Tampon usage is a significant aspect of feminine hygiene practices, reflecting a long history and a notable presence in the daily lives of many women. In the United States, tampons are one of the most popular menstrual products, preferred particularly for their convenience and supposed effectiveness.
In terms of prevalence, it's estimated that approximately 70% of women in the United States use tampons. This statistic underscores their widespread acceptance and preference over other menstrual products, such as sanitary napkins or menstrual cups. The preference for tampons can be attributed to various factors, including convenience, perceived hygiene, and the active lifestyles of many women today. The number of tampons used annually is staggering, with estimates suggesting that the average woman uses over 11,000 tampons in her lifetime. Given the number of menstruating women in the U.S., this amounts to billions of tampons used and disposed of each year.
The modern tampon, as we know it today, was invented in the 1930s. However, the concept of internal menstrual products dates back centuries. The earliest records of tampon-like devices were found in ancient civilizations. For instance, in Ancient Egypt, papyrus was used to fashion tampons, while in Ancient Greece, lint wrapped around small pieces of wood served a similar purpose (ouch). These early versions were rudimentary but set the foundation for the internal menstrual products that would evolve into the modern tampon.
The invention of the contemporary tampon is credited to Dr. Earle Haas, who patented the first applicator tampon in 1931. Dr. Haas wanted to produce a tampon that was supposedly hygienic, disposable, and could be applied without being touched, thus ensuring the product's cleanliness. His invention included an applicator made of cardboard, which allowed the tampon to be inserted without direct finger contact. This innovation was groundbreaking at the time and laid the groundwork for future developments in menstrual products.
Dr. Haas sold his patent to Gertrude Tenderich, who started the company Tampax in 1933. Tampax would go on to become one of the most well-known and widely used tampon brands in the world. The introduction of the tampon brought about a revolutionary change in menstrual management, offering women more freedom and comfort compared to the bulky and often unreliable sanitary pads of the past.
Despite their convenience and widespread use, tampons have been the subject of various health and environmental concerns. Issues such as Toxic Shock Syndrome (TSS), a rare but life-threatening condition, have been associated with tampon use, particularly with super-absorbent tampons. This has led to increased awareness and education on proper tampon use, including the importance of selecting the correct absorbency and changing tampons regularly. Additionally, the environmental impact of disposable tampons, most of which are not biodegradable, has raised concerns about waste and sustainability. This has spurred the development of organic tampons and reusable menstrual products as eco-friendly alternatives to traditional tampons. However, another major concern is the impact that tampons can potentially have on women’s hormones.
Are Your Tampons Disrupting Your Hormones?
The vaginal and vulvar tissues that come into contact with pads and tampons are highly permeable, meaning chemicals can be absorbed directly into the bloodstream without being metabolized first. This poses significant risks when menstrual products contain endocrine-disrupting chemicals, which can interfere with hormone function and potentially lead to health issues like endometriosis and uterine fibroids.
A study led by George Mason University's Joanna Marroquin, a Ph.D. student in Public Health, and Associate Professor Anna Pollack, scrutinized research from 2013 onward, focusing on the presence of chemicals in menstrual products and their biomarkers in humans. Their review highlighted the occurrence of various endocrine-disrupting chemicals in menstrual products, including tampons, pads, and liners. These chemicals encompass phthalates, volatile organic compounds, parabens, environmental phenols, fragrance chemicals, and dioxins.
Marroquin emphasized the significance of recognizing these chemicals in commonly used menstrual products due to their potential impact on reproductive health. The urgency of this issue is underscored by legislative moves such as the introduction of the Robin Danielson Menstrual Product and Intimate Care Product Safety Act of 2023 in the U.S. House of Representatives. This Act aims to initiate research into the risks posed by harmful substances like dioxins, phthalates, and chemical fragrances found in menstrual and intimate care products.
Over 90% of the analyzed menstrual products in one study contained detectable levels of phthalates.
The study reviewed 15 papers published between 2013 and 2023, which tested menstrual products in the United States, Japan, and South Korea. The researchers noted a scarcity of publications addressing the chemical composition of these products. Moreover, despite the detection of “forever chemicals” (PFAS) in menstrual underwear, there is a notable lack of peer-reviewed research on these and other emerging menstrual products, such as menstrual cups and discs, especially in the United States. The findings of this comprehensive review were published in BJOG, an international journal of obstetrics and gynecology, in September 2023. The study, involving additional contributions from Marianthi-Anna Kiomourtzoglou of the Mailman School of Public Health at Columbia University and Alexandra Scranton from Women's Voices for the Earth, brings to light the critical need for more rigorous research and regulation regarding the chemical content of menstrual products.
A research team from New York University embarked on a study to determine the presence of endocrine-disrupting chemicals (EDCs) in menstrual hygiene products. EDCs were measured in 77 different products from 47 prominent brands sourced in Albany, NY. These products were categorized into seven groups: pads, panty liners, tampons, wipes, bactericidal creams and solutions, deodorant sprays, and powders.
The study revealed that over 90% of the analyzed menstrual products contained detectable levels of phthalates, a type of EDC commonly used to enhance the flexibility of plastics. Notably, the highest phthalate concentrations were found in panty liners, tampons, and pads. While the complete impact of phthalate exposure on human health remains unclear, existing research links it to issues such as recurrent pregnancy loss, puberty disruptions, hormone imbalances, and thyroid dysfunctions.
Dr. Kurunthachalam Kannan, one of the study's authors, highlighted the absence of legal standards for phthalate content in menstrual products like tampons, rendering the risk to consumers uncertain. He emphasized the need for regulatory bodies to be informed and to establish limits based on scientific evidence, without causing undue alarm among consumers.
Despite pads and tampons being regulated as "medical devices" by the FDA, manufacturers are not mandated to disclose the full list of ingredients on product packaging.
Despite pads and tampons being regulated as "medical devices" by the FDA, manufacturers are not mandated to disclose the full list of ingredients on product packaging. This lack of transparency persists even when manufacturers are aware of harmful chemicals in their products. In contrast, the U.S. does enforce phthalate restrictions in other products, such as children's toys.
Efforts to bridge this regulatory gap were made through the introduction of the Tampon Safety and Research Act of 1997, which aimed to promote research on menstrual product additives and their health implications. However, this act and its subsequent iterations, introduced in various years up to the present, have not been passed into law.
While many brands now market their menstrual products as "non-toxic" or "chemical-free," the exact chemical composition of these alternatives remains undisclosed. These products, often priced higher, offer consumers a choice, yet the assurance of their safety and the transparency of their contents are still in question. For example, a brand called L. promotes their tampons as “100% organic cotton core.” That sounds promising, but if you look at the ingredient list, it includes polyester, glycerin, paraffin, and titanium dioxide.
Polyester, a synthetic fabric, can negatively impact women's hormones due to its potential to release EDCs. These chemicals can leach from the fabric, especially when heated or in contact with the skin or inside the body, and interfere with the body's hormonal balance. EDCs mimic, block, or alter hormone signals, potentially leading to various health issues such as reproductive problems, hormonal imbalances, and increased risk of certain cancers. Titanium dioxide, commonly used in cosmetics and sunscreens, can negatively affect women's hormones as well. Nanoparticles of titanium dioxide penetrate the skin barrier and can interact with the endocrine system, disrupting the natural balance and function of hormones. This interference can lead to hormonal imbalances, potentially contributing to reproductive issues, developmental problems, and an increased risk of hormone-related cancers. The intimate and frequent use of products containing titanium dioxide raises concerns about its long-term impact on women's hormonal health. So why are tampons that contain these hormone-disrupting ingredients being marketed as 100% organic cotton?
The research raises concerns about the EDCs in menstrual pads as well, but tampons will always be more concerning than any other product due to the fact that they are inside our bodies for multiple hours at a time.
What Are the Alternatives?
If you want to find better tampon alternatives, there are a few brands out there that really are 100% organic cotton, such as Viv and Cora. These are truly made with only organic cotton – no polyester or rayon or any other endocrine-disrupting chemicals. You can also consider menstrual pads that are lacking EDCs, such as Rif Care, which are made with organic cotton and hemp fiber. There are also options such as the menstrual cup, which is a small, flexible, bell-shaped cup that is inserted into the vagina to collect menstrual fluid. Menstrual cups are reusable and can provide protection for several hours, depending on the flow. Most cups are made from medical-grade silicone, rubber, or thermoplastic elastomer (TPE), materials chosen for their safety, durability, and comfort. Unlike tampons and pads, menstrual cups are eco-friendly due to their reusability and they are cost-effective, as one cup can last for several years with proper care.
Whatever choice you make, just ensure that you are looking closely at the ingredients of your menstrual hygiene products. It’s easy to be fooled by the fancy marketing that covers the boxes of tampons and is splattered all over social media. After all, the whole point of these campaigns is to cater to women’s desires and concerns, even if they aren’t able to follow through with their big claims. Be skeptical, don’t be afraid to ask questions, and always prioritize your health above all else.
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