Menstrual hygiene in Nigeria is under growing strain, with more than 37 million girls and women lacking access to safe and affordable menstrual products, according to Gavi, the Vaccine Alliance, a global partnership for increasing access to immunization in poor countries

Across the country, women rely on different menstrual management methods ranging from disposable sanitary pads, tampons, and menstrual cups to reusable pads, cloth rags, and even tissue paper. These choices often depend on cost, availability, and awareness.

Disposable sanitary pads are the most common due to their convenience, hygiene, and availability. A 2024 mixed-methods study involving adolescent schoolgirls in Abuja revealed that 57.8% maintained good menstrual hygiene practices, with disposable pads identified as their primary menstrual product of choice. However, tampons and menstrual cups remain rare because of the price and limited market presence.

In urban areas, sanitary pads are commonly used due to their availability in shops and pharmacies, while in rural areas, limited retail access and infrastructure gaps lead many women to rely on other alternatives such as cloth rags.

Price hike driving change 

In 2024, sanitary pad prices in states like Abuja, Plateau, Enugu, and Sokoto rose by 80-100%, depending on brand and location. According to the United Nations Population Fund (UNFPA), nearly 1 in 10 girls in Sub-Saharan Africa miss school during their periods due to lack of menstrual hygiene products.

In Nigeria, inflation, low household incomes, and gender stigma push many women toward reusable pads or even unsafe materials, increasing their vulnerability to infection and social discomfort.

For women unable to afford disposable pads, reusable pads or improvised clothes often become the alternative option. But without proper hygiene practices such as thorough washing, sun-drying, and regular changing, these alternatives can create a breeding ground for bacteria and fungi.

For Aishat Suleiman*, a 200-level student at the Federal University of Technology, Minna, switching to cloth was purely a financial decision. “I used a piece of cloth because I could not afford to buy a pad at the moment, and it affected me socially because I wasn’t free to move around like when I used a pad,” she recounted.

Blessing Oluwaseun*, a small shop owner at the same university, endured more than just inconvenience. “It wasn’t a pad, it was a rag. The rag leaked, it wasn’t very absorbent, and I got stained often. I had rashes and itching. When I stopped using it, the itching stopped.”

For Halima Umar*, a 400-level Food Science and Technology student, the reaction was severe.

“I used reusable pads and started having allergies, itching, and rashes. There was severe itching and I was feeling sore. I went to the school clinic. The doctor advised me to stop using them. I realized I had to choose my health over cost.”

Also, partial use of reusable pads caused problems for Bidemi Awoyemi, a corps member in Minna, saying, “the rashes and itching lasted for a week after my period. I only used them at night to save on pads. I still have them at home, but I won’t use them again.”

Hygiene practices

Some women attempt strict hygiene practices to reduce risks. According to Oluwaseun, she said “the hygiene practice I use is that I wash it and spray it in the sun.”

But Halima explained that the hygiene practice she tried to maintain was soaking the pads in hot water, washing with detergent, and drying them.

“I had like 4 to 5 of them. I use 2 per day and immediately after I finish using it, I soak them in hot water, rinse out the blood and wash them normally. I guess the use of detergent also added to the soreness and infection,” she said.

Expert weigh-in

Sexual and Reproductive Health Physician and founder of SMILE With Me Foundation, Dr. Chioma Nwakanma-Akanno, explained that reusable pads pose serious health threats if not properly maintained.

“Generally it’s a foreign body. Any risk associated with any foreign body can be associated with reusable pads. And that goes from odour to infections, both yeast infections, bacterial infections, and some of these infections if not properly managed can become ascending infections that could lead to pelvic inflammatory diseases and if they are not properly managed can even lead to infertility or other reproductive health care issues largely related to fertility or even sepsis,” she explained.

According to Dr. Nwakanma, common issues among patients using reusable pads include vaginal itching and rashes, fungal infections like vaginal candidiasis, urinary tract infections, persistent irritation due to moisture retention.

She warns that improper hygiene such as wearing the pad for too long, poor washing methods, or storing them damp, provides a breeding ground for bacteria and fungi can contribute to health risks.

“Inadequate hygiene practices, like not bathing regularly, not changing these reusable pads regularly can also contribute to health risks. So, because they are reusable doesn’t mean you need to leave them in all day. Ideally for pads that are quite absorbent, you say about eight hours, depending on the person’s flow. So it all depends on if the flow is light, heavy, medium, and if you know how many hours your pads should be in, once it’s about 4-8 hours, please change your pads, wash and you know replace the pads, and then you will be able to wash the one you just removed.”

Balancing sustainability and safety

Reusable pads are often promoted as an eco-friendly and sustainable alternative to disposable pads. In theory, they reduce waste and provide a cost-effective option. But in practice especially in a country like Nigeria where the prices of disposable pads are on the high side and in communities with limited access to clean water, sunlight, or menstrual hygiene education, the risks may outweigh the benefits.

Dr. Nwakanma emphasizes that unless reusable pads are well-manufactured and come with user guidelines, they could do more harm than good.

“Ensure that the reusable pad you’re using is quite absorbent, made with cotton, pure cotton, so that it absorbs the fluid and keeps you dry to an extent. It should also be layered with a kind of waterproof lining, so it doesn’t leak. Because when it leaks, it gives room to stains, odor, leak, and of course, it could cause irritation to the skin, depending on how long the fluid has contact with your skin,” Dr. Nwakanma added.

She also shared some hygiene practices that can help minimize the health risks of using reusable pads, saying “my advice would be before you wear the pad, ensure that the pad is clean. I don’t know where it was produced, but ensure that you’re using a new or clean one, properly dried, sun-dried, like crispy sun-dried.”

Way forward

While reusable pads are not inherently unsafe, their use must come with proper education and infrastructure. Access to clean water, soap, sun drying, and healthcare services are essential.

Dr. Nwakanma suggests that the production and packaging of reusable pads should be done in sanitary conditions. She spoke on the need for reusable pad producers to include hygiene manuals, disposal bags with waterproof packaging and guides for first-time users.

Dr. Nwakanma also stressed the importance of government intervention in incorporating menstrual health into the national health agenda, and improving Water, Sanitation and Hygiene (WASH) facilities.

“I think reusable pads are good and sustainable means for menstrual hygiene management. However, it doesn’t come without risk, but these risks are things that if we put heads together, can be well managed, and of course, with good education, with access to WASH facilities, these issues, would be a thing of the past, and that reinforces the fact that we can’t do this without political will or government action.

“So social determinants on health have to be in place for us to definitely get to a point where we say, oh yeah, reusable sanitary pads are the thing, and work for us as a community, you know, for the betterment of our girls,” she added.

Editor’s Note: Names of the individuals interviewed have been changed to protect their anonymity, according to their request.