Absorbing the Problem: How Pads Can Mask Heavy Menstrual Bleeding!

Variable Sizes of Modern Menstrual Pad

Everything in our lives evolves with technology — from our phones to our menstrual pads. These changes bring improvements in appearance, comfort, and functionality. Sometimes, however, they become so good that they end up hiding the underlying problem.

Just 10 years ago, during my standby shifts in the Emergency Department, we would often receive high school girls brought in by teachers or parents because of excessive menstrual bleeding. Their uniforms would be soaked, making the problem immediately obvious.

Nowadays, such referrals are rare. Menstrual pads have improved to the point that even in cases of very heavy bleeding — what we call menorrhagia — the modern pad can contain it without visible leakage.

The downside? By the time these patients see a doctor, months or even years of heavy bleeding may have passed unnoticed. They come in only when they experience symptoms of anaemia like extreme lethargy, dizziness, or near-fainting episodes — with haemoglobin levels sometimes as low as 6–9 g/dL. When I ask about the heaviness of their periods, they often say there’s no leaking or soaking — and that’s when it hits me: the menstrual pad has done its job too well.

I am not denying that advancements in menstrual pad technology have enabled women of this era to pursue work and earn independently.

Even the cheapest pad today outperforms the most expensive pad from 20 years ago. As doctors, we must adapt — changing not only the questions we ask, but also how we ask them. We may even need to familiarise ourselves with the different types and brands of menstrual pads available.

Current definitions of heavy menstrual bleeding are often based on the number of pads used. But with the technology leap in menstrual products, perhaps it’s time to rethink these definitions — and look deeper.