Each month, 1.8 billion people menstruate. This blood, normally discarded as waste, can reveal quite a bit about the status of someone’s health. If scientists used menstrual blood instead of venous blood draws to detect biomarkers and monitor disease, it could open up the possibility for less invasive and more accessible blood tests. However, unlike urine or blood, menstrual blood hasn’t been widely seen as a diagnostic sample and there have been very few scientists studying this area.
“To put it in a nutshell, the field's not very crowded,” said Lucas Dosnon, a PhD candidate in the mechanical engineering department at ETH Zurich, who has been trying to tackle this problem. Recently, Dosnon and his colleagues in Inge Herrmann’s lab developed a point-of-care test to detect biomarkers straight from menstrual blood (1). Historically, blood tests, including those that use venous blood, required the samples be sent to a lab to process the blood before it could be analyzed. Their new test, a device that consists of a silicon casing that collects menstrual blood and contains a lateral flow assay to detect biomarkers, sits within a menstrual pad for direct analysis without the need to pre-process the blood.
Lucas Dosnon cofounded the company MenstruAI based on this work.
Credit: Charlotte Meyer
Before using menstrual blood, Dosnon first added specific amounts of biomarkers to venous blood to create reference points so that biomarkers could be quantified in future tests. The biomarkers he chose for this study were C-reactive protein (CRP), which is often elevated during infection and inflammation; carcinoembryonic antigen (CEA), which is elevated in gynecological cancers; and cancer antigen 125 (CA-125), which is elevated in gynecological cancers and endometriosis. Once they obtained these curves, the team moved on to the next stage: designing the in-pad wearable sensor. Their design encased the lateral flow test in a silicon casing that was enmeshed into the pad. The main question here was whether the lateral flow test could still work even with minor stressors like normal body movement or sitting. To find out, volunteers wore the pad for four hours during menstruation. After the four hours, the team found that the lateral flow tests ran properly. Study participants noticed no difference in comfort compared to commercially available sanitary pads.
The last part of their study focused on the point-of-care aspects of the test. They developed a smartphone app that takes pictures of the test results and determines the concentration of the different biomarkers. By adding CRP, CEA, and CA-125 into menstrual blood, Dosnon found that the app reliably detected and quantified these biomarkers in menstrual blood.
Christine Metz, a reproductive health researcher at the Feinstein Institutes for Medical Research at Northwell Health who was not involved in this study, said that the work is a good proof of concept but the biomarkers the team chose aren’t necessarily the biomarkers that would be used clinically in diagnosis. To be useful as part of a diagnosis, she said, these biomarkers would need to be added to a larger set of biomarkers because it would be difficult to understand a person’s disease status based on just one biomarker. For example, CA-125 is upregulated in ovarian cancer, pelvic inflammatory disease, and pregnancy, and doesn’t detect mild forms of endometriosis so it’s difficult to distinguish between those conditions based on just CA-125 alone.
It gives us great hope for the future of women’s health.
– Christine Metz, Feinstein Institutes for Medical Research at Northwell Health
In the future, the team plans to do larger field studies to account for heterogeneity in menstrual blood and to detect more biomarkers at once. Dosnon said that monitoring additional biomarkers could better reflect overall health, but adding them makes test design more challenging. Using more biomarkers increases the chance of nonspecific binding to the assay and can reduce sensitivity of the assay.
In addition to diagnosis, Metz said in-home tests like this one could be helpful for monitoring disease over time or to see if a treatment is successful. “In the ideal situation, someone would do these tests in between their yearly appointments, and if they see something … they would contact their doctor for follow-ups,” said Metz.
“It gives us great hope for the future of women’s health,” said Metz. “Right now, the uterus is like a big black box.”
References
- Dosnon, L. et al. A Wearable In-Pad Diagnostic for the Detection of Disease Biomarkers in Menstruation Blood. Adv Sci (2025).
