There is no shortage of blog posts out there with terrifying headlines about how toxic pads and tampons are. But what’s the actual risk and should you be switching to organic tampons and pads, or other menstrual products entirely?
I’m digging into the issue here so you can feel confident about the choices you make going forward – no matter what your budget.
But before I go any further, let me say right off the top that I am a big proponent of reusable menstrual products. Both for your health, and the environment.
The tampon alternative is the menstrual cup. There are also period panties that many people swear by or reusable cotton pads. At the end of this post, I list out some of my top recommended brands of reusable alternatives, along with healthier disposables.
But first, let’s look at the concerns around conventional vs organic tampons and pads and whether the risk of toxic exposures is really there.
The Problem with Tampon & Pad Regulations
It seems kind of crazy that something many women put inside their bodies for 2000+ days over our lifetime wouldn’t be studied or tested intensely. But yes, here we go again with the pattern of grossly underserved field of women’s health.
Pads and tampons are considered medical devices by the FDA and Health Canada. Many brands will spin this to mean they must meet rigorous safety standards, but that’s a gross overstatement. Because of this classification, they don’t have to disclose ingredients and just like household products, it’s still an after-market regulatory system.
This means that products can be put on store shelves without full toxicological or other safety testing. If a problem arises, it’s only discovered after consumers like you and I have purchased and started using them. Sometimes many, many years later when it’s too late to prevent harm.
The FDA and Health Canada offer many recommendations for manufacturers around marketing language and ingredients. Recommendations, not requirements. For example, Health Canada recommends not using tampons overnight (to prevent Toxic Shock Syndrome), however, looking at some manufacturer website FAQs they say it’s totally fine.
Toxic Shock Syndrome
If you use tampons, you may have seen warnings about this on the label. Toxic Shock Syndrome (TSS) is a complication of certain bacterial infections. It can affect anyone, but in menstruating women it is attributed particularly to super absorbent tampons. It was an epidemic in the 1980s, but since them rates have significantly dropped as awareness rose and super absorbency products were manufactured less.
The FDA and Health Canada recommend wearing tampons with the lowest absorbency rating required, changing them every 4 – 8 hours, and alternating use with pads.
Dioxins are hormone disruptors and carcinogens that are persistent environmental pollutants released from industry and incineration. They build up in the body, and infants and children are most at risk due to their developing bodies. Our greatest exposures to dioxins are through our diet (primarily seafood and animal fats) and for workers in industries where dioxins are released like pulp and paper, smelting, and pesticide production.
Of note here too, animal studies suggest a link between dioxin exposure and endometriosis severity.
In consumer products, dioxins are formed when chlorine bleach is used to whiten and sanitize products. It was previously used to remove impurities from the fibers in pads and tampons, but according to this Forbes’ article, “all brands now use either elemental chlorine-free (ECF) bleaching without chlorine gas or totally chlorine-free (TCF) bleaching agents.”
The FDA recommends that manufacturers identify the bleaching process used, e.g., Elemental Chlorine-Free (ECF) or Totally Chlorine-Free (TCF). I spot-checked a few conventional brands and those that gave information about how their products were made, did indicate they use ECF bleaching. But some didn’t disclosed the bleaching process at all.
According to research published in Environmental Health Perspectives Journal, dioxins are found in trace amounts in both cotton and pulp sanitary products. However, exposure to dioxins through tampons and diapers does not significantly contribute to overall dioxin exposure in the United States.
Synthetic fragrance contains any number of hundreds of chemicals, many of which are linked with cancer, hormone disruption, and/or asthma and allergies. (Read more here.)
Common ingredients in fragrance are phthalates, which are hormone disruptors. But do they actually get absorbed by the body?
One study looked at the concentration of various phthalates in women and correlated them to the feminine hygiene products they used. It found that douching was linked with the greatest increase in a particular phthalate, DEP (diethyl phthalate), compared to pads, tampons, and other so-called feminine hygiene products.
Several case studies have been published examining symptoms experienced by women from using conventional pads. Common symptoms include irritation and allergic rash, although many go undiagnosed for months before attributing it to the pads.
In one case study, the fragrance used in scented pads was found to be the cause of a rash. In another, methyldibromo glutaronitrile (MDBGN), which is used in the adhesive, caused dermatitis.
In most cases, discontinuing use of pads, switching to unscented pads or simply changing brands resulted in symptoms disappearing.
I always recommend avoiding synthetic fragrance, and menstrual products are no exception.
Glyphosate and Other Pesticides
The FDA recommends that tampons be free of 2,3,7,8- tetrachlorodibenzo-p-dioxin (TCDD)/2,3,7,8-tetrachlorofuran dioxin (TCDF) and any pesticide and herbicide residues. They also recommend that manufacturers “describe any assurances that chemical residues are not present or, if residues are present, the level present and the method used to assess it. These assurances may include, but are not limited to, test methods, tolerances, or acceptance criteria.”
Again, this is a recommendation and there is no enforcement of the messaging or the actual testing. I have yet to see this description on mainstream pads and tampons websites.
What appears to be the first publicly available testing of pesticide residues in tampons was published by Naturally Savvy in 2013. They hired a 3rd party lab to test o.b. brand tampons for pesticide residues, which found a range of pesticide residues, including high concentrations of a carcinogen and potential endocrine disruptor.
Another study done at the University of la Plata in Argentina found 85% of tampons and pads tested contained the pesticide glyphosate. Glyphosate is defined as a “probable human carcinogen”. You can read more about it here.
Should You Switch to Organic Tampons and Pads?
Here’s the thing: what you use near, on, or in your vagina shouldn’t be taken lightly. The tissue in the vagina is highly absorptive, and what goes in it can enter your body. This has been shown to be an issue with talc used in baby powder, which is linked with ovarian cancer in women who use it as a feminine hygiene product (you have to see the film Toxic Beauty if you can, which reveals the lengths to which Johnson & Johnson are going to fight this).
But I digress…
The fact is, we don’t know what may or may not be in any particular pad or tampon, because nobody is forced to actually test nor tell us. Given the concerns with glyphosate contamination of so many things we eat and drink, I think we owe it to ourselves to reduce the risk of exposure where we can. Dioxins appear to be taken care of with different processing, but it’s another unknown in many cases.
I recommend making the switch at the very least to fragrance free products. That should be a non-negotiable.
If you’re ready to move away from conventional pads and tampons altogether, consider switching to a reusable option or an organic alternative. Here are some of my top recommendations:
Menstrual Cup: I personally have been using the Diva Cup for over 10 years, but there are a tonne of others that work well for people too. This website helps you find a brand that works for you. I highly recommend choosing a made-in-North-America brand with high-quality silicone and testing standards. There are more and more brands coming out with these, so do your research on quality control.
Period Panties: I personally haven’t tried these, but the most recommended in my community are Thinx. However, given recent news that they may contain PFAS, you may want to try Knix instead.
Cloth Pads: Just like cloth diapers, you can now find cloth pads. I also haven’t tried these, but the most recommended brand is Luna Pads. You may be able to find a local maker for these as well. Just make sure they’re using natural materials, ideally with no dyes or safe dyes.
Organic Pads & Tampons: Natracare makes plastic-free, organic tampons and pads in a range of sizes and formats. I keep these in my travel bag for emergencies when I forget my cup and they perform really well.
If you’re looking for more healthy and green product recommendations, be sure to join us over in our free Facebook Group, the Green Product Forum! It’s an amazingly supportive community with thousands of people working to create a healthier, greener home. Join us here!