Over her lifetime, a woman will have about 450 periods, according to the Association of Reproductive Health Professionals. That's a ton of tampons, menstrual cups, pads, and panty liners! But what exactly is in these feminine hygiene products that we use on our intimate areas month after month?
That's actually a tough question to answer. Most tampons and pads only provide a partial list of ingredients that "may" be within the product. Since feminine hygiene products are considered medical devices, manufacturers aren't required to disclose what's in them or how they're made—and most of them don't, says Lona Prasad, MD, FACOG, an OB/GYN at NewYork-Presbyterian/Weill Cornell Medicine.
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We do know, however, that most of them are made with a ton of chemicals. "Research suggests that a single conventional pad can contain as many chemicals as, something like, four plastic bags," Prasad says. And many of these chemicals carry potential health risks.
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For example, many tampon applicators contain phthalates, a group of hormone-disrupting chemicals that have been linked to everything from early-onset menopause to diabetes, and the cotton used to make tampons and pads is typically bleached.
"Although no supportive evidence exists to date, there are claims stating that the chlorine bleaching process may cause the release of a toxin called dioxin," says Adeeti Gupta, a New York City-based OB/GYN and founder of Walk In GYN Care. "If dioxin is absorbed into the bloodstream, it may cause cellular damage."
In response to concerns, the FDA did a review of tampons, and found that the level of dioxin absorption was just 0.2 percent of the allowable intake set by the Joint Expert Committee on Food Additives.
Many feminine hygiene products also contain rayon and polyester. After being in contact with body fluids, these materials can release chemicals akin to BPA and other phthalates.
"Long-term exposure to these substances has been associated with hormone imbalances and immune suppression," Gupta notes.
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While being exposed to chemicals is never a good thing, it's especially worrisome when the chemicals are absorbed through the vagina. "The skin and the vaginal mucosa are a very, very absorbent area," says Iffath Hoskins, MD, an obstetrician at NYU Langone. "In fact, there are certain medications we give as vaginal inserts because we know the absorption is so good."
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While this all sounds quite alarming, Gupta and Prasad both point out that there's an overall lack of studies on how the body absorbs chemicals from tampons and pads. That said, we've drawn much of what we know about these chemicals from studies involving oral intake.
But even so, you can never be too careful when it comes to your health—and there are clearly some potential risks here, people! If you're eager to limit your exposure to potentially problematic ingredients, consider buying one of these gynecologist-recommended feminine hygiene products:
Natracare Organic Tampons
We like these tampons because they are 100% organic cotton, and free from rayon, plastic, and dye.
"If you have risk factors that may make you more susceptible to infection or illness, or even if you've just made a lifestyle decision to be very cautious, then it's very important to look for organic cotton—it's the extreme in terms of safety," says Prasad.
Buy it now: $8, amazon.com
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Natracare Ultra Natural Pads With Wings, Regular
"It's crucial to actually read every single ingredient, and not just rely on the highlighted packaging," cautions Gupta. "Generally, the 'organic' designation—or lack thereof—does not mean as much as the actual ingredients used in the tampons."
These pads are made with certified organic cotton, ecologically certified cellulose pulp, cornstarch, and non-toxic glue, making them a smart pick.
Buy it now: $7, amazon.com
Here are seven reasons your period is late (other than pregnancy):
Seventh Generation Organic Cotton Tampons, Regular with Applicator
These tampons are made from organic cotton and whitened without the use of chlorine. The product description calls out the lack of fragrances and dyes. That's reassuring—Prasad points out the if "the packaging highlights fragrance and odor neutralizers, you can be pretty certain there are chemicals in the product that are not good for you." (Psst: Don't miss these 25 Trade Secrets Of Top OB/GYNs.)
Buy it now: $8, amazon.com
Emerita Organic Cotton Non-Applicator Tampon
When women purchase tampons, Prasad recommends scanning the packing and ingredient lists for mentions of the use of synthetics, BPA, phthalates, artificial colors, and polypropylene. These tampons specifically call out that they're made without a lot of these and other common ingredients that may cause allergies or potential health issues including rayon, perfume, chlorine, and synthetics.
Buy it now: $10-$11, walmart.com, jet.com
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Diva Cup
"Menstrual cups work quite well for some of my patients," says Prasad, adding that for the most part, they're chemical-free.
The Diva Cup is made from silicon, and free from latex, rubber, and plastic. Prasad says silicone cups are non-absorbent, good for people with latex allergies, and do not seem to dry out the vagina. Hoskins cautions, however, that women should have three priorities in mind when choosing a feminine hygiene product: safety, ease of use, and accessibility.
"You can have the best product, but if it's sitting on your dresser when you need it, it's useless," she says.
Opt for the menstrual cup only if you're prepared for the effort involved. It will need to be emptied and washed at least twice a day.
Buy it now: $26-$37, amazon.com; target.com
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GladRags Day Pads Undyed
Like a menstrual cup, this product requires a bit of commitment, as you will need to clean it between wears. GladRags are a two-part system: There is a cotton holder that snaps around your underwear, and the pad is placed within the holder. Both parts are reusable—once the pad is saturated, both it and the holder go into a laundry basket to be washed and reused. Compared to disposable pads and panty liners, these reusable pads are more cumbersome.
"A pad is probably the least invasive option," says Hoskins, and this option eliminates the use of adhesive, since it does not stick directly onto panties, but rather is snapped in place.
Buy it now: $22-$30, amazon.com; walgreens.com
