For years, menstruation has been a topic steeped in social stigma and medical under-research.Now, a growing wave of scientists and entrepreneurs are challenging that status quo, investigating menstrual blood as a potential goldmine for early disease detection. Recent breakthroughs, including a new rapid-test procedure developed at the University of Zurich and detailed in Advanced Science, offer the possibility of at-home biomarker analysis using standard sanitary products – potentially revolutionizing women’s health diagnostics.
For decades, depictions of menstruation in advertising and public health materials have often relied on a sanitized, unrealistic blue liquid. But a shift is underway, with growing recognition of the importance of studying menstrual blood for insights into women’s health – and overall wellness. This change gained momentum in September 2021 when Procter & Gamble announced it would begin featuring realistic red depictions of blood in its feminine hygiene products.
Historically shrouded in stigma, menstruation has been largely overlooked by medical research. Now, scientists worldwide are investigating menstrual blood as a potential source of biomarkers for diseases like cancer and diabetes. This emerging field is also attracting attention from startups eager to develop new diagnostic tools. The advancement of these methods hinges on continued research and broader societal acceptance.
“Period blood is an informative bio-fluid with additional biomarkers from vaginal fluid,” explains Inge Herrmann, a chemistry professor at the University of Zurich and head of the Ingenuity Lab at the Balgrist University Hospital. Professor Herrmann and her colleagues recently unveiled a rapid test procedure capable of detecting biomarkers in menstrual blood collected on sanitary pads, as detailed in a study published in Advanced Science.
The test utilizes a non-electronic sensor – a paper-based rapid test strip embedded within a flexible silicone chamber – integrated into the sanitary pad. After use, a smartphone image of the pad is analyzed by an artificial intelligence-powered app. Functionally, the at-home test mirrors a COVID-19 test, but analyzes blood instead of saliva. When a biomarker in the menstrual blood interacts with a specific antibody on the test strip, a line appears. The intensity of the line corresponds to the concentration of the protein, providing a visual reading or a precise measurement via the app’s machine learning algorithms.
The test focuses on three biomarkers: C-reactive protein (CRP), an indicator of inflammation; carcinoembryonic antigen (CEA), a tumor marker elevated in some cancers; and CA-125, a protein that can be elevated in endometriosis and ovarian cancer. “Our test procedure can indicate not only women-specific diseases, but generally any disease detectable in the blood,” Herrmann stated. This represents the first functional sensor capable of analyzing whole blood directly from a sanitary pad – eliminating the need for a laboratory.
Menstrual Blood Offers Clues to Cancer and Diabetes
Herrmann is not alone in her research. Gynécologist Paul Blumenthal of Stanford University is a pioneer in the field. A 2022 study led by Blumenthal demonstrated the presence of two key indicators in menstrual blood: high-risk human papillomavirus (HPV), which can lead to cervical cancer, and hemoglobin A1c, a crucial parameter for diagnosing and managing diabetes. These findings suggest menstrual blood could offer a non-invasive way to screen for these conditions.
Blumenthal emphasized in an interview with The Stanford Daily, “Women need to generally know that the blood is not waste product. It has a health value.”
Beyond academic institutions, menstrual blood is increasingly recognized as a valuable resource by the burgeoning “Femtech” industry. Several startups, often women-led, are developing specialized blood tests. Qvin, based in California, is one of the most well-known, working on a specialized sanitary pad, dubbed the “Q-Pad,” designed to detect health markers in blood. CEO and physician Sara Naseri has collaborated with Blumenthal on studies.
In Germany, Theblood, a Berlin-based company, has developed an analysis process to diagnose conditions like diabetes and endometriosis using menstrual blood samples. Isabelle Guenou, the company’s founder, has personal experience with endometriosis, which motivated her to create a diagnostic tool that validates women’s biology. She describes menstrual blood as “non-invasive, monthly, and accessible to millions.”
Early detection of hormonal, gynecological, and metabolic issues could be significantly improved. “If we harness this potential, we can not only make earlier diagnoses, but also make women’s health visible and measurable.”
It’s important to note that an elevated biomarker doesn’t necessarily indicate disease, cautions Herrmann. However, these rapid tests could allow for more targeted and efficient use of expensive medical investigations. The tests are designed to be user-friendly and potentially cost-effective, and could be particularly beneficial in regions with limited access to healthcare.
Menstrual Blood Tests: Not Just a Lifestyle Product
In an era of personal health tracking, it would be easy to market these tests as lifestyle products. Some startups may pursue this approach. However, researchers like Herrmann aim to create genuine medical value. “We want to develop a technology that is meaningful and offers medical benefit,” she says.
Menstrual blood remains a relatively understudied area of research, with gaps in existing literature. Herrmann’s team faced initial challenges in understanding the complexities of menstruation and blood composition. “We had to develop not only the chemistry, but also understand the fundamentals, the biology,” she explains.
Herrmann’s work has faced criticism, with some individuals expressing concerns about the focus on women or the use of artificial intelligence. Her pad-and-app test, named “MenstruAI,” has drawn particular attention.
Following an initial feasibility study with volunteers, a larger field study involving over 100 participants is planned for the coming years to assess real-world performance. If all goes according to plan, Herrmann anticipates the test could be commercially available by the end of 2027, and compatible with standard sanitary pads. Whether health insurance will cover the cost remains to be seen.
