department of Health Center for Disease Control). Rely tampons escaped regulations because they were produced in 1974, when they were considered merely cosmetic devices. In 1976, tampons were classified as medical devices, a classification that imposed testing requirements and additional compliance with additional regulations (Vostral, Sharra L. Rely and Toxic Shock Syndrome).

Since Rely tampons escaped regulation testing before 1976, it was unknown that they could foster bacteria causative of Toxic Shock Syndrome. Rely tampons were made of materials that promoted the growth of the bacteria Staphylococcus aureus (S. aureus) (Vostral, Sharra L. Rely and Toxic Shock Syndrome). The tampon was made of polyester and carboxymethylcellulose, which is “an edible thickening agent used in puddings and ice cream” (Vostral, Sharra L. Rely and Toxic Shock Syndrome). The increased surface area of the polyester cubes allowed bacteria to proliferate. One of the major ingredients, carboxymethylcellulose, is commonly used in paper towels (Moira, Fran Shocking). Another dangerous aspect of the Rely product was the pH increase of the vagina, from 4.2 to 7.4, and a temperature increase to 100 degrees. Both of these factors created a perfect environment for the bacteria to grow.

The Toxic Shock Crisis in the 1980s affected hundreds of menstruating women in the United States. In America, there are 70 million women who have a regular menstrual cycle, and 70% of them use tampons as their menstrual product (Moira, Fran Shocking). Rely, one of the most popular brands in 1980, distributed 45 million tampons nationwide. In the early research reported that “3 of every 100,000 women [contracted Toxic Shock], [and] that number has now risen to about 10-15/100,000, as the public is more aware of the disease's existence." (Moira, Fran Shocking). At the height of the crisis, in 1981, there were 1,200 cases of TSS connected to menstrual products (U.S Department of Health Center of Disease Control). The prevalence of Toxic Shock frightened the public. Menstrual products had never received this public focus before, but now demanded the attention and action of the media and government.

After failing to properly regulate tampons due to the shame associated with menstruation, the Toxic Shock Crisis shamed the Food and Drug Administration (FDA) into regulating tampons. The FDA helped society make progress against the taboo of menstruation with a new classification of tampons, warning labels, and regulation on tampon ingredients. Tampons were originally classed as Type I medical devices, which are of low to moderate risk to public health, requiring only general control regulations (Kohen, Jamie The History of the Regulation). Then in 1980, tampons were classed as Type II medical devices, which are of moderate to high risk. Type II devices require special controls such as special labeling and data requirements. The warning labels issued by the FDA on December 20, 1980 required the statement: "ATTENTION: Tampons are associated with Toxic Shock Syndrome (TSS). TSS is a rare but serious disease that may cause death. Read and save the enclosed information" (Kohen, Jamie Shocking). Along with these actions, the FDA removed Rely’s synthetic ingredients used for high absorbency. These ingredients fostered bacteria proliferation causing TSS (U.S. Department of Health U.S. Food and Drug Administration). Twenty years after the crisis, with the increase in public knowledge and FDA safety measures, the rates of TSS cases decreased dramatically.

Company manufacturers wanted to return to the days of minimal requirements for labeling or ingredient safety testing, but women demanded change after the Toxic Shock Crisis and expected more regulation from government. Women expected the government and menstrual product companies to protect consumers from danger (Dan, Alice J.What Have We Learned?). Women who developed TSS, as a result of Rely tampons, filed lawsuits against Procter and Gamble: Case Kehm v Procter and Gamble and Miss Lampshire v. Procter and Gamble (Kohen, Jamie The History of the Regulation). Women fought the companies that were infringing on their safety. The increase in women’s acknowledgement of their periods forced “...the heavy hitters in the feminine hygiene industry… to get creative” (Boscamp, Emi In 2015,). The debunking of the menstrual taboo, coupled with hundreds of deaths, forced companies to create safe and effective products.

Although the menstrual stigma has decreased since the 1980s, it remains part of American culture. In 2015, Rupi Kaur challenged the menstrual taboo by posting a picture on social media of her menstrual blood showing through her sweatpants (Kaur, Rupi Period.). The social media site, Instagram, removed this picture twice because it was against their community guidelines. Although people post pictures of bloody injuries or fight scenes on Instagram, but the site does not remove the pictures. Kaur explains that "...the fact that the vagina is used for something other than sex is a direct attack on our idyllic conceptions of a manicured feminine identity” (Kaur, Rupi Period.). Society continues to shun menstruation in order to confine women into an accepted public image. According to Houppert, no significant leaps in menstrual awareness have occurred because of the "peculiarly mapped landscape of menstrual etiquette, where beliefs are based on superstition, shame and sexual self-consciousness” (Houppert, Karen The Curse).  Still, women hide their menstrual products and talk around the subject. Although Toxic Shock is not sweeping through the nation, the menstrual taboo lingers.

Currently, the taboo lingers in both government regulations and taxation. Tampon companies are still not required to disclose their ingredients. This is obviously unsettling as products could include unsafe ingredients. Since women prefer products which disclose ingredients, some companies, like Procter & Gamble and Kotex, voluntarily list them (Houppert, Karen The Curse). The “Tampon Tax” remains one of the most prevalent aspects of the menstrual taboo in American culture (Schulman, Kori “The Whitehouse”). Remarkably, in no fewer than forty states, tampons are taxed as luxury items. Luxury items are deemed nonessential, and therefore subject a higher tax. Other items such as food and food stamps are considered essential, non luxury items, exempt from tax. As a result of the tax, California takes 20 million dollars annually in taxes for merely buying menstrual products (Gass-Poore, Jordan Citing Gender Bias). When President Obama was asked in an interview why tampons are taxed as luxury items, he expressed disapproval but explained that the tax is a state decision (Schulman, Kori “The Whitehouse”). Menstruation cannot be controlled. Women depend on feminine products for personal hygiene, but are taxed for doing so. Due to this tax, low income women struggle every month to practice good personal hygiene.

The menstrual taboo that contributed to the Toxic Shock Crisis in 1980 has diminished, but it has not been completely debunked. The use of language, sexualization of the female body, and immoral connotation concerning menstruation still prevails in American culture. After the 1980 crisis, women demanded safety research and increased menstrual awareness. The “Tampon Tax” in forty states continues to hinder women in American society from obtaining this essential, non-luxury, hygiene product. Although great strides have been made in female menstruation product design, development, and safety regulation, a cloud of negativity continues to overshadow the natural bodily process of menstruation.  Ultimately, menstruation still involves shame, but it is not a shame on women, but on society itself.

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