Non-Toxic Tampons: Do They Exist?

When I went through puberty, there were no commercial feminine hygiene products where I lived. We made reusable sanitary pads of layered cheesecloth. Washing them and hanging them on the clothes lines to dry was a mundane thing in every household. Therefore, when commercial disposable pads appeared on the market, it was a definite upgrade. But when tampons became available, it was like a different universe: they were so mysterious and so enticing at the same time. Using them was a matter of pride. The subjects of environmental health and safety were not even a consideration.

Even though there is a variety of menstrual products on the market today, including menstrual cups and period underwear, tampons and pads seem to be the most popular ones. In fact, in a 2022-2023 survey among 7,394 participants, 46% of respondents reported using sanitary pads, 47% – regular tampons, and 33% – super-absorbent tampons. Of those using tampons, 60% admitted using them overnight. But are tampons safe or can they contain potentially toxic chemicals?

In this post, you will get a roundup of relatively non-toxic tampons as well as find out which feminine care products are better to avoid.

Non-Toxic Tampons

To begin with, there is no established definition of a “non-toxic” tampon. The Food and Drug Administration (FDA) refers to tampons as “medical devices” and lists certain labeling requirements aimed at preventing toxic shock syndrome (TSS). Specifically, the label should contain information on TSS symptoms, advice on tampon absorbency, and general use instructions.

Further, in its guidance for menstrual tampons and pads industry and FDA staff, the Food and Drug Administration (FDA) includes some recommendations (not requirements) as to tampon safety.

First, when it comes to the description of these medical devices, the FDA recommends including materials for the:

• pledgets
• overwraps
• removal strings, and
• tampon applicators.

Second, the FDA recommends mitigating health risks, such as adverse tissue reaction, vaginal injury or infection, and toxic shock syndrome (TSS).

Third, the FDA recommends that tampons be free of any levels of dioxin and residues of potentially harmful chemicals, such as pesticides and herbicides.

In addition, the FDA recommends identifying the bleaching process used, e.g., elemental chlorine-free (ECF) or totally chlorine-free (TCF).

While there are several other preclinical toxicology and microbiology recommendations for menstrual products manufactures, they are suggestions, not requirements. In other words, it may be difficult to estimate tampon safety without well-established norms and standards.

Are Tampons Toxic?

As follows from the previous section, there are many unknowns regarding feminine hygiene products. Since there is no FDA requirement for material and ingredient disclosure, we don’t know what potentially toxic chemicals tampons may contain. (By the way, the World Health Organization (WHO) calls for menstrual health to be addressed as a “health and human rights” issue, not a “hygiene” issue.)

Thus, researchers are yet to determine what contaminants are in tampons, to begin with, and whether they enter the body, and, if they do, whether their concentrations are high enough to cause concern (source).

Taking into consideration the unknowns as well as the frequency of exposure and the intimate positioning of a tampon in your body, it’s a good idea to follow the basic tenets of tampon safety:

• Read the personal care product’s directions.
• Remove or replace after 6-8 hours.
• Do not use tampons overnight.
• Use the lowest absorbency.
• Know the signs of toxic shock syndrome (TSS) (e.g., sudden high fever, vomiting, dizziness, a rash etc.).
• Go to the hospital if you are experiencing TSS symptoms.

Toxic Chemicals In Tampons

It is important to know that, first, menstruation is not the only potential cause of toxic shock syndrome (TSS) (source). And second, in the case of menstruation, researchers are not sure what exactly may trigger TSS – feminine hygiene products’ materials or something else.

For instance, this study suggests that it was synthetic materials used to boost tampon absorbency that triggered TSS. Whereas this study found that any super absorbent tampons, regardless of their material, introduced a greater volume of oxygen responsible for amplifying the growth of the staph bacteria that can lead to TSS. 

Based on the conclusions of the former study, all-cotton tampons without synthetic absorbent materials are less likely to contribute to TSS. Conversely, the latter study stated that any highly absorbent tampons, including all-cotton ones, introduce a greater volume of oxygen into the vaginal environment, which leads to the growth of staph bacteria. 

Therefore, it probably makes sense to use tampons only when it is absolutely necessary. On those occasions, try to choose tampons made with organic cotton. Also, try to avoid tampons made with:

• rayon
• paraffin
• fragrance
• titanium dioxide
• non-organic cotton
• super-absorbent material
• plastic (e.g., polyester, polypropylene)
• ethoxylated ingredients (e.g., polysorbate 20), and
• synthetic dyes (e.g., CI disperse blue 60, CI disperse yellow 235).

Let’s discuss these ingredients.

Rayon

Technically, rayon is a manufactured fiber composed of regenerated cellulose (source). The major sources for natural cellulose are wood pulp (pine, spruce, or hemlock trees) and cotton linters (residue fibers which cling to cotton seed after the ginning process). To turn into rayon, cellulose goes through multiple steps of processing involving treatment chemicals. Hence, rayon may contain residues of all those potentially harmful chemicals that you don’t want inside your body.

Paraffin

A soft colorless solid, paraffin wax is derived from petroleum, coal, or oil shale. This means that it may have contaminants associated with petroleum, such as benzo[a]pyrene, benzene, toluene, ethylbenzene, and xylene. For your information, paraffin is banned in cosmetic products in Europe if it contains more than 0.005% of potentially carcinogenic benzo[a]pyrene (source).  

Fragrance

The main issue with fragrance is that it is a mixture of multiple ingredients, many of which have allergy and even endocrine disruption concerns. Also, more often than not, companies do not disclose the ingredients of “fragrance” in their products. Personally, I avoid using such products, including those that list “natural fragrance” as an ingredient.   

Titanium Dioxide

While titanium dioxide is okay in solid and liquid makeup products, as well as in mineral sunscreens (except aerosol sunscreens), its necessity in tampons is questionable. Indeed, they use TD in menstrual products for a whitening effect. In my opinion, neither the whitening effect, nor titanium dioxide are necessary in feminine care products. (Learn more about titanium dioxide in my post about safe lip color for you.)

Non-Organic Cotton

The cultivation of cotton involves the heavy use of pesticides and fungicides. Some estimates show that cotton is grown on 2.5% of the world’s agricultural land but consumes 16% of all the insecticides and 7% of all herbicides used worldwide, which is more than any other crop in the world (source). So, among other things, my problem with non-organic cotton tampons is potential residues of these toxic chemicals that may end up in your body.

Super-Absorbent Material

As I mentioned above, at least one study claims that a super-absorbent material inside your body introduces a greater volume of oxygen that feeds the growth of the staph bacteria that can lead to TSS (source). One such material is sodium polyacrylate (SAP). It was discontinued from use in tampons due to a 1980s concern over a link with toxic shock syndrome (TSS).

(Note that SAP is still used in disposable diapers. However, in diapers, it does not create the same risks because they do not go inside the babies’ bodies. If you are looking for safer diapers for your baby, you will benefit from my unprecedented Diaper Rating List E-Book. Indeed, the book will allow you to see the ingredients of more than 50 diapers so you can choose those that work best for you. Plus, you will learn more about SAP and other diaper materials.)

Plastic

Generally speaking, plastic is a petroleum-based material with the potential presence of endocrine disruptors and petroleum contaminants. Even BPA-free plastic is not safe (learn more in my post about plastic water bottles). Therefore, such types of plastic as polypropylene, polyethylene, and polyester are definitely not the best materials for a tampon.

Ethoxylated Ingredients

These ingredients are made with carcinogenic ethylene oxide and, as a result of the chemical reaction, can leave residue of carcinogenic 1,4-dioxane. Just to be clear, using products with ethoxylated ingredients doesn’t automatically mean getting cancer. But I choose not to use and promote products using them, mainly because they are bad for the environment and factory workers. Learn more about ethoxylated ingredients in my post about polysorbates.

Synthetic Dyes

In addition to heavy metal residues, synthetic dyes may contain carcinogenic and endocrine-disrupting byproducts of petroleum. Plus, some dyes are linked to carcinogenicity, genotoxicity, and hypersensitivity (​source​).

“Not-A-Fan” Tampons

Tampons in this category are those made with any of the above-mentioned materials, as stated on their websites as of April 2024.

“Better” Tampons

Mostly, tampons in this category are made with organic cotton. Although some of them list “paraffin” or “water-repellent wax,” I have included them in this section because they specified that they use it on the string, not on the tampon itself.

“Best” Non-Toxic Organic Tampons

Before I started researching this subject, my hope was to find several tampon brands that I could put in the “best” category. However, my findings just confirmed my initial concern with tampon safety in general.

I mean, this product is designed to go inside your body and stay there for hours. Given there is no law that requires disclosing the ingredients of these medical devices, it’s hard to gauge their safety. That is to say, there is no way to know for sure what harmful chemicals your body may be exposed to for 6-8 hours at a time.

Even in the case of “certified organic cotton” tampons, it’s not all that simple. In fact, I didn’t see any certifications proving that the cotton was indeed certified organic on the websites of those tampons that described their cotton as “certified organic.” Additionally, not all of them seem to fully disclose their ingredients, and we just don’t know what additives their tampons may contain. Actually, Consumer Reports points out the same concern. 

Therefore, the “best” category has no options for tampons because I believe that it is best not to use tampons at all. If you absolutely must use a tampon, please refer to the “better” category. Please be sure to replace your tampon at least every 6 to 8 hours and not use it overnight. Consider buying Period Underwear made with organic cotton and without toxic chemicals for your menstrual care. It will be better for environmental health, too.

Summary: Non-Toxic Tampons

It Is Best To Avoid Using Tampons, But If You Must Use Them, Choose Those Made From Organic Cotton And Without Fragrance, Ethoxylated Ingredients, Titanium Dioxide, And Synthetic Dyes.

In sum, the convenience of disposable tampons and pads seems to make them more popular among women than other menstrual products such as menstrual cups and period underwear.

The Food and Drug Administration (FDA) does not require that companies disclose tampon ingredients. Therefore, it is hard to gauge their safety. With this in mind, I believe it is best to use tampons only when it is absolutely necessary. On those occasions, try to choose tampons made with organic cotton and avoid tampons made with:

• rayon
• paraffin
• fragrance
• titanium dioxide
• non-organic cotton
• super-absorbent material
• plastic (e.g., polyester, polypropylene)
• ethoxylated ingredients (e.g., polysorbate 20), and
• synthetic dyes (e.g., CI disperse blue 60, CI disperse yellow 235).

Remember to replace your tampon every 6 to 8 hours and not use it overnight. Consider buying Period Underwear made with organic cotton and without toxic chemicals for your menstrual care.

Browse the I Read Labels For You blog for the valuable information on non-toxic products. Also, check out my non-toxic products shop and my e-books, and book a service if you need inspiration on your healthy living journey.

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