THE disposable sanitary pad debuted in the late 19th century. It was such a taboo that a purchase involved dropping the exact sum in a box at the chemist’s counter. The pack was handed over, no words uttered. Menstrual products could not be advertised on American television until 1972. In 2015 an ad showing a runny egg yolk was questioned by New York’s subway for being too suggestive of period flow (which was the point).

Squeamishness has hampered innovation. The applicator tampon, invented in 1931, was the last big novelty in menstrual devices to go into widespread use. Its cardboard applicator, a tube within a tube, allowed women to push a tampon inside without committing another no-no (touching their bodies).

In the decades since, big manufacturers such as Procter & Gamble, Kimberly-Clark and Essity have only made tweaks. Pads became thinner and acquired an adhesive strip. Plastic replaced cardboard in applicators. Compact tampons with no applicators that fit into pockets and small handbags appeared in the 1960s. Recent novelties include a black pantyliner to match the most popular colour of underwear.

Yet firms have shied away from bringing out alternatives to pads and tampons. With well-established brands and profit margins reaching over 50% the status quo makes for solid business. Startups struggled to sell new products with advertising that allowed only veiled allusions to how they are used. An insertable rubber cup, from a startup in the 1960s, flopped, in part because of these hurdles.

The rise of online marketing and e-commerce have spurred new products. Startups are trying to win a slice of the market (worth some $ 19bn globally) in America, Australia, Canada and Finland. THINX, Knix Wear, Dear Kate and Modibodi make knickers of absorbent, leakproof fabrics that can be tossed in the wash and reused. The Flex Company offers a menstrual “disk”, a soft pouch to collect menses which is attached to a bendable polymer ring. When inserted, the ring creates a seal between the pouch and the cervix. It can be worn for 12 hours, including during sex—a feature that grabbed men’s attention when she pitched for funding, says Lauren Schulte, the firm’s founder. Diva, Intimina and Mooncup make reusable silicone cups that also go inside the body.

They can get off the ground without expensive television spots. Online ads direct intrigued consumers to websites with step-by-step instructions, videos and user reviews. E-commerce lets manufacturers bypass high-street retailers. Flex offers a subscription, paid monthly.

These newfangled products remain niche for now. Tampax Pearl tampons rake in $ 290m a year in America alone; Diva sold only around $ 20m-worth of cups worldwide in 2017. But that is up from $ 2.5m five years earlier. Its most popular model was the top-selling “feminine hygiene” product in Canada by dollar value in 2016, according to Nielsen, a market-research firm. Flex, too, has seen demand soar. “We had to pause marketing because we ran out,” says Ms Schulte.

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