It is (not) in my blood : An analysis of the domestication of reusable menstrual products and the role of communication

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It is (not) in my blood.

An analysis of the domestication

of reusable menstrual products and

the role of communication.

Master thesis, 15 hp

Media and Communication Studies

Supervisor:

Ekaterina Kalinina

Sustainable Communication

Spring 2021

Examiner:

Renira Rampazzo

Gambarato

Luisa Steinkogler

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2 JÖNKÖPING UNIVERSITY

School of Education and Communication Box 1026, SE-551 11 Jönköping, Sweden +46 (0)36 101000

Master thesis, 15 credits

Course: Sustainable Communication Term: Spring 2021

ABSTRACT

Writer: Luisa Steinkogler Title: It is (not) in my blood. Subtitle:

Language:

An analysis of the domestication of reusable menstrual products and the role of communication.

English

Pages: 41

Reusable menstrual products like the menstrual cup or washable cloth pads are an economical and environmentally sound alternative to disposable options. However, these innovations diffuse rather slowly into the mainstream market with a relatively high risk of rejection. Referring to previous research regarding stigmatized innovations as well as sustainable product innovations, this thesis aims to analyse the role of communication in the process of adoption and rejection of reusable menstrual product innovations used for a personal purpose. Specifically, this research addresses the question of why some menstruating people in a higher income setting adopt and some reject reusable menstrual products. Based on the theories of diffusion of innovations and domestication, semi-structured in-depth interviews with users and rejecters of named innovations are conducted.

The analysis demonstrates that the adopters’ decision-making process is mostly congruent to the findings of previous research, however newly associated values and conflicts are identified. Additionally, novel insights into rejecters’ decision-making process are stated. Referring to the role of communication during the domestication of reusable menstrual products, the analysis shows that interpersonal communication plays a crucial role when gaining knowledge and getting persuaded. Also, the findings suggest that interpersonal communication gets stimulated by the usage of such products, which could support the normalization and breaking of taboos surrounding menstruation. Even though previous research proposes a high significance of social media during the successful domestication of reusable menstrual products, this study’s contrasting results encourage further studies on this subject.

Keywords: Reusable menstrual products, sustainable product innovations, stigmatized

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Illustrations

Figures

1 A model of five stages in the innovation-decision process…...………17 2 Thematic qualitative text analysis process………..………23

Table

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Introduction

An average menstruating person will have around 480 periods in their lifetime. Using tampons or disposable sanitary pads, the needed products and the produced waste are enormous. At least 500 years is the time it takes for a sanitary pad that consists of plastic to decompose (Borunda, 2019). At the same time, tampons and sanitary pads often contain chemicals and are a financial burden every month. However, disposable products stay popular among menstruating consumers. On the contrary, reusable menstrual products such as cloth pads and menstrual cups are an economical and environmentally sound alternative to disposable options (Lamont et al., 2019, p. 1). They are not only resource-efficient since they can be used for several years when stored and used carefully, but reusable menstrual products can also be a way to prevent period poverty (Beksinska et al., 2015) – both in lower income settings but also in countries with a higher income. With precisely this aim, Scotland started in 2020 as the first country in the world to provide free period products, including reusable ones, to everyone, regardless of age, social status and income (Diamond, 2020). Additionally, research shows that the usage of reusable menstrual products can have a positive effect on both personal but also collective needs just like body positivity and environmental protection (Gaybor, 2019). The question now arises as to why those sustainable period products have not been able to establish themselves further within society.

Representative studies about the usage, adoption, or rejection of reusable menstrual products are hard to find. Nevertheless, an international group of researchers reviewed 43 studies including over 3300 participants addressing the acceptability of menstrual cups, besides others. They found that around 70% of participants in 13 studies wanted to continue using the menstrual cup after trying it (Van Eijk et al., 2019). Rogers (2003) argues that most people that have tried an innovation move to an adoption decision in case the product proves to have a specific degree of relative advantage (p. 177). But if such products seem to have economic, practical, and sustainable advantages, what are the reasons that make some people adopt reusable menstrual products and others reject them? How come some users defeat the social stigma surrounding such products? What convinces or discourages users? An empirical way to analyse and explain such questions is by referring to the domestication approach.

Coming from the theory of diffusion of innovations, the domestication approach describes and explains how a product or an idea enters somebody's life and what symbolic meaning they ascribe to them (Rogers, 2003). Even though the menstrual cup and cloth pads are not new to the market, reusable menstrual products are still considered an innovation. This is due to the rather newly associated value of sustainability. Hence, the following study focuses on the domestication of reusable menstrual products, how it is carried out, what problems are

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encountered by users, and how they are (not) solved by users and rejecters, leading to further adoption or rejection of the products.

To analyse this, qualitative interviews with users and previous users are conducted. Even though communication, whether mediated communication or interpersonal communication, plays a key role in the adoption process of stigmatized and sustainable product innovations on an individual level (Manchanda et al., 2008), previous studies tackling this issue have only superficially included the communication aspect. This shall also be taken into account in this study. Summing up, by focussing on the role of communication within the domestication framework, this thesis aims to tackle the questions of why menstruating people use or reject reusable menstrual products and what role communication plays in that process of (unsuccessful) domestication.

Background

What are reusable menstrual products?

Reusable menstrual products can be cloth pads, menstrual cups, menstrual underwear, and also little period sponges. The menstrual cup is made out of medical-grade silicone or thermoplastic elastomer. During the period it is inserted into the vagina, right below the cervix, to collect the menstrual blood while a slight vacuum keeps it in place. To empty it, it has to be removed, washed and can be used directly again (Gaybor, 2019). In between cycles, the menstrual cup needs to be sterilized by cooking it in water for several minutes. The cup can be used for up to 10 years. Cloth pads are washable menstrual pads, sewed out of cotton, bamboo, fleece, and/or water-resistant material (Precious Stars, n.d.). It is clipped into underwear and can be reused for several years as well. Menstrual underwear is worn just like normal panties but consists of cotton and water-resistant material to absorb the menstrual flow. Period sponges, however, can be natural or synthetic and are inserted into the vagina. They are invisible from the outside and can also be worn during intercourse. The costs of those products

differ from country to country, depending on brands and taxes. In Germany, for example, a

menstrual cup cost between 9€ and 30€, reusable pads around 6€ per piece and period panties

around 18€ to 30€ per piece (dm, n.d.; https://de.erdbeerwoche-shop.com).

The stigma of menstruation

Hardly any other biological function is as much of a subject to stigmatization as the period; even though it affects half of the world’s populations in any corner of the world (Kowalski & Chapple, 2000; Spadaro et al., 2018). To talk about menstruation as a stigma, first, we need to have a look at the basic definition of such. The foundation of social science research regarding

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the construct of stigma is oftentimes based on Ervin Goffman (1963). He defines stigma as any mark or stain that differs from other people, it “conveys the information that those people have a defect of body or of character that spoils their appearance or identity” (Johnston-Robledo & Chrisler, 2013, p. 9). Further, he identifies three different types of stigma: abomination of the body, blemished of individual character and tribal identities or social markers associated with marginalized groups (Goffman, 1963, p. 4 as cited in Johnston-Robledo & Chrisler, 2013). All these three types of stigma can be found in menstruation, as Johnston-Robledo and Chrisler (2013) argue. Empirical research has been tackling this issue of menstruation as a stigma since the 70s. It concentrates, on the one hand, on attitudes and the perception regarding menstruation, but also, on the other hand, on the effects on self-perception, self-assessment, the consequences on women’s impression management behaviour as well as on possible results of the stigma (Kowalski & Chapple, 2000; Roberts et al., 2002). Menstrual stigma can therefore have possible consequences on women’s health, well-being, and social status (Johnston-Robledo & Chrisler, 2013). Burrow and Johnson (2o05) have observed before that previous feminist literature highlights “how negativity surrounding menarche and menstruation is a product of socio-historical processes and cultural attitudes, and that there is a need to attend to these in order to seek change” (p. 235)

Social stigma can be made noticeable through communication and media. Media and communication studies have been focusing on this phenomenon since the 70s as well, investigating for example the low acceptance of ads promoting menstrual products (Rehman & Brooks Jr., 1987). Central themes are the analyses of interpersonal communication, the silence around menstrual conversation, the usage of language, the construction in mass media and ads, and finally educational material.

When focussing on the menstrual stigma in interpersonal communication, researchers have been analysing e.g., mother-to-daughter conversations (Costos et al., 2002) but also the actual silence around menstrual conversations. Kissling (1996), as well as Jackson and Falmagne (2013), identified negative discourses of menstruation when young girls talk about their menarche (the first period in life) and pointed out the fact that in their study conversations about menstruations were generally tried to be avoided. Building on this, Rubinsky, Gunning & Cooke-Jackson (2020) analysed the (un)supportive communication regarding early menstruation experiences. The answers of the survey’s participants suggest that there is a “desire for conversations that normalize menstruation as typical and acceptable, validate period pain and prescribe management tactics, and describe the existence of feminine hygiene products other than pads and tampons'' (p. 242).

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Linguistically, communication about menstruation has also been studied, mainly concentrating on euphemisms used (Ernster, 1975; Golub, 1992; Newton, 2016). These describing and belittling words can be found anywhere on the globe in almost any culture even though they are changing over time (Chrisler, 2011). Johnston-Robledo and Chrisler (2011) argue that if there wasn't a stigma around period blood, there would be no reason to use phrases like “auntie’s coming to tea”, “mother nature’s gift” or even “the curse” (p. 12). In addition, communication through mass media, just like newspaper or TV ads, has “contributed to the communication taboo by emphasizing secrecy, avoidance of embarrassment, and freshness” (Johnston-Robledo & Chrisler, 2011, p. 11). In academia, mostly the self-objectification through menstrual product commercials received and the construction of female bodies and identities are addressed (De Waal Malefyt & McCabe, 2016; Del Saz-Rubio & Pennock-Speck, 2009; Kane, 1990; Spadaro et al., 2018). It shows that commercials about menstruation management products can reinforce the stigmatization, stereotypical knowledge about periods, and women’s experience of shame (Spadaro et al., 2017). Throughout the literature, it is mentioned that commercials of menstrual products “provided confusing, conflicting and paradoxical messages” (Raftos, Jackson & Mannix, 1998, p. 174) or depicting the period as a “hygienic crisis” (Havens & Swenson, 1989, p. 89). While these examples originate from studies that are over 20 years old, newer investigations reveal similar results even though the approach has changed somewhat since the 90s. One example is the US-American study of De Waal Malefyt and McCabe (2016). In their work, they analysed interviews and advertising images of the feminine care industry which showed a binary view of periods: the discourse of “protection” which dominates marketing, on the one hand, and the “natural” discourse used by female customers (p. 555), on the other. Del Saz-Rubio and Pennock-Speck (2009) conducted a qualitative analysis of Spanish and British television commercials containing disposable menstrual products. They found that in the analysed TV ads not only the practicality and the advantages of the products have been addressed but also a certain celebration of womanhood motivating women to break with stigma.

Lastly, research by Erchull et al. (2002) showed that the stigma of menstruation can also be transmitted and strengthened through educational material like booklets produced by companies producing disposable menstruation products. The researchers analysed such booklets which were published between the years 1932 and 1997, finding that the publications rather emphasized negative than positive aspects of the period. In addition, Erchull et al. argue that both language used, and illustrations shown in these booklets are problematic: While only in few publications the terms menstruation, ovulation or menses was used, at the same time, the illustrations lacked to show the female reproductive organs as included parts of the female

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body. Hoerster et al. (2003) conclude that such representation could support negative attitudes towards periods.

Aim and research questions

This study aims to analyse the role of communication in the process of adoption and rejection of sustainable product innovations used for personal purposes. Specifically, this thesis will analyse why some menstruating people in a higher income setting adopt and some reject reusable menstrual products. The focus will further be on the role communication plays during this adoption and domestication process. Following research questions shall be answered:

RQ: Why do some menstruating people adopt reusable menstrual products and some actively reject them?

Sub-RQ1: How do menstruating people formulate their decision to adopt or reject reusable menstrual products?

Sub-RQ2: What role do thereby interpersonal and mediated communication play?

Thus, the goal is to analyse a group of people that have either adopted or rejected such products in their lifetime, to investigate how they experienced the domestication process and how they communicated about the products and their decisions. The findings of this thesis could help to identify problems during the domestication process, to develop possible ways to improve education and marketing of reusable menstrual products to assure the further establishment of such.

Previous research

This research is positioned within the field of communication and diffusion of innovation. Studying the (non)adoption of reusable menstrual products falls within research on communication of stigmatized as well as sustainable product innovations. In this chapter, first, previous literature on sustainable product innovations as well as stigmatized innovations are explored and analysed. Especially the role of media and communication within these studies is considered. Then, existing research tackling the issue of the adoption of reusable menstrual products in different settings is demonstrated.

Sustainable product innovations

Our global society lives beyond its resources. One of the biggest and most important challenges of the current time is the transition towards a sustainable world through a “development that meets the needs of the present without compromising the ability of future generations to meet

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their own needs” (United Nations General Assembly, 1987, p. 43). To realise this, fossil energy, the emission of greenhouse gases as well as marine pollution, besides others, have to be reduced stringently (Noppers et al., 2014). While organisations like businesses, national and provincial governments, non-government organizations as well as local municipalities have the resources and power to move society in the direction of being sustainable (Robèrt et al., 2019), an increasing number of individuals and consumers discover their responsibility in this development: by engaging in “sensible green shopping behaviour” (Averdung & Wagenfuehrer, 2011). Therefore, sustainable technologies have to be developed, transferred but also successfully adopted (Guerin, 2001). Varadarajan (2017) distinguishes between sustainable

innovations and sustainable product innovations. The former refers to the impact of a

company’s activities on the natural environment, the latter, however, is defined as the following:

”Sustainable product innovation is a firm’s introduction of a new product or modification of an existing product whose environmental impact during the lifecycle of the product, spanning resource extraction, production, distribution, use, and post-use disposal, is significantly lower than existing products for which it is a substitute”

(p. 17).

Nonetheless, the adoption of such sustainable product innovations often does not go smoothly. Researchers of different fields like economics, sociology, management and marketing have already suggested several reasons why environmentally friendly products diffuse rather slowly into the market (Karakaya et al., 2014; Ozaki, 2011). The focus lies for example on the consumer decisions for green everyday products (Thøgersen et al., 2012), green electricity (Bollinger & Gillingham, 2012; Ozaki, 2011; Pichert & Katsikopoulos, 2008) or electric cars (Stryja et al., 2017). Key barriers to adopting sustainable product innovations are “availability, high cost, lack of awareness, perceived lack of effectiveness […], social pressure and feminization of sustainable behaviours” (Chwialkowska, 2019, p. 33). Feminisation refers here to an even higher barrier for men to adopt a green lifestyle as it is associated with a “green-feminine stereotype” (Brough et al., 2016, p. 567). Moreover, they might require a behaviour change (Ozaki, 2011). Such human resistance behaviour can be explained “as an interplay of different personality traits that favour the status quo” (Stryja et al., 2017, p. 2885). Luchs et al. (2010) mention, moreover, that increased greenwashing “resulted in consumer cynicism of green products and distrust” (Chwialkowska, 2019, p. 33).

Guerin (2011) argues that theoretically sustainable product innovations are adopted because of a combination of economic, environmental and social needs (p. 2). Therefore, adoption and also nonadoption is dependent on their social, environmental and/or economic context. The process of adopting a sustainable product innovation is a highly dynamic process. According

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to Verbong et al. (2019), consumers play hereby a more active role than just adopting passively a new product into their lives. They rather “become deeply involved or even leading actors in the generation of innovations” (p. 238), bringing social and organisational changes. Research examining the role of consumers of sustainable product innovations shows that people that have a more active involvement can “inject the spirit of sustainability into their own lives through activities such as raising awareness and lobbying (for example, by campaigning and using social media” (p. 241).

This addresses another important aspect of the diffusion and adoption of sustainable product innovations: social influence and the use of media and communication. In general, media and communication play an important role during the adoption process (Rogers, 2003), which will be later explained in detail. However, the role of social media is somehow neglected in existing theory. Chwialkowska (2019) argues that even though the majority of consumers living in developed countries are environmentally conscious, the minority of people actually embrace a green lifestyle (p. 34). The resulting social pressure prevents individuals from going against the norms of the majority. This is where social media comes into the picture: Since social media is an important part of our everyday life, it can contribute significantly to behaviour change (Adewuyi & Adefemi, 2016) and be an “important venue for advocating sustainability as it offers conditions for minority influence” (Chwialkowska, 2019, p. 34). This can be realised through peer communication and consumer socialisation that make people “acquire skills, knowledge and attitudes relevant to their functioning as consumers on the marketplace” (Ward, 1974, p. 3, as cited in Chwialkowska, 2019, p. 34). Opinion leaders, just like influencers on social media can thereby promote behaviour change by facilitating knowledge dissemination and processing new information (Chwialkowska, 2019, p. 34). Building on this knowledge, Chwialkowska (2019) conducted a study analysing the communication style of green lifestyle advocates on social media. She found that the main characteristics of such involve the majority in systematic thinking, consistency, a non-dogmatic approach, and encouraging identification through normalizing sustainable behaviours. She argues that these make the adoption of green products through the influence of social media more successful. Reusable menstrual products are a special case regarding sustainable product innovations. Reusable sanitary pads as well as menstrual cups are not newly invented products. At this point, the difference between innovation and invention has to be explained: Invention refers to the process of discovering or creating a new idea (Rogers, 2003), innovation, however, refers to the combination of purpose and means in a hitherto unknown form (Hauschildt, 2005). While the cup was invented in the 1930s but never entered the mainstream market until recently (Shihata & Brody, 2019), reusable cloth pads used to be one of the only accessible ways how to manage menstruation until the first part of the 20th_{century (Weissfeld, 2010). Before}

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adopting more “modern” practices like using disposable pads and tampons, menstruating people in today’s higher-income countries used mostly homemade cloth pads that had to be washed and reused (Freidenfelds, 2009). The technological improvement of menstrual products led to the development of innovations such as disposable tampons and pads. Even though they were less economical, menstruating people experienced them as liberating, according to a study about the changes of menstrual hygiene products in socialist Slovenia and wider Yugoslavia (Sitar, 2018). In this case, the innovation of disposable menstrual products got associated with the liberation of shame since “not only […] the risk of blood-soaked clothing [was] reduced but the secret washing of home-made pads was obviated” (p. 775).

Having this in mind, the rediscovery of reusable menstrual products as an innovation in recent years is especially interesting. Referring to the above-mentioned definition of innovations as well as sustainable product innovations, such reusable menstrual products of today can be seen as innovations in two ways. On the one hand, they serve as innovations of disposable products as they are environmentally friendlier than tampons and disposable pads. On the other hand, they can also be seen as innovations of the original reusable menstrual products as the means and purpose have changed: the function of these products today is not only to the pure collection of blood anymore, but sustainability is newly attributed to them as a value.

Stigmatized innovations

Besides being sustainable, there is another crucial aspect of reusable menstrual products: the stigmatization of such. As previously mentioned, there is hardly any biological function that is as much a subject of stigmatization as the period – and with it menstrual products. Moreover, “stigma influences consumption decisions and experiences” (Ndichu & Rittenburg, 2021, p. 340). To analyse the adoption process of reusable menstrual products it is especially essential to take a look at the adoption process of other products and innovations associated with taboo and stigma. Ndichu and Rittenburg (2021) argue that scholars addressing the adoption of stigmatized products and practices have been focussing on the process of how those are transformed, popularized, accepted and less stigmatized. Examples are hereby wearing tattoos (Larsen et al., 2014), the Islamic veil in Turkey (Sandikci & Ger, 2010) and casino gambling (Humphreys, 2010). Referring to the underlying theory of adopting new products, the theory of diffusion of innovation (Rogers, 2003), there are five characteristics of an innovation influencing the acceptance and adoption: compatibility, low complexity, observability, relative advantage and trialability. This approach is explained in more detail later on in the chapter on theory. Ndichu and Rittenburg (2021) identify two barriers when adopting stigmatized innovations: the consumers’ perception of low compatibility as well as psychosocial risks (p. 342). Rogers (2003) defines compatibility as “the degree to which an innovation is perceived as being consistent with the existing values, past experiences, and the needs of potential

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adopters” (p. 15). Ndichu and Rittenburg explain this as the “purchase, use, and disposal take place in a social context marked possibly by anxiety, controversy, embarrassment, risk of disapproval, shame, or unease, primarily on the part of the purchasing or consuming party” (Bailey & Waronska, 2015, p. 219, as cited in Ndichu & Rittenburg, 2021).

Sundstrom (2014) concentrates especially on the taboo and stigma that persistently surrounds women’s bodies and reproductive health – and with it products as well as innovations associated with them. It, therefore, concerns “menstruation, pregnancy, miscarriage, childbirth, and breast-feeding” (p. 91). In her study, she explores the diffusion of innovations theory in connection to the social marketing approach while analysing the understanding of communication behaviour and the social system of 44 biological mothers of newborns. Besides others, her findings show that “online networks offer reprieve from system norms that create a taboo around women’s health issues” (p. 87). Additionally, Sundstrom (2016) expanded her results by solely focussing on the role of communication during the diffusion of innovations process of biological mothers of newborns. The study shows that the participants, when faced with health questions, used the internet to search for solutions and answers. She suggests that “new media comprise a new communication channel with new rules, serving the functions of both personal and impersonal influence” (p. 91).

Adoption and domestication of reusable menstrual products

There is already quite some research tackling the issue of the usage of reusable menstrual products from an innovation perspective. When reviewing existing research about the adoption of reusable menstrual products, it is noticeable that researchers frame these innovations in two different ways: on the one hand, as a tool to find a way out of poverty, discrimination and to end health issues; on the other hand, as a means to achieve global sustainability and as a carrier of values like equality and self-determination. It is striking that the majority of research contains the frame of poverty, discrimination and to end health issues and is mostly set in countries with lower income (Beksinska et al., 2015; Hennegan, 2017; Kambala et al., 2017; Kaur et al., 2017; Madziyire et al., 2018; Pokhrel et al., 2021; Tembo et al., 2020; van Eijk et al., 2018). On the contrary, only a few studies can be found that are set in a higher-income setting, just like Europe, the US or generally the middle class (Gaybor, 2019; Lamont et al., 2019; Peberdy et al., 2019). If so, the usage of such products is mostly framed as a means to achieve global sustainability and as a carrier of values like equality and self-determination as well as deal in detail with the decision-making process of the user.

Studies conducted in lower or middle-income countries, just like South Africa, Zimbabwe, Uganda, or Nepal, focus mostly on period poverty, taboo, cultural norms and practices, discrimination and poor access to sanitation facilities that can have a severe impact on health,

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education as well as employment and livelihood (End the Stigma. Period., 2019). To tackle this issue, the introduction and the acceptance of less resourceful and less visible period products, such as reusable menstrual products, are analysed academically. These researchers address the practicability, applicability and feasibility of reusable menstrual products (Beksinska et al., 2015; Madziyire et al., 2018; Pokhrel et al., 2021). In these, menstruating people indicated, on the one hand, that they rate “comfort, quality, menstrual blood collection, appearance, and preference” significantly better (Beksinska et al., 2015, p. 151). Also, they “did not experience discomfort during cup insertion or during their daily activities and did not experience leakage” (Madziyire et al., 2018, p. 59) and the usage was “helpful for promoting dignity” (VanLeeuwen & Torondel, 2018). On the other hand, the results also show doubts, concerns or discomfort of the participants. For example, pain, concerns it may “‘get stuck’ in the vagina” and concerns of relatives regarding “reduced fertility or losing virginity” (p. 1). It is striking that none of these studies consider especially communication when analysing the adoption of such innovative menstrual products.

Besides the quite well-researched field of sustainable menstrual products in low- and middle-income settings, only a few studies are addressing the question of who uses reusable menstrual products and why in a higher-income setting (Gaybor, 2019; Lamont et al., 2019; Peberdy et al., 2019). They give interesting and new insights into the decision-making process of menstruating people when deciding for or against reusable menstrual products.

Gaybor’s study “Empowerment, destigmatization and sustainability: the co-construction of reusable menstrual technologies in the context of menstrual activism in Argentina” (2019) shows the versatile motivations of menstruating people to use reusable period products. In her research, she analysed the process of integration in which reusable menstrual products become part of the users’ everyday life. Building on the domestication framework, she conducted 24 interviews and 4 focus group discussions with Argentinian middle-class women as well as observation on online and offline sites in Argentina. Her findings show that the decision to use a reusable menstrual product is not an immediate event but rather a gradual process which is influenced by changing motivations and practices, tensions, and multiple sources of information (p. 123). Further, her analysed users classified reusable menstrual products as useful to satisfy personal (including health and economic benefits) but also collective needs (including the protection of the environment and the wellbeing of future generations) (Gaybor, 2019). Their decision to use reusable menstrual products was functionally and socially motivated. On the one hand, functionally refers here to the comfortable and inexpensive management of menstrual bleeding, to the environmental harmless aspects of such zero-waste options but also the product as a tool to “self-explore the body, learn about one’s anatomy and observe the consistency of menstrual blood for health purposes” (p. 124). Socially driven usage

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refers, on the other hand, to the user’s social and ideological positions and networks and the coherence between these and their lifestyle. Such ideologies could be environmentalism, feminism, zero-waste life, and the fight against menstrual stigma. Addressing media and communication, Gaybor’s results show how the access of information, online and offline, about these products influence the incorporation of them in the routines of the respondents. She argues “that social networking websites such as Facebook and YouTube challenge ‘the monopoly of education and knowledge provided primarily by institutions and elites by bringing learning to the grassroots’ (Alhayek, 2016, p. 335 in Gaybor, 2019, p. 124)”. Concluding, social media “seems to be a tool to connect across borders and languages and to facilitate learning” (Gaybor, 2019, p. 124).

While Gaybor (2019) concentrates on the motivation of people who are already using reusable period products, Peberdy et al. (2019) focus on the general level of the environmental awareness of menstruating people and their product choice. Their results of online surveys and focus groups conducted in the UK indicate that most of their respondents were not aware of the environmental impact of disposable period products. Nevertheless, the participants who had a higher awareness of e.g., the plastic contained in tampons and disposable pads tended to choose more sustainable options, such as cloth pads and menstrual cups.

As already mentioned, using e.g., a menstrual cup involves getting intimate with your own body. Lamont et al. (2019) took this as an opportunity to investigate further to what extent body shame and self-objectification which, according to the authors, encourage women to distance themselves from their bodies (p. 1), affect the decision to use reusable menstrual products. In a cross-section study, they conducted a survey with 62 students with menstrual periods studying in the US. The results show that a “greater self-objectification predicted higher body shame, which in turn predicted negative attitudes toward and low willingness to use [reusable menstrual products]” (p. 1). Here, self-objectification was defined as the internalization of body standards which describe the female body as free of odors and appearance of natural bodily function. By menstruating and thereby not meeting these expectations, women (or anybody menstruating) might distance themselves from their own bodies (p. 2-3) and, hence, from using a period product that demands the willingness to deal with the body.

The just mentioned studies show that there is an imbalance of research conducted in lower and higher income settings. However, menstruating people all over the world have to deal with stigma and taboo when it comes to their period. At the same time, the usage of reusable menstrual products could improve anybody’s lives, not only the ones living in a poorer

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environment. This thesis tries to tackle this colonialistic view on the patronising of who is in need of an innovation and who is not.

Research gap

Summarizing just demonstrated previous research, it becomes apparent that several gaps are worth following up on:

First, research set in higher income settings about the adoption of reusable menstrual products is rare to find. Second, analysed research shows that reusable menstrual products can be classified as stigmatized as well as sustainable product innovations. Studies regarding these have indicated that media and communication play an interesting and crucial role during the decision-adoption process of such products – however, hardly any studies focus specifically on the influence of media and communication. The same applies mostly to the reviewed research addressing the adoption of reusable menstrual products in a higher income setting. Lastly, it is striking that just mentioned studies either concentrate on reasons why people adopt reusable menstrual products or why they rather won’t adopt such products. None concentrates on people that have considered adoption or even tried adopting but then rejected the innovation. These research gaps are combined and analysed in this thesis.

Theoretical frame and concepts

From the diffusion of innovations to the domestication approach

Even though reusable menstrual products have been on the market for some time, they can still be seen as innovative products, as already argued above. Most research regarding the adoption of new products is based on the theory of diffusion of innovations by the US-American communication theorist and sociologist Everett Rogers (2003). In his book, he defines diffusion as “the process in which an innovation is communicated through certain channels over time among the members of a social system” (Rogers, 2003, p. 5). In the research field of communication science, the theory of diffusion is relevant regarding two points: the analysis of the diffusion of information and communication technologies as innovations as well as the analysis of interpersonal and mass media communication channels that play a role within the adoption process (Karnowski, 2017). The latter will be the focus of this study.

The process of the diffusion of innovations is distinguished between four main elements: (1) time, (2) innovations, (3) communication channels and (4) social systems. Further, such a process of diffusion can be observable on a macro and micro level. The latter, which means the decision of an individual to adopt or reject an innovation is called the innovation-decision process. It is characterised by the procedure of “gaining initial knowledge of the innovation, to

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forming an attitude towards the innovation, to making a decision to adopt or reject, to implementation of the new idea, and to confirmation of this decision” (Rogers, 2003, p. 168). The process is described in figure 1. An innovation can hereby be a practice, an idea or object which is perceived as new by this individual (p. 12). Rogers defines adoption as the decision “to make full use of an innovation as the best course of action available”. Rejection, however, refers to the “decision to not adopt an innovation” (p. 177).

For a positive adoption decision, it is usually crucial to have the possibility to try an innovation. Most people who have tried an innovation, as already mentioned in the introduction, decide to adopt it in case it proves to have a relative advantage to a specific degree. Each stage of the innovation-decision process can be a possible point of rejection, even after the previous decision to adopt an innovation. This decision is called discontinuance. In addition, there are two different types of rejection: active rejection and passive rejection (p. 178). Active rejection describes the process of considering the adoption of an innovation but then deciding against it. Passive rejection or also nonadoption, on the contrary, means not even considering the adoption from the beginning on. Rogers observes that there is a lack of attention in research regarding the investigation of rejection behaviour.

Figure 1

A model of five stages in the innovation-decision process

Source: Rogers (2003, p. 170).

During the innovation-decision process, different communication channels play different roles. Rogers categorises communication channels as mass media versus interpersonal

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channels, on the one hand, and localite versus cosmopolite, on the other hand (p. 205). He argues that, as mass media channels can reach large audiences rapidly, create knowledge and spread information and change weakly held attitudes, they are relatively more important at the knowledge stage. Interpersonal communication, on the contrary, can accomplish the formation and change of strongly held attitudes by dealing with resistance or apathy. It follows that interpersonal channels are relatively more important at the persuasion stage of the decision process (p. 205). Further distinctions can be made between localite and cosmopolite channels and their roles at different stages of the innovation-decision process. Rogers argues that interpersonal channels can hereby be localite or cosmopolite, while mass media channels are mostly cosmopolite. Referring to Rogers, the influence through cosmopolite channels is relatively more important at the knowledge stage while localite channels show their influence rather at the persuasion stage in the innovation-decision process (p. 207). However, considering that his work was published in 2003, an extension would be needed here regarding the role of the internet and social media sites.

Rogers (2003) indicates that a decision to reject or to adopt an innovation is not the terminal stage during the innovation-decision process. During the confirmation stage, the adopter or rejecter searches for reinforcement for their decision already made. Individuals prefer hereby to “avoid a stage of dissonance or to reduce it if it occurs” (p. 189). This has an impact on their communication and information seeking behaviour. Rogers argues that consumers try to avoid such dissonances by seeking only information that confirms their decision and receiving only similar messages (Festinger, 1957). In case opposite information and messages that are not congruent to their decision reach the individuals, it can have an impact on reversing their previous decision.

Reusable menstruation management products are on the one hand, quite radical, and on the other hand, a stigma-laden change from disposable ones. Radical innovations, however, demand a higher level of knowledge by the actors for them to adopt the new technology. Roger argues that radical innovations, such as products of taboo or stigma, “represent a type of unstructured decision, and their adoption entails a much more difficult process” (p. 426). This suggests that new approaches are needed.

Roger’s diffusion of innovation theory didn’t change significantly during the last decades. Despite this, critical voices were raised; mostly concerning the dichotomy between acceptance and rejection of an innovation (Karnowski, 2013). By overcoming technological determinism and taking everyday life as a complex phenomenon into account, the domestication framework was developed. Originally, empirical studies referred to the domestication framework to describe, analyse and explain the acceptance, rejection and use of communication and

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information technologies (Berker et al., 2006; Karnowski, 2013; Silverstone et al., 2006). Domestication was seen as “a process of consumption” (Silverstone, 2006, p. 232). Later on, the approach got extended, covering not only new electronic technologies but any object in a household. It shifted to a “process of bringing things home – machines, ideas, values and information” (p. 233). Silverstone (1994) developed this approach further by categorising the domestication process into different dimensions: commodification, appropriation,

objectification, incorporation, and conversion. These dimensions are interrelated but not

successive.

Firstly, commodification is the way a possible user gets an idea about the innovation; through, for example, the influence of other users, commercials, and mass media (Karnowski, 2017). Secondly, appropriation can be explained by the motivations and reasons associated with the innovation in focus (Juntunen, 2014). It refers to the moment in which an innovation transforms from the status of just being a commodity to being an object with meaning. The dimension of appropriation consists of the negotiations, conflicts and decisions which play a role in adopting new technology and in including it into a personal or collective space (Gaybor, 2019; Haddon, 2011). Thirdly, the just mentioned dimension is carried out through

objectification, on the one hand, and incorporation, on the other hand. Objectification means

the spatial aspect, both mentally and physically. By attributing an object “cognitive and esthetic values”, the innovation takes a “specific place and meaning” in the user’s life [...and] contributes to the construction and manifestation of their personal identity, thereby legitimizing their acquisition and use” (Gaybor, 2019, p. 113f). Incorporation refers to the time and the way a user integrates an innovation into their social practices. The way people include a new product into their daily life and routines is shaped by “given meanings, symbolic values and practices” (p. 114). Lastly, the dimension of conversion includes how the ascribed meaning concerning the innovation is shared with others and how somebody is representing themselves with the object. Thereby, a user is reaffirming their decision (Gaybor, 2019; Karnowksi, 2017).

It is important to mention here that the process of domestication rarely happens without tension which can result in the non-adoption of the innovation (Karnowski, 2017). Here, it is important to refer back to Rogers’ definition of different kinds of rejections. Further, the process is dependent on characteristics such as gender, class, age as well as takes local and cultural ways of giving meaning to an object into account (Gaybor, 2019).

Even though researchers developing and applying the approach of domestication do not specifically elaborate on the importance of different ways of communication in different stages of the just explained dimensions, the diffusion of innovations approach has shown that they

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are crucial. Especially within the dimensions of commodification and conversion, media and communication must play important roles.

Method and material

To analyse the above-mentioned research questions an empirical analysis is conducted. Provided that there are only a few studies regarding the intentions of adopting or rejecting reusable menstrual products in a higher income setting (Gaybor, 2019; Lamont et al., 2019; Peberdy et al., 2019), and, to my knowledge, no investigation concentrating on the role of media and communication, a qualitative approach is chosen. The focus lies hereby on how interpersonal and mediated communication is carried out during the domestication and diffusion process. Interpersonal or face-to-face communication and mediated communication are in this sense seen as opposing (Krotz, 2009). Based on Krotz (2009), mediated communication refers to communication that relies not only on expressed signs and sounds but also on symbols. It includes traditional terms like mass media but also encompasses contemporary approaches like “more individualistic forms of mediated communication” (Napoli, 2018, p. 4) as well as targeted and personalized one-two-many communication forms that are implemented on newer media technologies and platforms, just like social media (Napoli, 2018).

The analysis of just mentioned is carried out by conducting semi-structured in-depth interviews. This choice is supported by Hartmann’s (2008) statement that research regarding domestication is still primarily based on qualitative interviews as a research method. Bryman (2012) summarized that the nature of qualitative research is, besides others, defined by the researcher’s search for “an understanding of behaviour, values, beliefs” (p. 408). Referring to the research questions and the underlying theory of domestication, this definition goes in line with the intention of this study.

By dividing the interviewees into two groups, the aim is to approach the topic from two different perspectives: From the point of view of the successful domesticators should tell those who tried a reusable menstrual product and have since continued to use this product with satisfaction. On the contrary, people who have tried such a product at least once but have decided to reject and not adopt it report from the perspective of the unsuccessful domesticators.

Selection of the interviewees

The interview partners are chosen by using a combination of sampling approaches, as suggested by Bryman (2012). First, the participants are chosen purposively followed by

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broadening up the contacts through a snowball method. Following the theory and research questions, two sample groups are developed: users of reusable menstrual products and active rejectors that have used such a product at least one time but decided against further usage. Kaiser (2014) argues that for qualitative interviews a selection of interviewees based on content considerations is justified. Additionally, addressing a stigmatising issue such as menstruation can be accompanied by communication barriers. By choosing only participants who are acquainted with the interviewer or were recommended and recruited by somebody who is acquainted with the interviewer, these difficulties are to be reduced or even avoided. Nevertheless, it can be assumed that such a sampling method will produce a fairly homogeneous group of participants which might share similar attitudes and experiences. Although representativeness is not sought, this must be taken into account in the evaluation of the results. Eventually, 14 interview partners got chosen, seven who were using reusable menstruation products during their period at the time of the analysis and seven who had tried them before but then rejected them.

Creation of the interview guides

The interviewees are asked to share their thoughts, feelings, and knowledge about their usage of reusable menstrual products. In order to get rich and detailed answers, semi-structured interviews are conducted. Thereby, flexibility during the interviews is ensured. An interview guide was, therefore, created including “fairly specific topics” (Bryman, 2012, p. 471). This style of interviewing allows the interviewer to react to things, pick up on topics, and ask in detail. However, mostly the same questions with similar wording are asked in the interviews. In general, the questions in the interview are generated in a narrative-generating way. Two slightly different interview guides are used during this process: one for adopters and one for rejectors. At the beginning of the interviews, the participants are informed about their rights and the aim of the study. This also includes the protection of personal data, anonymization, and the possibility to cancel the interview at any time. The interview guides can be found in Appendix I and Appendix II of this study.

In general, the conversations are intended to answer the research questions about the domestication process of reusable menstruation products and the role of media and communication within this. More specifically, there is a focus on the possible problems during the domestication process and how these problems were (not) overcome. The questions and topics that are broad up during the interviews are based on the five categories identified within the domestication framework: commodification, appropriation, objectification, incorporation, and conversion. Based on previous research by Gaybor (2019), Peberdy et al.

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case media and communication are mentioned or not mentioned, follow-up questions are asked. The order of the questions is supposed to follow a natural narrative flow while not being obligatory but can be adapted to the interview situation.

Table 1

Operationalisation of the categories

Commodification - first idea and knowledge development of products - role of media and communication

Appropriation - motivation and reasons to use the product - way of informing about product

- role of media and communication - conflicts during the decision process - experience during the purchasing process Objectification - values connected with the product

- coinciding with personal values and attitudes - function in life

- physical handling of product while cleaning and storing Incorporation - difficulties or challenges when using the product

- role of media and communication - process of getting used to the product

Conversion - conversations with somebody who had similar experiences - recommending/not recommending the product to anybody - role of media and communication

Sample and analysis strategy

The sample consists of seven users and seven rejecters, all of them identify themselves as women and use she/her pronouns. The group of users includes participants coming from Germany, Hungary, Spain, Sweden, and Switzerland, while six of them live in Sweden and one in Germany. The participants in the group non-users are all Germans, two living in Sweden, two in Germany, two in Austria, and one in Switzerland. The age of all participants ranges between 21 and 27 with an average age of 24 in both groups. All participants are currently taking courses at a university. As already mentioned, the process of adoption and domestication is dependent on characteristics such as gender, class, age as well takes local and cultural ways of giving meaning to an object into account (Gaybor, 2019). This has to be considered when analysing and evaluating the data.

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The interviews were conducted individually via Zoom in weeks 17 and 18 of 2021. The first conversations with a user and a rejector were treated as a pretest and provisionally evaluated. The interview duration, flow, and guiding questions were appropriate and worked well, so no major changes to the guides were necessary. In general, more specific questions about the role of media and communication were added. However, the pretest interviews are fully included in the sample. All interviews took between 22 and 38 minutes.

The conversations were conducted in English and German language and transcribed in this respective language. Statements and quotes used in the analysis, later on, are translated by the researcher herself. The transcription follows the rules proposed by Kuckartz and Rädiker (2019). The conversation is transcribed as literally as possible. Language and punctuation are approximated to written English. Longer and clear pauses are marked by ellipsis points (...) placed in brackets. Laughter and other vocalisations are noted in brackets if they clarify the statement.

Figure 2

Thematic qualitative text analysis process

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As the method of analysis, the thematic qualitative text analysis is chosen for this research, which is mostly based on Kuckartz (2014). Figure 2 shows how the building of categories and analysis is conducted. After the initial work with the text to highlight important text passages, the main thematic categories are developed. In this case, the main categories are created deductively based on domestication theory and the major guidelines used in the data collection. Then, the first coding process is carried out using the main categories. After compiling all of the passages assigned to each of the main categories, sub-categories are determined, and a second coding process is conducted. These steps all end in a category-based analysis and presentation of results. “By comparing and contrasting sub-groups of interest, the category-based analysis gains sophistication, complexity, and explanatory power” (Kuckartz, 2014, p. 70). The analysis is carried out with the help of software for computer-assisted qualitative data analysis (MAXQDA).

Analysis and presentation of results

During the analysis, it became clear that the participants are divided into three groups according to usage, rejection and satisfaction of the adopted or rejected product: users, satisfied rejecters and unsatisfied rejecters. The group of users (n=7) is congruent with the group of users chosen in the sample. All of them have tried and adopted at least one reusable menstrual product. Satisfied rejecters (n=3) had adopted a product but decided to discontinue it. However, they report that they have been satisfied with their chosen product. Lastly, unsatisfied rejecters have tried at least one reusable menstrual product but decided during the adoption and domestication process to discontinue – they state that they have not been satisfied with the product (n=5). One participant counts in both rejecter groups as she tried two different products and had different experiences with them (R05). Depending on what products she refers to she is counted in either of the groups in the analysis.

In general, all users have adopted menstrual cups, one additionally adopted reusable pads (U07). All rejecters have tried to adopt cups, one additionally tried out menstrual underwear (R05), another one washable pads (R06). Most users describe their parental home as academic (n=4); most unsatisfied rejecters categorise their parental home as a combination of academic and working-class (n=3). Regarding the duration of successful adoption, the users mention that they have used their products for between three months and six years. All satisfied rejecters had used the products for around two years. Most unsatisfied users had used the products only for one day, only one rejecter had used it for two cycles (R05).

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Commodification

In the first part of the interview, the questions aimed to explore how the users and rejecters got an idea about the products, through for example other users, commercials, or mass media. During the interviews, it was shown, that for some users as well as rejecters exclusively interpersonal communication played a role, for some only information on social media and for others the combination of communication channels including advertisement, social media and interpersonal communication were decisive. Users and rejecters that didn’t have any interpersonal communication before deciding to adopt the products (U02, U05, U07, R03, R05) got in contact with reusable menstrual products through the internet. They explain this, on the one hand, by not having any “friends [that were] using them by that time” (U07), on the other hand, they indicate that there was some kind of communication barrier between them and other possible users in their environment. They report that they have been “shy” (R03) or “less open about this” (U02). One user formulates the barrier like the following:

U05 – “I wasn't like, ‘Oh I heard about this new thing, friends. Have you heard about

it?’ This was like 6 years ago; we didn't talk about that in my friend group so much that you mostly said, ‘Yeah I'm on my period’ and no follow-up questions.”

This can be interpreted as a sign of stigmatization surrounding menstruation and reusable menstrual products. As previously mentioned, the stigma around periods can be seen in how it is referred to in media and communication but also in the actual silence about it (Johnston-Robledo & Chrisler, 2013). Further, previous research about stigmatized innovations suggests that one barrier to the adoption of such products are psychosocial risks that are reflected in embarrassment, risk of disapproval, shame or unease (Ndichu & Rittenburg, 2021). Participants refusing direct conversations with peers and informing themselves exclusively through new media avoid these risks as it “offer[s] reprieve from system norms that create a taboo”, as Sundstrom (2014, p. 87) already argued.

However, other users and rejecters mention that they have tried the product as a direct outcome of conversations or recommendations without reported or recognised influence from media, advertising or social media (R01, R05, U01, U06). They express that friends and flatmates recommended or explained the products. It is striking, that the users and satisfied rejecters emphasize in their explanation how friends “explained how it works” (R05), how they addressed their concerns, “explained that it is not like that” (U06) and how they informed themselves in a group (U01). One unsatisfied rejector, on the contrary, underlines how the conversation was pressuring her from the beginning:

R01 – “A friend […] tried the cup and told us all how great it was and tried to convince

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Two aspects of these findings are especially interesting: first of all, the behaviour of those friends recommending the products, second of all, the importance of interpersonal communication during the knowledge and persuasion phase. Referring to the former, previous research regarding sustainable product innovations shows that consumers adopting such products tend to raise awareness and to lobby for those themselves as they “inject the spirit of sustainability into their own lives” (Verbong, 2019, p. 241). Even though it is not apparent whether the named friends of the participants were motivated by a sustainable attitude, this reason could be suspected for them to share their thoughts as the sustainability aspect of reusable menstrual products is salient. The last-mentioned quote of R01 shows, on the contrary, how such consistent lobbying can lead to pressure on the part of the participants. Referring to the role of interpersonal communication during the knowledge and persuasion phase, Rogers (2003) notes that radical innovations, just like reusable menstrual products, demand a higher level of knowledge of actors to consider adoption. Further, interpersonal communication can accomplish the formation and change of strongly held attitudes during the persuasion phase by dealing with resistance or apathy. These theoretical considerations can be found in the statements of the users and satisfied rejecters.

All three participants who mention that they were influenced exclusively by social media say that they were going through a “lifestyle transition” (U02), trying to implement more sustainable habits into their life accompanied by following influencer on social media posting about sustainability, zero waste and veganism (U2, U3, R03). Differences between users or rejecters could not be determined. This finding allows referring back to the role of influencers on social media as opinion leaders regarding advocating sustainability. Chwialkowska (2019) argues that on social media peer communication and consumer socialization coming from influencers can provide knowledge and skills as well as it can influence behaviour. This gets apparent in the statements of the participants. However, since also one unsatisfied rejecter (R03) reports on this kind of influence, the question arises whether this influence is strong enough to be resistant to difficulties that may emerge later during the decision-adoption phase.

Appropriation

The second part of the interviews targeted the motivation and reasons for adopting reusable menstrual products as well as possible conflicts in the decision process and ways of informing about the products.

Motivation and reasons

Different motivations and reasons for people to adopt reusable menstrual products can be found. In general, the participants mention comfort, curiosity, external pressure,

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sustainability, health aspects, financial aspects and practicality as reasons to use reusable menstrual products. The main motivation was hereby consistently sustainability, specifically the reduction of waste. One satisfied rejecter expands on this reasoning even further:

R06 – “I think the first big reason is that I wanted to avoid this waste. But I also

wanted to avoid the pesticide use with the cotton that goes along with it. On the one hand for me, but also for the world.”

As all participants have been at least open to trying sustainable products, this goes on in line with the findings of Peberdy et al. (2019). They discovered a correlation between the level of environmental awareness of menstruating people and their openness to choose sustainable friendly period products. The same connection can be found in this case.

Around half of the interview partners throughout the groups took health as well as financial aspects during the decision process into account but rather as “side motivations” (U02). Regarding health, the participants addressed two concerns during the usage of conventional tampons: contained toxins and bleach as well as the drying out of the vaginal flora. Furthermore, most of the participants emphasize the practicality of especially the menstrual cup by addressing options of being more active or careless when using it.

R06 – “It was a big advantage that I saw for myself, that I change it less often. Much

more practical. And you can really let your period be your period for a short time, you don't have to think about it every 3 or 4 hours in your everyday life.”

R05 – “I didn't have to change it as often as a tampon for example, once in the

morning, once in the evening. I don't have to worry anymore, especially in the summer when you went swimming. I felt safer with it.”

However, two persons don’t mention practical reasons at all as their reasons to adopt the products, both are interestingly unsatisfied rejectors (R01, R07). Moreover, curiosity (R02, R03) and external pressure (R01, R02) are only mentioned by rejecters.

Previous research has mentioned that using sustainable product innovations and specifically using reusable menstrual products can satisfy economic, environmental, and social needs (Guerin, 2011), separated into personal and collective needs. Also, it can be motivated by practicality and comfort (Gaybor, 2019). All these motivations can be found also in this analysis. Still, the reasons curiosity and external pressure, only mentioned by rejecters, are new. This can be explained as previous research mostly analysed motivations and reasons of adopters that stuck to their decision. Consumers that adopted or tried a product and then rejected them are usually not covered. At this point, conjectures can be made as to why curiosity and external pressure can only be found among rejecters. An explanation could be

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that such motivations have an impact on trying a new product, but they are not sufficient to overcome barriers that can appear during the usage.

Conflicts and decision

Several similar conflicts during the decision process can be identified in the sample. Most mentioned conflicts are financial barriers, uncertainty about the application, and decision-making problems during and before the purchasing process. Nine participants saw the relatively high purchase price as a hurdle (U01, U02, U03, U05, U06, R01, R05, R06, R07) even though most of them knew that reusable products “are cheaper in the long run” (U02). In particular “insecurities” (U05) if the investment is worthwhile were playing a role.

R05 – “You pay quite a lot of money, and I was worried that if I didn't like it, I would

have spent the money on a product that I don't use.”

U01 – “I was really sceptical at first, because if I order this now and it doesn't fit, then

I have to order a new one and if it doesn't fit again, I have to order a new one and that ends up costing me money and that's frustrating.”

This goes in line with previously found barriers to adopting sustainable product innovations (Chwialkowska, 2019). The second quote also alludes to another conflict, and that is the application. More than half of the participants experienced during the decision phase uncertainties and concerns regarding how to actually use the menstrual cup. This includes, for example, the knowledge and fear of possible difficulties when inserting, removing or leaking also in connection with negative experience regarding the usage of tampons (U02, U04, R03, R04, R05). Similar concerns have been stated by previous research in low and middle-income countries (VanLeeuwen & Torondel, 2018). Also, the fear of public shame and exposure went hand in hand: the fear of having to go to the “gynaecologist” (R04) or to “stand there with your mishap” (R05). Here, the stigma around reusable menstrual products comes into play. Previous research about the adoption of other stigmatized innovations mentioned similar psychosocial risks perceived by consumers (Ndichu & Rittenburg, 2021).

When asked how they informed themselves about the application and usage of the chosen product, the participants gave a variety of answers: YouTube, the websites of producers, the instructions in the packaging, friends, Google, and advice in a pharmacy. Particularly interesting are the answers of the unsatisfied rejecters who, in comparison to the other participants, conspicuously often obtained information directly from manufacturers' websites (R01, R03, R04, R07).

It is (not) in my blood : An analysis of the domestication of reusable menstrual products and the role of communication