The Next Fifty Things That Made the Modern Economy – Sanitary Towels

In Fifty Things that Made the Modern Economy, the revolutionary, acclaimed book, radio series and podcast, bestselling economist Tim Harford introduced us to a selection of fifty radical inventions that changed the world.

Now, in this new book, Tim Harford once again brings us an array of remarkable, memorable, curious and often unexpected ‘things’ – inventions that teach us lessons by turns intimate and sweeping about the complex world economy we live in today.

To celebrate publication, we’re sharing extracts of five of the fifty things Tim includes in his new book. Today we’re shining the spotlight on sanitary towels.

‘I wish someone would tell me what Kotex is,’ said one bemused young American man at a dinner party in the 1920s. Nobody would, of course. Kotex was a code word – an arcane reference to a secret man was not meant to know. Kotex was – and remains – one of the US’s most popular brands of menstrual pad. But to tell you the truth, I had never heard of it.1

To Sharra Vostral, author of Under Wraps, this is unsurprising. One of the defining missions of menstrual products such as pads, tampons and cups, says Vostral, is discretion: the rest of the world simply isn’t supposed to know whether a woman is menstruating or not. Not for nothing was one early brand of tampons called ‘Fibs’.2 Not everyone approved of the wink implicit in that name. ‘ “Fib” is a polite word for “lie”,’ complained one woman to market researchers. ‘ “Fibs” suggests something nasty, secretive, unclean. If I wanted to buy tampons at a store, I would not buy “Fibs” just because of the awful name.’3

Nevertheless, women have had good reason to keep quiet about menstruation. It is the centre of many taboos around the world. Passages in the Old Testament of the Bible refer to menstruation as polluting, and menstrual rags as loathsome.4 Such ideas have been slow to fade. In 1868 the vice president of the American Medical Association noted that female physicians could not be trusted during their monthly ‘infirmity’. Five years later the American doctor and sex educator Edward Clark argued that girls should be removed from the classroom during their periods. It was too demanding to expect them to think and menstruate at the same time. The writer Eliza Duffey sharply responded that Dr Clark had no objection to women performing strenuous housework during their periods. Perhaps he just wanted to deny education to girls? Perhaps indeed.5

It was hardly surprising that women preferred to keep the details of their monthly cycle to themselves, using home-made approaches. Tampons have existed for thousands of years: made from wool in Rome, vegetable fibres in Indonesia, paper in Japan, grass in Africa, papyrus reeds in Egypt and ferns in Hawaii.6 Women would fashion pads from scraps of fabric, often washing and reusing them. We now know reused pads bring the risk of infection and even cervical cancer.7 But in the late nineteenth century, as home- made products were replaced by manufactured commodities in other parts of life, why not in this case?

The challenge was: how to advertise and sell a product that society found unmentionable. The first recorded attempts to sell disposable pads date to the 1890s. Johnson & Johnson made and marketed ‘Lister’s Towels’ in the US in 1896; ‘Hygienic towelettes’ from the German manufacturer Hartmann were advertised in Harrods in London in 1895.8 But these products did not make much impact. It seems that most women found it cheaper, or more comfortable, or less embarrassing, to make their own sanitary towels from whatever material they had to hand.9 But the key technological breakthrough came during the First World War. Kimberly- Clark, a paper company, used a new material called ‘cellucotton’ to make bandages. Cellucotton was made of wood pulp. It was much cheaper than cotton, and far more absorbent. At the end of the war, as Kimberly-Clark was looking for new markets, they received letters from nurses explaining that they were using the cellucotton for something other than bandages.10 Clearly, there was a business opportunity. But it seemed risky: wasn’t the product too taboo to advertise – or even to purchase? Kimberly-Clark launched anyway, settling on the mysterious name ‘Kotex’. It stands for ‘cotton texture’, but more importantly, young men at dinner parties had no idea what ‘Kotex’ meant.11

The new product caught on fast. For decades, women had been finding some independence by taking jobs in factories and offices. Whatever Dr Edward Clark might believe, they could think and menstruate at the same time, and they needed a convenient, disposable product. To everyone’s surprise, Kimberly-Clark had a hit. The first detailed study of the growing menstrual technology market was conducted in 1927 by Lillian Gilbreth, a pioneer in applying scientific ideas from psychology and engineering to commercial problems of marketing, ergonomics and design. She noted that modern women needed to be out and about. She emphasised that women wanted a product that was discreetly packaged – it should not crackle or rustle when being unwrapped – and ‘be completely invisible no matter how tight or thin their clothes might be’.12 The product she helped design for Johnson & Johnson could even be ordered silently by handing a shop assistant a coupon that read ‘one box of Modess, please’.

But while the products themselves were made to be used in secrecy, soon there was nothing secretive about the way they were marketed. The booming demand encouraged manufacturers to bombard consumers with advertisements, albeit euphemistic ones. Men may have been mystified in the 1920s; by the 1930s some felt under siege. The future Nobel literature laureate William Faulkner complained, ‘I seem to be so out of touch with the Kotex Age here that I can’t seem to think of anything myself.’ It takes quite a broflake to blame Kotex adverts for your writer’s block, but it says something about how quickly the previously unutterable technology had entered the cultural mainstream.

The cellucotton pad was followed in the 1930s by the commercial tampon, patented in 1933 and marketed as ‘Tampax’.13 The first menstrual cup appeared soon afterwards in 1937, patented by a woman, Leona Watson Chalmers.14 Then came the war. Menstrual products were marketed as a way to help women participate in the war effort. One Kotex ad showed a teenager moping, her broom and mop abandoned. ‘Who would have thought you’d turn out to be a deserter from a dustmop and a few dishes . . . when Mom’s counting on you? . . . It’s girls like you taking on “homework” who release a whole army of mothers for rolling bandages and selling war bonds and driving drill presses.’15

Come the 1950s, of course, the adverts returned to the idea of ladies of leisure in ‘soft silk twill’ dresses hanging around in art galleries. These days, women spend about $3bn a year on sanitary products in the US alone.16 They have long since become part of the cultural conversation. From a Western perspective the old sense of embarrassment is laughable – twenty-first century adverts have mocked the tropes of an earlier age, of blue liquids in sterile laboratories interspersed with shots of women in tight white shorts riding white horses.17

But in many parts of the world, it’s no joke. Consider the case of Arunachalam Muruganantham, a school dropout from southern India, who in 1998 decided his wife deserved hygienic, affordable pads rather than the dirty cloth she was having to use. ‘I would not even use it to clean my scooter,’ he said.18 He began experiments to produce a simple pad-making machine – something that could bring both jobs and cheap pads to women across India. His wife walked out on him. So did his widowed mother. What he was doing was simply too humiliating. Muruganantham is now celebrated for his invention – and, yes, his wife Shanthi did come back. But his setbacks give a sense of just how powerful the stigma remains in many parts of the world.

That stigma is one reason why – according to UNESCO – one in ten girls in sub-Saharan Africa miss school during their periods.19 Dr Edward Clark might have approved, but this is a serious matter: after falling behind, some girls drop out entirely.20 Stigma alone is not to blame – there’s also a lack of access to clean water and lockable washrooms. And of course, there’s the problem that Arunachalam Muruganantham was trying to solve: young women can’t afford the menstrual products others take for granted. William Faulkner may have felt alienated by the Kotex age – but nearly a century later, many women are still waiting for that age to arrive.

All reference sources for this extract are below

1. Sharra Vostral, Under Wraps (Plymouth: Lexington Books, 2011), ch. 4.
2. Vostral, Under Wraps, ch. 1.
3. Thomas Heinrich and Bob Batchelor, Kotex, Kleenex, Huggies: Kimberly-Clark and the Consumer Revolution in American Business (Columbus: Ohio State University Press, 2004), p. 96.
4. Janice Delaney, Mary Jane Lupton, Emily Toth, The Curse: A Cultural History of Menstruation (New York: New American Library, 1976).
5. Vostral, Under Wraps, ch. 3.
6. Delaney et al., The Curse; Ashley Fetters, ‘The Tampon: A History’, Atlantic, June 2015, https://www.theatlantic.com/health/archive/2015/06/history-of-the-tampon/394334/.
7. A. Juneja, A. Sehgal, A. B. Mitra, A. Pandey, ‘A Survey on Risk Factors Associated with Cervical Cancer’, Indian Journal of Cancer 40.1 ( January–March 2003): 15–22, https://www.ncbi.nlm.nih.gov/pubmed/14716127; Colin Schultz, ‘How Taboos Around Menstruation Are Hurting Women’s Health’, Smithsonian Magazine, 6 March 2014, https://www.smithsonianmag.com/smart-news/how-taboos-around-menstruation-are-hurting-womenshealth-180949992/.
8. Delaney et al., The Curse; Museum of Menstruation website, http://www.mum.org/collection.htm.
9. Kat Eschner, ‘The Surprising Origins of Kotex Pads’, Smithsonian Magazine, 11 August 2017, https://www.smithsonianmag.com/innovation/surprisingorigins-kotex-pads-180964466/.
10. Eschner, ‘Surprising Origins’.
11. Eschner, ‘Surprising Origins’.
12. Vostral, Under Wraps, ch. 4.
13. Fetters, ‘The Tampon’.
14. Kelly O’Donnell, ‘The whole idea might seem a little strange to you: Selling the menstrual cup’, Technology Stories, 4 December 2017, https://www.technologystories.org/menstrual-cups/.
15. Delaney et al., The Curse.
16. Susan Dudley, Salwa Nassar, Emily Hartman and Sandy Wang, ‘Tampon Safety’, National Center for Health Research, http://www.center4research.org/tampon-safety/. They cite a 2015 Euromonitor report.
17. Andrew Adam Newman, ‘Rebelling Against the Commonly Evasive Feminine Care Ad’, New York Times, 16 March 2010.
18. Vibeke Venema, ‘The Indian sanitary pad revolutionary’, BBC Magazine, 4 March 2014.
19. Oni Lusk-Stover, Rosemary Rop, Elaine Tinsely and Tamer Samah Rabie, ‘Globally, periods are causing girls to be absent from school’, World Bank Blog: Education for Global Development, 27 June 2016, https://blogs.worldbank.org/education/globally-periods-are-causinggirls-be-absent-school.
20. Thomas Friedman, ‘Cellphones, Maxi-Pads and Other Life-Changing Tools’, New York Times, 6 April 2007.