Rethinking the flow: menstrual and continence care for every body​ (2025)

At Open Inclusion we recently did some research to better understand experiences and uncover disability-specific barriers around menstruation and incontinence management and wellbeing.

Through a focus group and in-depth interviews with disabled people, and individuals with chronic health conditions or unique product, needs we uncovered key insights that identified significant gaps in product design, packaging, inclusive branding and representation, and education.

These gaps aren’t just inconvenient — they impact the health, safety, dignity and confidence of disabled people managing menstruation and incontinence.

These conversations revealed:

• the complexity of managing periods or incontinence with today’s products when combined with disabilities or other access needs, and
• the opportunity to create products, packaging, information and marketing materials that could enable greater independence and dignity needed by some and which could benefit many customers.

This short article explores the top findings and what they mean for the future of menstrual care and personal hygiene, especially to people living with a range of disabilities.

Menstruation and toileting are normal parts of life. Yet for many disabled women and people who experience incontinence, managing these experiences is far from straightforward. Life can include messy moments! These moments matter.

Menstrual cycles impact women for decades of their lives from puberty to menopause. Urinary incontinence is estimated to effect 5-10% of the population (est. 7 million people in the UK) of which the majority are also women as our bodies get impacted by pregnancy, childbirth and the menopause. Men also experience incontinence whether due to disability, age or other triggers.

Many disabilities make menstruation or incontinence management harder. The products currently available are not well designed for our varying bodies such as those of us with limited dexterity, mobility or sight loss, varying cognition, sensory needs or significantly heavier flows.

Managing heavier cycles: Conditions like fibroids or endometriosis can mean managing very heavy periods, increasing the risk of leaks and making frequent product changes essential. This becomes especially challenging — and anxiety-inducing — when out in public, at work, or travelling. Leaks can be deeply embarrassing and induce future fears of monthly body management.

Women who work in male dominated workplaces don’t always have suitable bathrooms and time flexibility for product changes, let alone frequent product changes.

We heard from someone who works in the travel sector that changing in public restrooms with heavy periods that need to be managed with a limb difference is difficult. Sufficient space, opening product packaging, placement, and lack of in-cubicle basins for cleaning can all make days when she is menstruating harder and messier.

Double trouble: Products don’t tend to consider combined needs of incontinence and menstruation. We heard from disabled women who experience incontinence and monthly have a double up of needs. While disabled women may experience this for years, we also heard (and know) that post-partum experiences for some women also create a similar ‘double up’ for a time after giving birth.

Managing with support: For those who rely on a carer to manage intimate hygiene, having to wait for a preferred person or scheduled support can lead to less frequent product changes, impacting comfort and health.

One woman when learning to manage a recent spinal cord injury tried to limit changes to a preferred carer who was available at the start and end of each day but not throughout. She ended up being hospitalised with toxic shock because of this preference. The implications of disability-related menstruation management challenges can be serious.

Inclusive design isn’t just the right thing to do — it’s smart innovation. And for the organisations ready to lead, it’s a valuable business opportunity.

Women may be half the population, but they are more than half of the disabled population and yes, disabled women menstruate.

1 in 7 people globally are disabled, but the prevalence varies by gender and geography. 1 in 5 women are disabled according to the World Bank. The greatest gender differences in disability are in low and middle income countries where up to 75% of disabled people are women (UN Women).

Despite this large market, most menstrual and continence products have not been designed with disabled users in mind. That’s a huge gap — and a huge opportunity.

We welcome ambitious organisations and innovators.

Improving the inclusive design considerations for menstruation and incontinence products, packaging, and brand positioning is great for your customers, your brand, and your bottom line.

We’ve identified two priority areas for progress

1. Product and packaging design
2. Representation and information

• Outer packaging and individual product inner packaging can be very difficult to independently open to access the product for people with limited dexterity, strength, mobility or flexibility.
• Placement of pads and tampons require a level of dexterity that makes it difficult or impossible for many people to use independently, requiring some to use alternative products or seek help with one of the most intimate and personal aspects of their bodies.
• Pads and tampons often leak or don’t fit properly, particularly for people with unique body shapes or heavy bleeding caused by fibroids or endometriosis.
• Menstrual cups are effective and sustainable — but hard to use for people with limited dexterity or nerve pain.
• Public restroom design (small stalls, hard-to-reach toilet paper, limited space or places to clean up) makes changing products even harder for people with disabilities. Accessible washrooms are particularly helpful but not always available. Women with non-apparent disabilities are less comfortable using them also.
• Products that work for both menstrual and bladder incontinence are almost non-existent (or at least unknown) — yet many people face both issues simultaneously.
• A more limited range of solutions that are independently usable for an individual can create pressure to use less sustainable, single-use products despite personal or environmental preferences.

Representation barriers identified,

• People with disabilities are either erased from advertising or presented at the extremes (pity or pedestal) rather than in their more normal and nuanced realities
• Products are rarely shown in the context of real-life scenarios — like a construction site, airplane bathroom, or wheelchair-accessible restroom.
• Stigma around incontinence and menstruation can prevent people from seeking help from professionals or discussing solutions with friends. Disability adds to this challenge as fewer people experience these bodily management challenges as you do, so fewer people able to practically offer better solutions aligned to your differentiated needs and contexts.
• There is a broader lack of understanding and acceptance of how menstruation and disability intersect — leading to heightened exclusion and discomfort.

The lack of education around menstruation and incontinence is widespread. Disability amplifies this gap.

Many girls, men and boys, and others without firsthand experience have little understanding of what managing a period or incontinence involves. Even those who do experience incontinence or menstruation may have limited knowledge and find it hard to access the information they would like. Very few people consider or understand the intersection of disability and either menstruation or incontinence. Information gaps enable confusion, shame and discomfort to emerge and are missed opportunities for empathy and help.

Information and education barriers identified,

• School curriculums often treat menstruation as a side note. When it is covered, it’s rarely framed in a way that’s accessible to students with different learning styles, communication needs, or body types.
• Students with disabilities impacting communication, such as deaf sign language users, those who learn differently or students with sight loss may not get the same quality and breadth of education due to access barriers. We heard of sign language interpreters being uncomfortable or lacking the skills to accurately interpret personal hygiene and sexual health information in classrooms where the primary communication was verbal.
• Outside of school, health education often doesn’t reflect differentiated needs of disabled people or have the personally relevant information required
• In many families and community settings, menstruation and incontinence are treated as taboo — and disability adds an extra layer of discomfort. That means fewer open conversations, and fewer chances to share useful tips or support.
• This lack of quality, relevant information leaving many disabled people without basic information on managing their bodies independently with dignity.

Information is power – but this power is only available to those for whom information is personally relevant, shared, understood, and accessible.

The gaps in menstrual and incontinence care aren’t just design flaws — they’re signals of deeper, systemic exclusion. They also point to a powerful opportunity.

• For product designers: Build with inclusion from the start. Design with, not just for, the people who’ve been left out for too long.
• For marketers: Ditch the white clad skipping stereotypes for menstruation products or Viagra styled ads for men’s incontinence products. Tell real stories. Show real people. Representation builds trust.
• For educators: Push for frank, accessible, and inclusive reproductive health education that reflects and supports every body.

This isn’t just about better products. It’s about dignity, independence, and equity. It’s about recognising the full diversity of human experience — and designing a world that works for all of us.

The insights are clear. The need is urgent. The opportunity is here.

Let’s close the gap — and open the door to intimate care solutions that include everybody.