A Cochrane review [Abstract] 1 included one cross-over trial with a total of 85 subjects. This trial studied six absorbent product designs: disposable insert pads, menstrual pads, washable pants with integral pad, and washable insert pads. For preventing leakage, for preference and for overall acceptability disposable insert pads are better than disposable menstrual pads which are better than washable pants with integral pad which are better than washable insert pads. There is no strong evidence that either disposables or washables are better for skin health. The disposable insert is the most expensive design and there is no dominant design for cost-effectiveness. There is evidence that some women will prefer alternative designs which are all cheaper than disposable inserts..
Comment: The quality of evidence is downgraded by limitations in study quality (cross-over design) and by imprecise results (few patients).
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