Sustainable Menstrual Equity: A Case Study on the Success of Low-Cost Menstrual Cup Distribution
In Brief
Free menstrual products at libraries are no longer a new phenomenon, thanks to the work of global menstrual equity advocates such as Period.org and Global Menstrual Collective. However, more often than not, these initiatives center around disposable period products. We argue that the work should not stop there. Libraries should explore the distribution of reusable menstrual products, such as menstrual cups and discs, cloth pads, and period underwear. These options are substantially better for the environment, safe to use, and can provide a form of long-term economic support by removing the need to continually buy disposable products. With $10,000 of grant funding, our academic library succeeded in distributing 701 menstrual cups for low cost on campus. Through our first vendor’s buy-one, donate-one policy, an additional 437 cups were donated to the vendor’s global charity partners (resulting in a total 1,138 cups distributed). This initiative not only addresses menstrual equity, with an average saving of $250 a year (and possible $2,500 savings over the ten-year lifespan of a menstrual cup) compared to disposable products, but also highlights the need for sustainable practices within institutional settings, providing a replicable model for others.
Our Menstrual Cup Project
Preparation
Our project started to take shape in Fall 2019, when our library, The Spencer S. Eccles Health Sciences Library, became one of the first buildings at the University of Utah, an R1 public university, to provide freely available disposable pads and tampons within all restrooms. Providing these menstrual products helped relieve some stressors resulting from being a commuter campus, where access to period products for the majority of the campus community would require leaving campus for home or a store. Two staff members within Access Services, Donna Baluchi and Alison Mortensen-Hayes, discussed the feasibility and budget needed to distribute reusable menstrual cups. In February 2020, Mortensen-Hayes researched potential menstrual cup vendors and pricing, as well as funding resources for the project itself. Our team determined the amount of funding we should be seeking and what kind of impact we could have.
Unsurprisingly, our smaller academic library did not have the ongoing budget for free distribution of reusable menstrual products, so we sought out external funding through grants and/or partnerships with organizations with similar sustainability and equity goals. At the time, we were seeing a wholesale average cost of $17 per menstrual cup and an overwhelming number of vendor options. It’s likely that conducting the same vendor and cost research today would result in even more brands and options, and pricing has likely shifted as well.
Understanding we would need to acquire grant funding, which would require budgetary and project management, we initially formed our project team exclusively with others in our library, primarily part-time student employees in the Access Services department: Olivia Kavapalu and Maha Alshammary. One team member, Olivia Kavapalu, was then able to connect us with two students already involved in sustainability initiatives on campus, Amelia Heiner and Sara Wilson. We were all, coincidentally, looking to do the same project at the same time. Together we were a team of two full-time library staff, two part-time library staff who were also students, and two undergraduate students. It ultimately proved valuable to have a diversity of backgrounds, skills, and audience reach when approaching this project.
To guide our approach, we surveyed the campus community to assess interest in reusable menstrual products and preferences for distribution. This survey was distributed via a newly created Instagram account for the project (@cups.for.uofu), the library’s Instagram (@EHSLibrary), internal campus email lists, and through our personal networks. We asked if people would like a menstrual cup specifically, if they would be willing to pick up on campus or if they would prefer shipping to home (in the midst of COVID-19, an important factor), if they would pay for one (including extra fees for shipping), and how many they would like. This data was then used to better inform our grant application and our logistics planning afterwards.
Our survey received 75 responses in total. Survey participants were predominantly students and all identified as female, highlighting student-driven demand for menstrual equity initiatives on campus. 53% of all respondents expressed interest in discounted menstrual cups, with a significant portion open to paying a small fee for added convenience in shipping. 20% stated they were not interested. 21% of total respondents replied “maybe”. We included an optional open comment for participants, specifically encouraging those who answered “maybe” to voice their hesitancy to the surveyors. Only 15 respondents included a comment, 8 of which responding that they would get a menstrual cup if it was discounted. 7 responded that they were nervous about trying menstrual cups. 1 stated that they “did not need one”, and 1 stated they had an IUD, but did not elaborate. The majority of respondents only wanted to purchase one or two menstrual cups. We also included an optional open question for “Additional comments or concerns” which received 10 responses. Nine of those responses included general excitement about the project and the prospect of discounted menstrual cups. Two mentioned wanting size options, and one asked if we would consider including period underwear as a reusable option.
These findings suggest strong community interest in affordable, accessible options for sustainable menstrual products, aligning with broader trends in menstrual equity. These findings also support a worldwide increase in interest in menstrual cups (Why Are Menstrual Cups Becoming More Popular?, 2018). In essence, survey responses were overwhelmingly positive/motivating and gave us sufficient data to proceed.
Full results of our survey are summarized in Table 1.
Table 1
| Question | ||||
| Would you be interested in purchasing the menstrual cup shown above at a significant discount through the University of Utah? (required with fixed options; 75 responses) | Yes 53.33% | Maybe 21.33% | No, I already use a menstrual cup or other zero-waste menstrual product 5.33% | No, I don’t want to switch from traditional menstrual products 20% |
| If you answered ‘Maybe’ to the above question, why? (optional open comment; 15 responses) | Nervous about trying menstrual cup 40% | Personal belief they do not need one 6.7% | Would get one if discounted 46.7% | Have IUD 6.7% |
| What would be your preferred method of receiving the cup? (optional, select all you would be willing to do; 73 responses) | Pay $3 in addition to the discounted price to have it shipped directly to you 56% of all respondents selected | Pay the discounted price and get free shipping directly to you 77.3% of all respondents selected | Pick-up on campus with COVID safety protocols in place 56% of all respondents selected | (2.7% did not respond) |
| How many cups would you purchase, if you did? (optional, select one; 70 responses) | 138.7% | 241.3% | 39.3% | 4+4% (6.7% did not respond) |
| To which gender identity do you most identify? (required with fixed options; 75 responses) | Female 100% | Male 0% | Nonbinary/Trans 0% | |
| Which best describes your affiliation to the University of Utah? (required with fixed options; 75 responses) | Student 89.3% | Alumni 10.7% |
Using the vendor research and survey data, we were able to apply for funding with a clear project vision, including budget and timeline. Very fortunately, our institution’s Sustainability Office offers grants called Sustainable Campus Initiative Funds (SCIF) (Sustainable Campus Initiative Fund – Sustainability, n.d.). This grant is funded by student tuition fees and therefore must go toward sustainability projects that primarily benefit students.
We were notified in March 2021 that we were awarded the $10,000 “medium-sized” grant. This enabled us to take the scope of our project from providing a few menstrual cups within our library to a large distribution across the entire campus. We were thrilled with this prospect since we knew a grant application has no guarantees, and were even warned that these grants are not often awarded to initiatives that are likely to die out without a consistent funding source.
Getting Started After Funding Obtained
Project members Maha Alshammary and Olivia Kavapalu researched potential campus partners that existed at the time to help advertise our efforts, including the LGBT Resource Center; Women’s Resource Center; Diversity Office; Office of Health Equity, Diversity and Inclusion; Sustainability Office; other libraries on campus; and all student resource centers. Team members of this project decided to use GroupMe as a way to communicate with each other, supplemented with occasional emails, and met virtually exclusively via Zoom. As briefly mentioned before, project member Amelia Heiner created a social media profile on Instagram to get the message out about our project, as well as inform everyone of the sustainability benefits of using a menstrual cup over traditional disposable pads and tampons: https://www.instagram.com/cups.for.uofu/. We planned to use this account to continue educating on the sustainability of reusable menstrual products, specific education on menstrual cup use, promote any tabling events we set up, and link to our shipping option. Providing drop-ship would allow patrons to purchase a deeply discounted cup directly with the vendor and have the product shipped directly to their chosen address.
From April to August 2021 we finalized logistics. Matters we had to settle included vendor options, selecting the cup we wanted to distribute, and how we would table and/or offer direct shipping in the light of campus COVID protocols. Accounting considerations took much of our focus, such as how billing would be handled with the vendor, how we could accept payments on campus, and how we would comply with university regulations. We were not in departments responsible for any of our library’s large purchases, and we did not realize the time-consuming complications that would later arise when having to navigate university purchasing and accounting policies.
Vendor Selection
It was important to our team that our vendor was as sustainable and ethical as our project aimed to be. There are many inexpensive silicon-based menstrual cups from large manufacturers in countries with less regulation, who will use the term “medical grade”. In many cases, these are less expensive, but lack any sustainability stance, medical education for users, or company ethics driving their production. Our choice of vendor emphasized sustainable practices and menstrual equity, supporting the environmental and social goals of the project. We initially chose the vendor Dot Cups Ltd., due to their prior partnerships with colleges and universities and their charitable company policy of donating one cup for every cup purchased to organizations of Dot’s choice, doubling our sustainability impacts. Dot did not indicate where they would be donating their charity cups, simply that they would send them to different global partners they had established. Dot did mention the opportunity for us to get more involved in their charity donation policy and connect them with a local establishment of our choosing. This was something we were excited to hear, but without any established partnerships to pursue this, we defaulted to Dot’s company connections. Dot additionally provided us with marketing material focused on college students who would be first-time menstrual cup users.
We had already begun working with Dot when accounting let us know that our request to work with a single vendor was denied by the university due to policy. Instead, we were required to put the project out to bid to all vendors to encourage fairness in vendor selection. Our public university requires all purchases using institutional funding of over $5,000 to go through this process, wherein multiple vendors are permitted to apply for consideration. After vendor applications are submitted, the central university accounting office makes the decision and selects a single vendor. While the nuances of their selection criteria were unknown to our team and we were not involved in their direct conversations with vendors, we did have the opportunity to suggest specific companies for them to reach out to and solicit an application. We returned to the vendor research we did at the very beginning of this project to supply accounting these additional vendor options. This allowed us to focus on companies that shared our values and could potentially meet the scope of our vision as previously described.
Fortunately, we did end up working with Dot, though the bidding process delayed the project by a couple of months (which we did not foresee).
Budget Management
Project members tentatively planned on purchasing half of the inventory for distribution on-campus, and half to distribute via drop-shipping. However, this was not purchased or acted upon all at once. Accounting advised us to place an order with Dot Cups with only half of our grant funding: $5,000. We were requested to stagger the purchases like this so that we could verify the inventory existed as advertised and calm our accountants’ fears of any fraudulent claims by Dot, which we highly recommend others also do when purchasing at this volume. Therefore, our initial purchase was for 295 cups (at $17 each, tax free due our nonprofit status as a public university) for in-person sales. At the time, Dot menstrual cups retailed on their website for $34 each.
Our campus’ sustainability grants are often applied for by students, and all grant awardees are assigned an advisor from the campus’ Sustainability Office to guide them through their awarded projects. At the advice of our assigned advisor, we decided to charge a minimal $5 fee per cup, in order to give them psychological weight and discourage waste of the cups themselves. If free, our advisor warned that there is the likelihood of people taking the cups simply because they are free and later throwing them away. In the case of drop-shipping, after discussing with our vendor, we decided on $8 total cost: $5 for the menstrual cup and an additional $3 for shipping. All fees collected were cycled back into the project to buy more cups and stretch the project further. Based on our survey data, we decided to limit each person to purchasing two cups to extend the number of people able to purchase a menstrual cup, and prevent any purchaser from buying many to attempt to resell them.
Sales
We began soft selling in August 2021 from the library’s front desk while working with the vendor to set up drop-shipments. Our library’s front desk is staffed by part-time, often student employees, who were not over-burdened by the task. There was no discomfort from anyone with handling the menstrual cups, and the menstruators who worked at the library were especially excited to get access to inexpensive menstrual cups and help in the distribution. We could only take payment using the accounting-approved methods of cash or our university credit card processing merchant services client, which required the use of a webpage and manual input of a credit or debit card. There was minimal training needed for this. Most purchasers were interested in buying a cup and leaving, but for purchasers who had questions or wanted more education about insertion techniques, they were directed to team member Donna Baluchi.
Marketing and Promotion
We advertised our low-cost menstrual cup distribution using every avenue we could think of to capture as much of the campus community as possible. Physical marketing included hanging flyers and posters within student resource offices, bulletin boards, and signage inside any menstrual product baskets within restrooms. Digitally, we took advantage of newsletter campus emails that go out to large audiences and sent some targeted emails as well. Our Instagram, however, is what reached students most effectively, after the posts were continually shared within student “stories”.
Two of our project members were interviewed for the university’s health sciences newsletter. The interview was met with several positive comments, most of which expressed excitement and asked where they could get the menstrual cups. Comment examples included:
“BRAVO! Well thought out, great investment and execution.”
“Way to lead the campus on period equity and sustainability!”
Distribution Strategies
We held two tabling distribution events that we heavily marketed through all of our advertising channels, including personal networks. Due to the geographic layout of our university, we determined it would be advantageous to hold one event in the large plaza frequented by all undergraduate students in September 2021 and another at our library’s open house in October 2021 to reach colleagues and students on the health sciences area of campus, which is located a significant distance from central campus with a large elevation change that deters travel between the two sides. Each tabling event was for approximately ninety minutes, and we sold over 200 cups between the two events. Nearly every purchaser was a current university student, and many commented that the limited in-store options and initial cost of $30-$40 is what prevented them from trying menstrual cups before. The majority only purchased one menstrual cup, and those buying two often commented that it was being purchased for a friend or family member. We had less than five purchasers who specifically asked to buy three or four, stating specifically they had family or friends who asked if the purchaser could get one for them. In one instance, a purchaser obtained a small batch to put in the student food pantry for free giveaway (paying it forward).
We finalized drop-ship logistics with Dot in early October 2021, and purchased 142 cups for these drop-ship orders to start. We had actually attempted to order 100 cups (as our plan had shifted to ordering the drop-ship inventory in increments, responsive to demand), but Dot realized there was an issue with the invoice when our check arrived – since our campus members would be paying $5 each, the cups were meant to be invoiced at $12 per unit but the bill was set at $17 each. We consented for Dot to keep the extra funding and up the cup inventory we’d be purchasing rather than start the payment process over again with a new invoice and check.
When drop-ship was publicized via our Instagram account in October 2021, it was incredibly popular, even with the added $3 shipping cost. Within two weeks, over half were purchased.
On November 8th, 2021, we completely sold out of all inventory from our initial purchases, both in-person and drop-ship. Due to a global silicone shortage during the COVID-19 pandemic, we had exhausted our vendor’s inventory. Our vendor representative informed us that we would need to check back after January 2022 after they were able to restock.
Navigating Challenges
Our team faced several logistical and vendor-related challenges, which provided important lessons for future projects. Firstly, throughout the project’s length, our group dynamic shifted when students involved would graduate and leave, and other students would ask to be involved. In our team, two members left the project after graduation,and one new member joined when they were hired as part of the library’s front desk crew after they expressed interest. Students truly drove the passion behind the project, and have great networking skills, reaching audiences many full-time employees cannot. Motivated entirely by their passion and interest in increasing menstrual equity, the students on the project contributed countless unpaid hours to our work. However, working with students also means classes and graduation are their highest priority, and an increased school workload does not allow room for extracurricular activities.
Our project’s biggest challenge was the loss of our original vendor. Dot Cup became uncommunicative and were no longer responding to emails. After months of silence, we made the decision that we would need to continue the project with a new vendor. While it was difficult to deal with the extended delays and the loss of a vendor we trusted and respected, we remained committed to achieving the project’s intended sustainability and equity goals. We took a moment to regroup (as the project had been going on for over a year at that point) and decided to do one final large purchase and distribution effort.
Thankfully, we did not have to put the project out to bid again as the amount of our remaining funds was under the bidding threshold. This experience highlights the importance of planning for vendor flexibility in case of unforeseen delays or issues.
We collectively researched vendors, and chose Saalt to work with next. Our reasoning in selecting Saalt was because, like Dot Cups, they are a US-based company who makes medical grade silicone cups, with a demonstrated commitment to sustainability and menstrual education. At the time (and possibly still), Saalt offered differing prices depending on if you’re distributing the cups for free or not. Since we had already charged $5 during the first round of cup distribution, we felt it would be unfair to distribute the next round for free. However, Saalt offers deeply discounted products (including cups, discs, and period underwear) if the buyer’s intention is to distribute the items for free. At the time of communication, free distribution qualified for a special price of $10 per cup, as opposed to their wholesale $17 per cup price. Unlike our prior vendor, Saalt also offers multiple cup sizes, so we sent out a survey in May 2022 with the company’s “size quiz” to our email networks on campus. The emails went to a list of students and colleagues who had reached out to us after we had sold out of our initial stock, so we could email them once we received our next shipment. We received 42 responses from colleagues and students, and the results were exactly half “regular” and half “small”. At the time of ordering, they did not offer their current “teen” size. With the new pricing information, we placed our last vendor order in June 2022 with our remaining funds: 132 small size and 132 regular size (264 total).
Saalt cups arrived without individual packaging, so our team needed extra time to prepare them for distribution by placing each cup in the provided cloth bags. When ready, we held a final tabling distribution event at our library in July 2022. The majority of the cups were sold during our tabling event, and the few remaining cups were sold from the library desk, trickling out over two months. We marketed this final round using our Instagram page, the health sciences campus newsletter, and through signage in our restrooms.
On October 4, 2022, we sold our last menstrual cups and closed out our project. The small remaining funds from this last round of sales were returned to the university’s Sustainability Office, whom we received the grant from, to be applied to other sustainability-oriented projects.
Conclusory Remarks
Sustainability and equity are both driving goals for our library and our institution. They are both found in our library’s strategic plan as well as the five-year strategy goals of our university. This project was a way to enhance both, while providing improved healthcare to our campus community.
In total, our project team distributed 701 menstrual cups, and 1,138 menstrual cups altogether when considering Dot’s policy of donating a cup for each one purchased. There are positive environmental and fiscal impacts related to each one of these cups that we dispensed. One report states that “a year’s worth of a typical feminine hygiene product leaves a carbon footprint of 5.3 kg CO2 equivalents” (“The Ecological Impact of Feminine Hygiene Products,” n.d.). At 1,138 cups, assuming one cup per menstruator and a longevity of 10 years per cup, our project has the potential to avert 60,000 kg CO 2 emissions. Using the EPA greenhouse gas calculator, the total potential emissions we saved are equivalent to taking 13 cars off the road for a year or saving 66,000lbs of coal from being burned (US EPA, 2015). In terms of disposable product waste, at an estimated 22 products used a cycle (“Menstruation Facts and Figures,” n.d.), if 1 cup went to 1 person for 10 year’s use, we helped to avert the use of 3,004,320 disposable products collectively.
Financially, sources claim that on average, menstruators spend $20/month (or $18,000 in a lifetime) on disposable menstrual products (Female Homelessness and Period Poverty – National Organization for Women, 2021). Using this calculation, we potentially saved each menstruator $2,395 (again, assuming each cup lasts the expected 10 years).
We received a significant amount of praise and appreciation from the campus community and recently inspired a new group of students to begin a similar project of their own. The Associated Students of the University of Utah (ASUU) partnered with our university facilities department to permanently provide disposable menstrual products in all student academic buildings in 2021 (Menstrual Product Project – ASUU, n.d.). Our hope is to continue these efforts into perpetuity, and we have contacted ASUU representatives to encourage and support any menstrual reusable initiatives they might consider.
Lessons Learned, Advice, & Words of Encouragement
We encourage everyone to consider doing a similar menstrual equity project with reusable products. None of what we accomplished was assigned or part of our promotion or job scope, but we still succeeded. Our project pushed boundaries by bringing often-overlooked issues like menstrual equity and environmental sustainability into public discourse while navigating a complicated accounting process. No project member had prior experience with a project of this size, nor had anyone applied for a large grant before this project. Yet, despite our inexperience and the challenges we faced, we succeeded in making positive, equitable, sustainable change within our workplace and community. The interest and need is there. We believe anyone with a few committed colleagues who can write for grants could do this. Any nonprofits, schools, health systems, or community aid could put together a similar project.
Planning and Timeline
Though some of the challenges we faced in our project could easily be avoided, in the future, we would still advise that you give yourself plenty of time between project start and completion. Even without a global pandemic, this would have more than likely been a multi-year endeavor.
Do your research into your vendors and their products. Verify they are equitable, sustainable, and aware of what their products contain and where they are manufactured. Certified B Corporations are given that designation when they meet a minimum sustainability standard. Medical-grade silicone should be the minimum for cups, and other reusables should not include any harmful substances. Products advertised as “organic” and “non-toxic” such as period underwear have been known to test positive for PFAS contamination (Kluger, 2023), so it is imperative to make sure the product you are distributing does not come with a hidden harm. As part of this, we recommend avoiding the inexpensive, factory-only bulk companies. Period Nirvana is an online education hub and store that details all the recommended menstrual reusables on the market and can help with vendor (or personal) decisions around menstrual products.
Collaborative Partnerships
Partner with others early and often. Doing so from the outset of the project will streamline processes down the line and foster shared ownership. If you are at an academic institution, you likely have sustainability-oriented offices as well as women’s and possibly cultural or diversity centers. We found this was a positive way for multiple types of groups to work together on a shared goal. Health sciences and public health institutions are especially good places to find partners in this work. Other libraries, including public libraries, could partner with nonprofits and community organizations. Also, academic libraries can partner with their local public libraries and vice versa. People committed to menstrual equity are everywhere.
Recognize that you will likely also have to work closely with departments outside your core team, like your institutional accountants and facilities team. It is crucial you discuss project logistics with your budget office or accounting department as soon as your project vision is in place, especially those requiring large funding. Approach your accounting and facilities colleagues ahead of time to get everyone on board and find out what will be sustainable in terms of expectations. Without this expertise, you likely cannot sustain a project of this size long-term.
Budget and Accounting Management
Speaking of accountants, though Saalt offered drop-shipping, in-person distribution was significantly easier for our accountants to monitor, and after a couple years and a vendor change, they were feeling fatigued with this project. We recognized that we should have been talking more in-depth with our accountants at the very beginning, as there were significant complications within the funding and purchasing of a project like this than we had originally assumed (which was then further complicated by a global pandemic). Beyond complications such as a “Sole Source Request” to more directly choose which vendor we wanted (which we assumed would be a simple process, but at large public universities it is not) then putting the project out to bid, there were Payment Orders for each inventory purchase, sales tax calculated and paid on each cup sold (even though we purchased them tax-free as a public institution), regular cash deposits (policy prevented use of direct cash transfer apps like Venmo or Paypal), record keeping, adding a new vendor in various systems (ours, the university’s, theirs), etc. We regret not communicating the full scope of our project with our accounting team from day one of our initial project idea, as it would have saved time and energy for everyone.
Diversity and Inclusion
Diversify your project team, and especially include teens/young adults/college students, to cover the many different roles in a project like this. Including a diverse team, both in terms of skills and demographics, ensures that the project has a greater chance to meet the needs of all interested parties and gains wider community support. However, note that students may come and go as the project goes on, and certain times of the year will be more difficult for them to participate. As mentioned previously, our group dynamic shifted when Maha Alshammary and Sara Wilson left our project after graduation, and Graycee San Cebollero asked to join the team after being hired as a part-time library employee (and later assisted in reviewing literature on menstrual cup sustainability impacts). Undergraduate college student (approximately ages 17-25) menstruators were the age group most interested in menstrual products during our project ,and having them on your project team ensures their broader peer social networks can be reached.
Though we were unable to in our project, we advise any future reusable menstrual product distribution efforts to provide options; both the type of product as well as sizes. Different bodies have different needs, and different people have different desires. Throughout our project, team members and purchasers would occasionally mention that reusable pads or menstrual underwear should be our next project.
Last but certainly not least, avoid making your campaign gendered. To encourage inclusion and accessibility for all, the products should not be placed just in women’s designated restrooms/spaces, and publicity should not discourage trans, nonbinary, and gender diverse people from engaging and benefitting from your service. Avoid using “she/her” or “women” and instead use “menstruators” or, simply, “people” when discussing periods and those of us who have them. We know this is a current culture war. Our library has been attacked online for posting about our menstrual products, as well as had our disposable products in gendered men’s restrooms damaged and vandalized. None of this stopped us. Thanks to advocates across the university, there are now menstrual products in every bathroom on campus, for anyone, and any reason.
Acknowledgment
The authors are incredibly grateful to our publishing editor Jaena Rae Cabrera, and Brittany Paloma Fiedler and Joshua Osondu Ikenna for their encouragement, guidance, and expertise as our peer reviewers. Thank you.
We are also thankful to menstrual equity advocates worldwide, whose pioneering work helped pave the way for this project.
This project would not have been possible without the support of the University of Utah’s Sustainability Office and the Eccles Health Sciences Library Access Services and Accounting departments. We would also like to dedicate this article to Joan Gregory, who initially forged the path towards menstrual equity at our library and our institution.