JMIR Publications

ABSTRACT

Background:

Menstruation has long been framed primarily as a hygiene issue, with mainstream products and public messaging emphasising concealment and disposal of menstrual blood (MB). This has contributed to a culture of silence in which conversations about menstrual health have been marginalised in both public and clinical settings. Recent international guidance, including the World Health Organisation’s call to reframe menstruation as a health issue, underscore the need for more open discourse. At the same time, social media has become a prominent space where menstruating individuals share experiences, seek advice, and challenge stigma. The resurgence of reusable menstrual products, especially menstrual cups, has increased users’ direct observation of MB, prompting questions about variations in colour, texture, and smell. These developments highlight growing curiosity about MB yet reveal persistent information gaps regarding how MB is understood outside clinical environments.

Objective:

This study aimed to examine how MB is represented in social media discourse and to explore individuals’ perceptions of MB’s potential use as a diagnostic tool.

Methods:

We conducted a mixed-methods social media listening study combining qualitative content analysis, social network analysis, sentiment analysis, and descriptive statistical analysis. Data were collected from TikTok, Facebook, Instagram, and Reddit using Mention and Apify. Between February 1 and 28, 2025, 6,263 posts and videos were extracted using three strategies: group searches, hashtag searches, and social listening alerts. All data were anonymised, and demographic information was unavailable. After removing duplicates, non-English content, images, and posts without reference to blood, 349 posts were included. Coding followed a multi-step deductive process in Atlas.ti. Network analysis examined associations between appearance descriptors and reported health conditions. Sentiment analysis assessed perceptions of MB-based diagnostics.

Results:

Among the 349 included posts, most originated from Reddit (65%) and Facebook (26%). Seeking help was the most common type of post. Appearance descriptions focused on colour (189 mentions), particularly brown, bright red, pink, and black; consistency (123 mentions), particularly coagulation; and smell (23 mentions), mainly unpleasant or metallic. Network analysis linked specific colours and textures to perceived conditions, including miscarriage, endometriosis, hormonal changes, PCOS, and infections. Discussion of MB as a diagnostic tool was less frequent (81 posts) but predominantly positive (78%), emphasising accessibility, non-invasiveness, and home-based sampling. Concerns focused on inclusivity, stigma, and bodily autonomy.

Conclusions:

Social media users often interpret menstrual blood (MB) characteristics as diagnostic indicators. These findings highlight the need for better menstrual health education and awareness of MB-based diagnostic testing in clinical care. Integrating patient-described MB features into clinical conversations could improve diagnostic pathways and drive innovation in sexual and reproductive health. This work supports emerging research on MB as a diagnostic medium and shows how patient-generated data can inform future clinical practices.