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While pads and tampons have reigned supreme since around the 1920s, alternative menstrual products — including period underwear, menstrual cups and menstrual discs — have gained significant traction in the past few decades. The rise can be attributed to several factors, including sustainability, cost effectiveness and a greater willingness to talk about menstruation in general.
“As folks begin to talk more openly and more often about menstruation and menstrual health, they share options beyond what they assume to be the one and only method of care — typically commercial pads and tampons,” explained Chris Bobel, PhD, a professor of women's, gender, and sexuality studies at the University of Massachusetts, Boston.
Period underwear in particular is a reusable alternative specifically designed to handle the different flows throughout your period, and it can help those who menstruate move away from traditional pads. Google searches over the past year show that interest in period underwear is higher than interest in period pads or menstrual cups (tampons still take the top spot, especially amidst a nationwide tampon shortage). And unlike the typical “period panties” that keep pads in place during that time of the month, period underwear can act as either a worry-free backup to a tampon, cup or disc or a menstrual management tool that can take the place of tampons and pads altogether.
To better understand how period underwear works, we spoke to gynecologists about its advantages, limitations and best uses. We also gathered some highly rated options to consider based on their guidance.
What exactly is period underwear?
Period or menstrual underwear is specially designed to absorb menstrual blood, so pads, tampons or cups rarely need to be used with them, according to Dr. Andrea Zuckerman, chief of pediatric and adolescent gynecology and vice chair of gynecology at Tufts Medical Center. It’s designed to look like normal underwear: You’ll see period underwear offered in all sorts of styles ranging from boyshorts and bikinis to briefs and thongs.
While period underwear may resemble any other standard pair, it utilizes a built-in pad with a “moisture-wicking top layer that draws away wetness and dries fast, plus a super absorbent core layer,” explained Dr. Carolyn Moyers, a board-certified OB/GYN and founder of Sky Women’s Health. A lot of period underwear is made from cotton and absorbent microfiber polyester, with some nylon or elastane thrown in for stretch and durability, Zuckerman and Moyers noted. Best of all, you usually can’t even tell there’s a pad built in — there’s little bulging and you don’t have to deal with the annoying issues that come with traditional pads, such as adhesive and wings.
Period underwear to shop in 2022
We separated the following pairs of period underwear into three categories — light, moderate and heavy coverage — based on the expert guidance we received. As one gynecologist noted, some of the most absorbent period underwear on the market can hold more than five regular tampons’ worth of blood, so we considered light absorbency to be similar to one to two tampons and medium absorbency to be similar to three to four tampons. Each of the following period underwear indicates its absorbency level and is machine-washable.
Light absorbency period underwear
Thinx is one of the more well-known period underwear brands with various lines designed for different ages and lifestyles, including a line for tweens and teens called Thinx (BTWN) and another for bladder leaks called Speax. The brand indicates five absorbency levels ranging from Lightest, which the brand says can hold up to one tampon’s worth of blood, to Super, which offers five tampons’ worth of protection, according to Thinx. The underwear is certified by OEKO-TEX, meaning it’s been tested for harmful substances, and it features a seamless fit made from nylon and elastane. It’s only offered in two styles in its lightest absorbency category: Thong and Cheeky, both of which currently come in sizes XXS to 4X.
ModiBodi’s period underwear is among its most popular pairs — the Sensual Hi-Waist Bikini has earned an average 4.9-star rating over more than 3,000 reviews. You’ll find a range of styles on the site, including a French Cut, Brief and Boyleg, which offers a lower rise. The brand says the Hi-Waist Bikini is meant for lighter flows — about the same as two tampons — and is designed to sit right at the hip with a higher leg. The bikini is also made with a stain-, odor- and bacteria-fighting lining, according to the brand. It’s available in five colors, including Sunset Orange, Moss Green and more, and in 10 sizes ranging from XS to 6XL.
Period label Proof designs underwear for different leaks and functions, including postpartum, workout and maternity. The Leakproof Thong has the absorbency of one tampon and is designed to both help with light leaks and erase panty lines, according to the brand. The pair is made from what Proof describes as a breathable microfiber and features a lower rise silhouette. You can use this period underwear in conjunction with a tampon — it’s primarily meant for spotting, sweat and other discharge, Proof says. It’s available in two shades, Black and Sand, and in sizes XS to 3XL.
Moderate absorbency period underwear
Though Rael doesn’t offer different underwear styles like the other options on this list, its period underwear comes highly rated and can absorb as much as three tampons’ worth of blood, according to the brand. It’s meant to look and feel like everyday underwear, and it’s made with four layers, including one from breathable cotton and another that’s meant to protect against moisture and odors, the brand says. It’s currently offered in four sizes — Small to X-Large — and you can choose to bundle the underwear in a pack of one, two or three pairs. In addition to period underwear, Rael carries its own collection of menstrual cups, pads, tampons and panty liners.
Saalt, one of our favorite women-owned brands, is probably best known for its popular menstrual cups. However, the brand has a period underwear line called Saalt Wear as well, which includes bikinis, thongs and briefs aimed at absorbing periods, bladder leaks and more. The Saalt Leakproof Mesh Hipster is designed to absorb as much as two to three regular tampons’ worth of blood, Saalt says. This pair is made from sheer mesh and offers a stretchy, mid-rise waistband. It comes in five colors, including Desert Sand, Volcanic Black and Warm Stone, and you can choose between sizes XS to XXL.
The Boost Boxer is designed with a statement waistband displaying the brand’s name along with an absorbency that matches up to four tampons, according to Aisle. It also comes with a booster that you can tuck into the ends of the gusset for even more protection — the same as two additional tampons, the brand says. The underwear is offered in sizes XXS to 5X and in four colors: Black, Beet, Ginger Spice and Kelp Forest. Along with period underwear, Aisle also offers its own line of liners, pads and cups.
Eco-friendly tampon and pad company Cora, which makes some of our favorite menstrual cups, also makes period underwear that it says absorbs the same as three regular tampons. The underwear is designed to be flexible, especially for those with active lifestyles, according to the brand: It has a moisture-wicking core and elastane to make it stretchy and comfortable. It’s available in sizes XS to XXL and in packs of one, three or five.
High absorbency period underwear
Knix’s period underwear falls into two categories: light-medium and heavy-super coverage, the latter of which the brand says is equivalent to eight tampons’ worth of protection. The Super Leakproof High Rise is among its most popular offerings: It boasts an average 4.6-star rating over more than 1,900 reviews. The pair features an extended gusset that’s 9 inches long and 4-way stretch that’s meant to create a more comfortable fit the more you wash and wear it, Knix says. In terms of fit, the brand says this period underwear sits at the natural waist. You can choose between sizes XS to XXXXL and 14 colors, including Dark Cherry, Lavender and Peony.
As its name implies, The Period Company is centered around period underwear (the brand also offers reusable pads and panty liners that are more recent additions). According to the brand, The High Waisted can hold up to 10 tampons’ worth of blood and is made with organic cotton and spandex. You can choose between six colors, including Rose, Mahogany and Burgundy, and sizes XS to 6X. Along with The High Waisted, you’ll also find The Bikini with a lower rise, The Boxer and The Adaptive Bikini, which equips velcro closures.
Absorbing the same as five tampons, the Super Hiphugger from Thinx offers the highest absorbency out of all the brand’s offerings. The pair is made from nylon and elastane and features a zigzag pattern at its waist, which has a mid-rise fit. It’s available in four colors — Black, Spicy, Moonflower and Dusk — and sizes XXS to 4X.
How to shop for period underwear
Period underwear is usually offered in three absorption levels for light, moderate or heavy flows. Moyers told us menstrual underwear can hold as much as — and sometimes more than — five regular tampons’ worth of blood for heavier or overnight menstruation (which is more than most pads can hold), while the light absorbency style can hold about as much as a typical pantyliner.
Just like with pads or tampons, you should pick period underwear based on your specific flow — our experts recommended trying out different absorbances to get comfortable with wearing them and to see how each feels with your body and flow. If you have a heavier flow, you may want to use it in combination with other period products like a tampon or menstrual cup for extra protection and to avoid leaks, added Dr. Taraneh Shirazian, a board-certified gynecologist at NYU Langone and director of the Center for Fibroid Care.
Is period underwear worth it?
Experts told us that most people shouldn’t have too many issues transitioning to period underwear. “It's not really going to require much of a change from days when you're not bleeding and just wearing your normal underwear — I think a lot of people like them because they feel most normal to what they're used to,” said Dr. Tina O’Shea, assistant professor in the department of obstetrics and gynecology at the University of Florida College of Medicine.
Benefits of period underwear
Period underwear stands out from tampons, pads and menstrual cups because of its absorbency, according to the experts we spoke to. O’Shea noted that period underwear absorbs anywhere from about 5 to 25 milliliters of menstrual blood, which she said can be more than several tampons’ worth. Because of this, period underwear usually doesn’t have to be changed as frequently as other period care products — the FDA recommends changing a tampon every four to eight hours and the American College of Obstetricians and Gynecologists advises the same for pads. While there’s no specific recommended timeframe for period underwear, experts told us you should change your pair every 10-12 hours. However, those with heavier flows should consider only wearing their period underwear for up to six hours to avoid sitting in moisture, which can be a recipe for vaginal infections, Shirazian said.
Another consideration for modern shoppers is the environmental impact of disposable period products: The average menstruating person uses between 5,000 and 15,000 disposable pads and tampons in their lifetime, and pads, tampons and panty liners all result in a large amount of plastic waste due to their materials and packaging. Period underwear is machine-washable and reusable, so it’s less likely to contribute to waste as much as other other disposable menstrual care products would, according to the experts we spoke to.
Drawbacks of period underwear
There are some downsides to period underwear: It’s not waterproof like tampons or menstrual cups, which means you won’t be protected when you’re swimming or playing water sports. Instead, a pair might absorb a lot of water and become soggy and heavy, similar to a diaper, Zuckerman warned. It also lacks the portability of disposable period products — you can’t carry period underwear around as you would an extra tampon or pad in a pocket.
Period underwear also tends to have a higher upfront cost, usually ranging between $25 and $55 per pair. “That cost does start to even out if you think about buying pads and tampons for many years, but I think the initial cost is going to be a little more than some people would like to spend,” said Dr. Lauren Naliboff, a board-certified OB/GYN and assistant professor at Rutgers Health.
Another consideration that holds true among many reusable period care products is your comfort level when washing and maintaining them — specifically, Naliboff said you need to make sure you will be comfortable with ringing out your underwear before throwing it in the washing machine. And if you’re going to use period underwear as your primary form of bleeding protection, O’Shea noted “you’ll need at least four pairs to get through your period without having to do laundry daily,” depending on your flow.