In a region where many communities chastise unmarried women for not being "virgins," tampons, believed by some to cause hymen breakage, are still rare.
It is a hot, humid day in Manila and 24-year-old Yen would like to go for a swim. While her male companions are free to splash around in the cool waters, she and her girlfriends can't indulge in this activity for about six days every month.
Yen, a university student, explains how a limited availability of tampons across the Philippines restricts many menstruating women from swimming or sports activities. "We miss out on the fun because we have our period … It's frustrating that tampons are not readily available."
Myths about menstruation
Menstruation has long been a taboo subject in many parts of Asia, widening gaps in knowledge about female reproductive health.
"Many women grow up in a society which doesn't facilitate talk about sex, the reproductive organs, the vagina, or sanitary issues," Varistha Nakornthap, founder of Cuppers Community Thailand, said. In some conservative communities, limited sex education and restricted dialogue feed myths and misconceptions about the female body.
A common myth surrounding menstruation is, for example, that contact with a woman having her period brings bad luck or contamination. In Nepal, an estimated 19% of women aged 15 to 49 follow a centuries-old practice known as "chhaupadi,"in which women are forced to spend the days when they have their period in outdoor huts. In India, menstruating women are not allowed into temples.
In several Asian countries, the usage of tampons has also been linked to women's sexuality. Some unmarried women find themselves socially stigmatized if caught using a tampon. Speaking to DW, several women from different East Asian countries said that in the societies they lived in, virginity was highly valued and using tampons was often associated with hymen destruction. Some spoke about possible health threats, including toxic shock syndrome and urinary tract infections.
Virginity still a virtue
There are no conclusive studies to suggest that a tampon breaks the hymen and "takes away" a woman's virginity. However, that myth is still prevalent.
University student Yen feels the tampon has been unsuccessful in the Philippines because many people believe that using a tampon, "means you're not a virgin." In Filipino society, which is heavily influenced by the Catholic Church, Yen said, "It's better to hide you're having unsafe sex than for people to know you're sexually active."
She believes the concept stems from the Spanish colonization period when women were severely repressed. She spoke of Maria Clara, the national heroine of the Philippines, who was raped by a Spanish priest under Spanish occupation.
"Maria Clara was characterized as timid, lady-like, and very conservative. So the Filipinos say, 'You should act like Maria Clara.'" Yen added that unmarried women feel pressured to hide anything that could potentially signal sexual activity, including using tampons.
Read more: 'We need men to talk about periods'
Twenty-seven-year-old Quan, a doctor at Vietnam's Can Tho Tumor Hospital said he'd never seen a tampon in his life and explained that "traditional" Vietnamese would "very likely assume" that any woman using tampons were not virgins.
Thi, his wife, knows only married women who use tampons. In neighboring Cambodia, Sonit Tholly from Phnom Penh said that many women don't use tampons for the same reasons and emphasized that "virginity values" are still "treasured" in large parts of Cambodian society.
Meanwhile, in Seoul, Juen, a 28-year-old businesswoman, attributes the unpopularity of tampons to South Korea's patriarchal culture. She explained that the country's "virginity pressure" deters some women from using tampons.
"Men still want to see a girl as a weak figure that needs to be protected,” she said, adding that the sexist mindset extends into women's sexual lives. "Men should always be the ones who want sex and girls must accept it in a passive manner," she said.
From traditional woven cloths in Cambodia to reusable fabric pads in Thailand, a "pad-like" style for dealing with the monthly cycle has existed for centuries and remains the region's favorite.
Rena Park, a young professional from Busan living in Seoul, explained that some members of South Korea's younger generation believe that sanitary pad companies, which dominate East Asia's female hygiene market, have fabricated myths and perpetuated stereotypes related to virginity and hymen destruction in their bid to stay on top of the market. She says it's possible that sanitary companies lobbied for a long time against the sale of tampons.
More recent discussions on women's hygiene, however, have turned towards the menstrual cup. The flexible vessel, made of silicone or latex rubber, collects menstrual blood instead of absorbing the flow and can be used several times over.
Heightened environmental awareness is increasing the cup's popularity in cosmopolitan cities across Southeast and East Asia because it is seen as an eco-friendly alternative to pads and tampons.
Nakornthap of Cuppers Community said that misinformation contributed to an overall lack of understanding and the exaggeration of myths around menstruation and the female sexual organ. She is hoping that advocating the menstrual cup and stimulating new forms of dialogue will change all that.