By Johanna Goldberg, Information Services Librarian
This is part of an intermittent series of blogs featuring advertisements from medical journals. You can find the entire series here.
For the past few weeks, subway-riding New Yorkers have been surrounded by advertisements for absorbent underwear, the latest in a long history of products designed for use during menstruation.
But what did people use before the era of special undies, tampons, pads, and cups? Very little is known about pre-20th century methods, but historians believe (and oral history interviews confirm) that many relied on homemade cloth or paper pads or diapers pinned to belts and strings. Some women reused these items, while others disposed of them after one use.1,2 Other women—even going back to ancient Rome—fashioned their own tampons from absorbent wool, fibers, paper, sponges, and other materials.3
Things began to change in the mid-1800s. Between 1854 and 1921 (the year the Kotex was first marketed), the U.S. Patent Office granted 185 patents for menstrual (or catamenial) devices.1 In her 1994 doctoral dissertation, Laura Klosterman Kidd breaks these patents into six interconnected categories:
(1) Belts or supporters, from which were suspended (2) a catamenial sack, pouch, shield, menstrual receiver, or napkin-holder, into which was placed (3) an absorbent, consisting of cloths, pads, napkins, sponges, or raw waste fibers. Ancillary categories of menstrual patents were (4) attaching devices used to secure or connect the catamenial sack to the supporter, (5) catamenial garments or appliances that aided in protecting the wearer’s clothing, and (6) vaginally inserted menstrual retentive cups.1
One of these patented products is advertised in the 1884 American Druggist. Despite claims that it is “the grandest invention for the convenience and cleanliness of ladies,” it certainly gives the modern audience pause. A soft rubber cup gets inserted into the vagina, and fluid flows into a “receptacle” attached to a belt. “At night, before retiring, the fluid can and should be removed [from the receptacle], simply by removing a cap, without removing the instrument.”
There’s a reason these never caught on. But they aren’t such a far cry from today’s (much less cumbersome) menstrual cups.
The real shift in feminine hygiene products came in the 1920s and 1930s. During World War I, nurses at the front lines used absorbent Cellucotton, a Kimberly-Clark product made from wood pulp, both to bandage soldiers (as intended) and to absorb menstrual blood. After the war, Kimberly-Clark developed Cellucotton into Kotex, introducing the product in 1920.4 These napkins were held in place using belts; adhesive napkins only became available in the late 20th century.2
This was not the first commercial sanitary napkin; earlier brands appeared for sale through mail-order catalogs. But it was the first to get a hard-won advertising campaign, which began in 1921. As Lara Freidenfelds relates in her book The Modern Period, advertisements for Kotex appeared in Ladies Home Journal once its editor’s secretary “declared the ads to be in good taste and of great benefit to women.” After Ladies Home Journal agreed to run the ads, other magazines, including the American Medical Association’s Hygeia, followed.2
Below are two early advertisements for Kotex, which appeared in Hygeia in 1924 and are both geared to nurses. We love that the coupon from the September 1924 ad has been clipped and, presumably, mailed in for a free sample.
While Hygeia does not appear to have run ads for Kotex prior to 1924, it did advertise an absorbent cotton on the back cover of its volumes in 1923. Bauer & Black Absorbent Cotton touted its many uses in these advertisements, noting that “Women use it to meet personal emergencies.” Even after the advent of commercially available sanitary napkins, some women preferred a more do-it-yourself approach.
Kotex wasn’t alone in the marketplace for long: Gauzets and other, often cheaper, brands came along soon after, and also advertised heavily.
The first widespread commercial tampon arrived in the 1930s: Physician Earle Cleveland Haas received a patent for his applicator tampon in 1933, which he named Tampax. He distributed his product beginning in 1936.2,3 Prior to Tampax, tampons had widespread use as medical devices dating as far back as the 18th century.2,3 Soon after the development of Tampax, other commercial tampon brands, like Wix and B-ettes, became available and also advertised widely.
These early ads show the hurdles Tampax had to overcome to win wide acceptance from consumers and doctors. In fact, Tampax spent $100,000 on advertising in its first nine months alone; by 1941, the company was “one of the one hundred largest advertisers in the United States.”2 The ads worked: a 1944 survey showed that one quarter of women in the United States used tampons, even as doctors debated their safety.2,3 These ads, spanning the first 10 years of commercial tampon availability, emphasize the safety, comfort, convenience, and invisibility of the products.
Click on an image to view the gallery:
Despite the worries of physicians, early tampons were safe. In fact, our main concern with tampon use today, Toxic Shock Syndrome (TSS), was only linked to tampon use about 40 years after their debut. In 1978, Procter & Gamble released Rely, a super-absorbent tampon made from synthetic fibers. This new kind of tampon led to 55 cases of TSS from October 1979 through May 1980. But non-synthetic, less absorbent tampons pose little threat, and the bacteria that causes TSS is present and active in only a small percentage of people.3,5
Other options entered the marketplace in the 1930s: several menstrual cups received patents, including the first commercially available cup in the United States, patented by actress Leona Chalmers as a “catamenial appliance” in 1937.6 This cup’s design looks much the same as those on the market today.
In less than 100 years, menstrual supplies have moved from mostly homemade affairs to mass-market items available in stores, from products hidden away at the back of mail-order catalogs to some of the most commonly advertised goods in the United States. The advances of the 1920s and 1930s still impact our lives, as sanitary napkins, tampons, and cups remain go-to products, improved upon over time but not abandoned.
1.Kidd LK. Menstrual technology in the United States, 1854 to 1921. Ames, Iowa: Iowa State University Department of Textiles and Clothing; 1994.
2. Freidenfelds L. The modern period: Menstruation in twentieth-century America. Baltimore: Johns Hopkins University Press; 2009.
3. Fetters A. The tampon: A history. The Atlantic. June 1, 2015. Available at: http://www.theatlantic.com/health/archive/2015/06/history-of-the-tampon/394334/. Accessed March 1, 2016.
4. World War I centenary: Sanitary products. Available at: http://online.wsj.com/ww1/sanitary-products. Accessed March 1, 2016.
5. Vostral SL. Rely and Toxic Shock Syndrome: a technological health crisis. Yale J Biol Med. 2011;84(4):447–59. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3238331&tool=pmcentrez&rendertype=abstract. Accessed March 1, 2016.
6. North BB, Oldham MJ. Preclinical, clinical, and over-the-counter postmarketing experience with a new vaginal cup: menstrual collection. J Womens Health (Larchmt). 2011;20(2):303–11. doi:10.1089/jwh.2009.1929.