November 19 2020 | Written by Pri Dogra (She/Her)
So, you’ve thought about how to optimize your health this quarantine-season by eating cleaner, sleeping earlier, hopping on the blue-light-glasses-train, and maybe even starting to use non-toxic makeup. But that time of the month rolls around and, if you’re like the old me, you don’t even know if you have any pads or tampons left in your house, let alone what goes into them.
The vagina is one of the most absorbent parts of the human body. It is actually more permeable than skin, and does not metabolize what’s absorbed, meaning chemicals directly enter the bloodstream. Ironically, some products that are supposed to support our health regularly might actually be harming us. That’s why it’s important to understand our products, and what goes into them.
Pads and tampons are classified as medical devices but at different levels - pads at Class 1, and tampons at Class 2. Tampons are more highly regulated by the FDA and Health Canada since they go in the body. For reference, contact lenses and latex condoms also belong to Class 2 in Canada. Historically, both pads and tampons were not required to disclose any of their ingredients because of their classification. It wasn’t until 2017 that Congresswoman Grace Meng introduced the Menstrual Products Right to Know Act, advocating for greater transparency in the menstrual product industry. As New York assembly member and bill-sponsor Lisa Rosenthal said, it is “ridiculous that we use these products, put them inside out bodies, and we don’t even know what’s in them.” Menstrual product companies are now required by law to publish their ingredients with the FDA, but not on the package.
My attention is very easily caught when I see something branded as “nontoxic,” “green,” or “eco-friendly.” I do hours of my own research, but I would be lying if I said these buzzwords didn’t initially draw me to the products. Knowing that about myself, I wanted to make sure that I wasn’t buying into something that may not actually be such a big deal. Here’s what I found:
In August 2014, the Women’s Voices for the Earth organization tested four Always pads – the unscented and scented Ultra Thins, and the unscented and scented Always Infinitys. The results indicated that all types of pads contained toxic chemicals according to standards of the U.S. Department of Health and Human Services National Toxicology program, the Agency for Toxic Substances and Disease Registry, and the State of California Environmental Protections Agency. The chemicals found included styrene, chloromethane, chloroethane, chloroform, and acetone (yes, the same agent used in nail polish remover). These toxins have been identified as known carcinogens, neurotoxins and reproductive toxins.
The chemicals were identified in parts per billion by volume and concluded to be “relatively low,” but it is discerning to some that they were ever included in the first place.
In October 2019, Gov. Andrew Cuomo said that feminine hygiene products “[had] inexplicably evaded [the] basic consumer protection” requirements of listing ingredients – he was absolutely correct. He then signed a bill requiring feminine hygiene product manufacturers to list the ingredients on their products in New York to take effect in 2020. This made New York the first state to enact this rule and Cuomo said he was proud to be “empowering women to make their own decisions about what goes into their bodies.”
However, making an informed choice is not simply about being able to read the ingredients, it’s also about knowing what they are and what they can do. Let’s take a look at some chemicals most commonly found in feminine hygiene products:
If you’ve read up on this topic at all, you have probably seen the chemical name “dioxin.” Dioxin is a by-product of cotton and wood pulp bleaching through chlorine. As noted by the World Health organization, it is a “highly toxic” known carcinogen that “can cause reproductive and developmental problems, damage the immune system, [and] interfere with hormones.” However, the risk factor associated with this toxin depends on the volume its found in in our products.
Rayon in tampons is also an ingredient that has potential harmful side effects, although it is not a toxin. Tampons are either made from cotton, rayon, or a blend of the two. The trade-off with rayon is that on the plus side, it absorbs blood more effectively than cotton. However, there is a higher associated risk of Toxic Shock Syndrome (TSS). This is because the fibres in rayon shed more than with cotton, leading to a possible increased risk of fibres getting stuck in the vaginal canal. These fibres can alter the natural pH and create a breeding ground for bacteria, leading to possible TSS. To test if your tampons shed, simply submerge a new one in a glass of water and wait to see if any fibres drift off. It is important to note that there is still a risk of TSS when using cotton-based tampons.
Ever wondered how companies get such coloured, floral-scented pads? You guessed it: artificial dyes and synthetic fragrances. These are irritants and are unnecessary additions to menstrual products. Pads and tampons may also contain parabens, pesticides, BPA, other plastic chemicals and furans – endocrine disruptors, carcinogens, and chemicals you might otherwise try to avoid in other aspects of your life.
Again, because I am a more-easily-convinced proponent of ‘alternative’ products, we can play devil’s advocate. Most opponents of the above have said that these chemicals, especially dioxin, only exist in trace amounts. Dr. Jen Gunter for example, references the FDA’s policy on dioxin in tampons and says that tampons do not contain harmful chemicals (for reference, the FDA says that it “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”). Over a lifetime however, according to Philip Tierno of NYU Med, a menstruator may use approximately 12,000 tampons. So while the dioxin exposure may not be intentional, that is still potentially a whole “lot of dioxin absorbed directly through the vagina.” While the studies have shown that we are only exposed to trace amounts of dioxins, you as the consumer still have the right to know.
If you’re now curious about alternatives to conventional menstrual care, I suggest browsing for organic cotton, hemp, or bamboo-based products. Examples include The Honest Company, Blume, Seventh Generation, Lola, The Honey Pot, La Vie, and of course, Marlow! Some more mainstream brands are also starting to produce chlorine-free, dye-free, non-applicator, unscented products which is also a good place to start. These include Tampax and Always’ organic cotton products. You can also find reusable cotton pads, which are even better for the environment - they do not end up in a landfill through garbage disposal, the ocean through flushing, or emit toxic fumes when incinerated. Lastly, silicone menstrual cups have been getting recent attention, and for very good, toxin-free reasons.
Every kind of menstrual care product has its own set of pros and cons. In the case of alternative products, it is not always safer with respect to TSS for example. Although some chemicals like rayon have been linked to it, it is still very much possible to develop when using organic cotton tampons. Also, ‘organic’ doesn’t necessarily mean no pesticides at all, just a different kind of pesticides. Overall, it might be too optimistic to say that organic-cotton pads can completely eradicate our dioxin exposure. Keep in mind that tampons have to be bleached as per health regulations to ensure purity of the cotton, but hydrogen peroxide is favourable to chlorine for this process in this case. Overall, it seems that chlorine-free, dye-free, and fragrance-free products are the way to go if you are looking to select the safest options for pads and tampons. Reusable cotton pads and silicone cups can also decrease your exposure even more - altogether in the case of silicone. As with any product, there is still an expected level of consumer-responsibility.
I personally choose to stick to organic cotton products. Hint: stay tuned for Marlow's product launch in early 2021, which will include 100% GOTS-certified organic cotton tampons, produced without the use of chlorine bleaching! Ultimately, what you choose to use is up to you, but we encourage you to take the time to research your products so that you can make an informed decision. All in all, as Meng’s act in 2017 affirmed, you have a right to know what is in your products, and why.