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Tampons and Sanitary Pads – Safe or Toxic?

Written by Irina Webb

Tampons and Sanitary PadsFeminine hygiene products (tampons and sanitary pads) are not easy to research.  First of all, their manufacturers are not required by law to disclose the materials/ingredients.  Second, the manufacture of tampons and sanitary pads has aroused controversial issues that have been circulating in the press for decades now.  I’d like to summarize what I found out and recommend safer alternatives.


My two major sources of information were not helpful this time. The Environmental Working Group (EWG) maintains a database of cosmetics and personal care products, which EWG calls its “Skin Deep” database.  Unfortunately, it does not include tampons or sanitary pads.  And I did not see any opinions published by EWG on the issue.  GoodGuide does not rate them on health impact because GoodGuide believes that “they are not a source of significant exposure to the ingredients used in their manufacture.”


For me, it is hard to believe that “they are not a source of significant exposure to the ingredients used in their manufacture” because tampons go inside a woman’s body and regularly stay there for a long time at a time. Why would a cream that is applied externally have an impact on human health but what goes inside the body does not?  And I am not the only one who thinks that way.


‘The vagina is like a sieve,’ explains Philip Tiemo, Jr., M.D., director of clinical microbiology and diagnostic immunology at New York University’s Medical Center, TSS researcher and leading expert on the health risks of tampons. ‘Whatever is in there goes right into the blood circulation. (Tanenbaum)


Also, women use thousands of them over the course of their lives. The average woman will use more than 11,000 tampons in her lifetime.


When you consider that the average woman will use more than 11,000 tampons in her lifetime, the health risks multiply, according to Karen Houppert, author of the book The Curse: Confronting the Last Unmentionable Taboo: Menstruation (Farrar, Straus, Giroux, March 1999). (Tanenbaum)


So what are the controversial issues with tampons and sanitary pads?  In my view, there are three major issues:


  1. Synthetic petrochemical materials in the tampons and sanitary pads that may cause discomfort and health problems;
  2. Toxic Shock Syndrome (TSS) that may be caused by tampons;
  3. Toxic chemicals released into the environment during the manufacture and possibly contaminating the feminine hygiene products.


Synthetic Materials


First, let’s talk about materials used to make tampons and sanitary pads. They are not conveniently listed on the package. If you do not pay attention, you might think that they are made of cotton.  But it is not cotton.  The manufacturers have been experimenting with different types to come up with materials that feel more or less like cotton, very absorbent and have cheap production cost.  I contacted Procter and Gamble to see what their Always pads made of.  They responded, and described the materials of Always Infinity pads and Always Maxi pads as follows:



Infinicel — Low density, highly absorbent, soft, resilient and open-celled foam (FAM).

Soft None-woven Topsheet — Helps the pad feel more like underwear

Top Layer — Draws fluid deep into a very thin pad

Adhesives — Used throughout the pad for construction and on the back of the pad so it may adhere to the underwear

Second Layer — The lower layer absorbs the fluid from the top layer and then distributes and stores the fluid on the back sheet side of the pad.

Unscented —- Majority of Always Infinity pads are unscented.  *Perfume-Always Fresh versions only Clean fresh scent added to a few versions of Always Infinity


Dri-Weave (Polyethylene) — Topsheet pulls fluid into the pad and lock it away to help prevent fluid from returning to the pad surface

Secondary Topsheet — Absorb and transfer fluid from the top sheet to the core.

Core (Wood Pulp Fibers) — Pull fluid deep into the middle of the pad

Backsheet — Keep fluid contained inside the pad.

Adhesives —- Pressure-sensitive adhesives which hold the pad together.

***Perfume — Always Fresh versions only Clean fresh scent ALWAYS INFINITY PADS

Infinicel — Low density, highly absorbent, soft, resilient and open-celled foam (FAM).

Soft None-woven Topsheet — Helps the pad feel more like underwear

Top Layer — Draws fluid deep into a very thin pad

Adhesives — Used throughout the pad for construction and on the back of the pad so it may adhere to the underwear

Second Layer — The lower layer absorbs the fluid from the top layer and then distributes and stores the fluid on the back sheet side of the pad.

Unscented —- Majority of Always Infinity pads are unscented.  *Perfume-Always Fresh versions only Clean fresh scent added to a few versions of Always Infinity


You can see for yourself that the word “cotton” is nowhere found in these descriptions. Instead, words like “polyethylene,” “non-woven,” and “highly absorbent foam” mean synthetic petrochemical materials.  The petrochemical materials may irritate sensitive skin and cause discomfort.  Also, they do not let the skin breathe, which increases a risk of bacteria growth. I think organic cotton alternatives would be a safer and more pleasant choice.  Based on my research, I highly recommend Natracare products.  Here are the links to Amazon for your convenience.

Natracare Natural Pads, Regular,14-Count Boxes (Pack of 12)

Natracare Mini Pant Liner, 30 Count (Pack of 10)


Toxic Shock Syndrome


The next controversial issue is Toxic Shock Syndrome (TSS), a potentially fatal illness caused by a bacterial toxin, normally by Strep or Staph bacteria. Super absorbent tampons may absorb more than menstrual flow leaving behind concentrated proteins that are used by staph or strep bacteria to create the toxin (Ikramuddin).  Toxic Shock Syndrome became a problem when, in the 1970s, super absorbent tampons were placed on the market, and women died from the application of these tampons.  In the 1980s, the U.S. Food and Drug Administration (FDA) made companies use less dangerous materials.  It might seem like the problem was solved.  However, TSS cases continue. The Centers for Disease Control and Prevention still report one or two women out of every 100,000 of menstruation age contract the disease annually. About 40 percent of those are teens whose bodies haven’t built up antibodies to the toxins. (Kunz)


The FDA says that it does not matter whether tampons are made from rayon or cotton but that highly absorbent tampons are to blame for the risk of TSS.  Note that rayon has much higher absorbency than cotton, and thus creates more risk.  Moreover, there are studies done by independent scientists concluding that “tampons containing synthetics amplify the production of the TSS-causing toxin by certain strains of bacteria, whereas the all-cotton tampons produced no measurable toxin.” (Ikramuddin)  In any event, the FDA recommends choosing a tampon with the minimum absorbency needed to control menstrual flow and using tampons only during active menstruation.


My advice is to (1) choose the most natural alternative, which, in this case, means using tampons only when you really have to, (2) choose all organic cotton regular tampons, such as Natracare, Organic Regular Tampons – 20 CT, 8 pack, and (3) change them frequently (never leave them overnight).

Dioxins in Tampons and Sanitary Pads

The last controversial issue is a contamination with dioxins, a by-product of the bleaching process.  Most tampons are made from rayon and most pads are made from wood pulp.  The manufacturers of these materials use chlorine-bleaching to make them appear white and clean to consumers.   During the bleaching process, dioxins get released, which pollutes the environment and trace amounts of them end up in the tampons and pads.


What are dioxins?  Dioxins are a group of toxic chemicals that share a similar chemical structure and induce harm through a similar mechanism.  They have been classified by the International Agency for Research on Cancer as a human carcinogen.  The Environmental Working Group has given them a rating of 10 out of 10, 10 being the worst, stating that they are anticipated to increase the risk of cancer even at background levels of exposure. They are on the U.S. Environmental Protection Agency’s list of priority pollutants.  They are persistent (they do not break down easily in the environment) and bioaccumulative (they build up in our bodies).


Tetrachlorodibenzo-p-dioxin (TCDD) is the most toxic and best studied of this family of chemicals. EWG’s analysis noted that TCDD “has been associated with a panoply of adverse health effects in people,” including heart disease, diabetes, cancer, endometriosis, early menopause, reduced testosterone and thyroid hormones, immune system disorders and abnormalities of the skin, teeth and nails.


Notice that dioxins are potent enough to make a harmful impact at a background level.  The FDA, on the other hand, does not believe that the small amounts of dioxins in tampons would cause harm in any way. There are many other statements that contradict the FDA’s position.  Here is one of them.


Carolyn DeMarco, M.D., a women’s health specialist in British Columbia, theorizes that lifelong exposure could increase a woman’s risk for breast cancer and endometriosis (in which uterine tissue grows outside the uterus). Scientific studies have already suggested a connection between dioxin and endometriosis. Because dioxin mimics estrogen, and because estrogen has been associated with breast cancer, experts feel dioxin may have similar effects. (Tanenbaum)


In its statement, the FDA informs that manufacturers now use an elemental chlorine-free bleaching method (i.e., they use chlorine dioxide instead of elemental chlorine gas, which is supposed to release no dioxins).  The exact words the FDA uses are as follows:


Some elemental chlorine-free bleaching processes can theoretically generate dioxins at extremely low levels, and dioxins are occasionally detected in trace amounts in mill effluents and pulp. In practice, however, this method is considered to be dioxin free.

It sounds a bit confusing to me.  If “[s]ome elemental chlorine-free bleaching processes can theoretically generate dioxins [even] at extremely low levels,” then what does the FDA mean when it says that “[i]n practice, however, this method is considered to be dioxin free.”  Considered by whom?  Using what standard?  What do they mean by “[i]n practice?”  I will let you be the judge.


Again, women use thousands of feminine hygiene products over the course of their lives.  Even if there are only trace amounts of dioxins in each product, they are bioaccumulative.  In other words, bit-by-bit those things accumulate in our bodies.  Would you want to increase the risk of cancer or birth defects?  What also surprises me is that after decades of the controversy, the FDA has not required manufacturers to disclose materials their tampons and sanitary pads are made of and to test for contaminants, even in trace amounts.

Safer Feminine Hygiene Products


It is important to note here that dioxins are everywhere – in our food and in human placenta. On the one hand, eliminating exposure to it through tampons is a drop in the sea; on the other hand, it is important to do so because by not buying products that create more dioxins in the environment we are taking steps towards a cleaner planet.  I am strongly convinced that with our purchasing decisions to buy products made of organic cotton we vote for a better environment for ourselves and our children.  I recommend using Natracare sanitary pads, such as Natracare Natural Pads, Regular,14-Count Boxes (Pack of 12), or reusable pads.


The Glad Rags company has been the first to introduce washable pads.  They are still the leader in the industry but there are also others, such as Imse Vimse. Both brands come in daytime and nighttime options. For your convenience, I found them on Amazon.


Print References:

Red Alert. Leora Tanenbaum. Vegetarian Times, December 1998. Retrieved from

 Toxic Shock! How Safe Are Feminine Hygiene Products? Aisha Ikramuddin. E Magazine, July-August 1997. Retrieved from

A Toxic Shock Naperville Teen’s Brush with Death from a Nearly Forgotten Disease Offers Warning. Tona Kunz. Daily Herald (Arlington Heights, IL), July 30, 2003. Retrieved from















19 thoughts on “Tampons and Sanitary Pads – Safe or Toxic?”

  1. Thank you very much for great information and interesting research! I learned so much new and am going to be careful about what I buy and use. It’s awful how companies get very sophisticated with their tricks and the use of the “right” words. I lust looked today at Kotex pantyliner box to read the following “We use the real materials in our products. Unscented. Aloe. Cotton touch” It’s a good choice of words to hide the truth, don’t you think?

    1. The Blog Owner

      Yes, a lot of corporations are involved in greenwashing – making consumers believe that the product is safe for consumers and environment. That’s why it is important to look closely at the list of ingredients and not be distracted by marketing slogans. Thank you, Galina.

  2. I also highly recommend a silicon menstrual cup like lunette or diva cup. They are not linked to TSS and are helpful with extremely heavy flow.

  3. Just left feedback for a company in their site. Instant migraine for “odor neutralizer”, it is in no way, shape, or form an odor neutralizer, it is a very noxious, toxic scent. I had to throw whole pack away, tie the trash, wash hands thoroughly and am still suffering from the migraine. I have enough pain and issues with my cycle I don’t need people preying on stealing my money and making me sicker. This happened about a year ago and since have been very careful, but in haste, and with limited options, bought. I had asked the store not to carry them anymore.

  4. Yes, What about Diva Cup or The Keeper made out of tree gum? I just got my period back from after having baby an am looking to invest? Not sure if cotton cloth pad or Diva Cup? As far as effectiveness and convenient and cheapest long term?

  5. “There are also allegations that some tampons contain toxic amounts of the chemical dioxin….State-of-the art testing of tampons and tampon materials that can detect even trace amounts of dioxin has shown that dioxin levels are at or below the detectable limit. No risk to health would be expected from these trace amounts.”

    “Tampons currently sold in the U.S. are made of cotton, rayon, or blends of rayon and cotton…At one time, bleaching the wood pulp was a potential source of trace amounts of dioxin in tampons, but that bleaching method is no longer used. Rayon raw material used in U.S. tampons is now produced using elemental chlorine-free or totally chlorine free bleaching processes.”

    “When questions about dioxin arose a number of years ago, FDA asked tampon manufacturers to provide information about their pulp purification processes and the potential for dioxin contamination. Manufacturers of rayon tampons are also asked to routinely monitor dioxin levels in the raw material used or the finished tampons. Manufacturers have provided FDA with test results of studies conducted at independent laboratories, using the most sensitive test methods available….The detectable limit of this assay is currently approximately 0.1 to 1 parts per trillion of dioxin.”

    “Using these tests, dioxin levels in the rayon raw materials for tampons are reported to be at or below the detectable limit of the state-of-the-art dioxin assay, i.e., approximately 0.1 to 1 parts per trillion. FDA’s risk assessment indicates that this exposure is many times less than normally present in the body from other environmental sources, so small that any risk of adverse health effects is considered negligible. A part per trillion is about the same as one teaspoon in a lake fifteen feet deep and a mile square.”…/Alerts…/PatientAlerts/ucm070003.htm

  6. Wow Nicole the troll, how much did they pay you to say that?, or are you just a company driven computer tool.

  7. Menstrual cups are problematic for vegans/vegetarians – most of them are made with medical grade silicon, therefore each batch of silicon will get tested on animals! 🙁 it’s really sad but until that changes I will be going organic

  8. I just came upon this blog and ironically enough, I just found out about a newish company that sounds like a very good alternative to some of the bigger brands of tampon/pad mfrs. It’s called Lola ( They make 100% organic cotton tampons (can be delivered directly to your door). Definitely worth looking into! Interested in hearing from anyone that has anyone used their products.

  9. I also have tried a product called cherish. They use cotton in their pads not by product trash like always pads.

  10. Becca @ The Earthling's Handbook

    I would like to share my extensive experience with reusable menstrual cups with any more readers who are interested. A reusable cup is the most environmentally friendly choice you can make because it takes very little water to clean and it lasts several years. It’s also the most convenient because you reuse the same one; you do not have to bring extras with you and wash them later, as you do with cloth pads.

    Thanks for spreading the word about the risks and environmental impact of disposable products! I had a very bad experience when I had my period during hernia repair surgery and thought it would be “easier” to use disposable pads than to wash cloth ones or use the cup so close to the surgical swelling–something in Always pads burned my skin!!!

    1. Hi, Becca:

      I agree that it is an environmentally-friendly solution; however, I am not willing to put silicone or natural rubber inside my body. Thanks! ~Irina

      1. Hi Irina,

        I was just about to ask your opinion about the menstrual cups…. Could you elaborate on why you feel this way about rubber and silicone? Thanks so much.

        1. Hi, Martie: I do not have any evidence that silicone or natural rubber menstrual cups are harmful in any way. It is just my personal feeling that I do not want to them inside my body. Have you read my personal story about implants? If you try them, let me know what you think. ~Irina

  11. Becca @ The Earthling's Handbook

    Have you found any information on the safety of microfiber fabrics used in some cloth pads (and cloth diapers)? I have always avoided these because they sound like they might be risky, but I have not seen any evidence one way or the other.

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