In the news this week was the tragic story of fashion model, Lauren Wasser, who lost her leg—and almost lost her life—to Toxic Shock Syndrome (TSS) caused by her tampon.
The topic of safe feminine hygiene products is rarely discussed, but it’s a vitally important issue for about a third of the world’s population. And while TSS is pretty rare, there are plenty of other reasons why you might want to consider a less toxic, more sustainable option for your period.
Here are a few…
Protect The Skin You’re In
Your skin is the largest organ in your body, and it’s also the thinnest. Less than one-tenth of an inch separates your body from potential toxins. Your skin is also highly permeable—especially the skin in and around the vaginal area.
Anything that comes in constant contact with your skin will enter your bloodstream for distribution throughout your body. This is why nicotine, birth control and other medicated patches work so well. This is also why it’s best not to put anything on your skin that you wouldn’t also eat.
Putting chemicals on your skin might be far worse than eating them. At least your intestinal lining protects you to a degree and the acids and enzymes in your digestive system help break down and flush chemicals from your body.
But when chemicals touch your skin, they’re absorbed straight into your bloodstream where they can circulate freely and accumulate in your organs and tissues, because there is nothing in your circulatory system to block them or break them down.
The Sustainability Factor
Tampons are used by up to 85 percent of menstruating women, and the average American woman can use as many as 17,000 tampons in her lifetime. According to Flow: The Cultural History of Menstruation, the average woman throws away 250 to 300 pounds of pads, tampons, and applicators in her lifetime.
It’s estimated that nearly 20 billion (billion!) pads and tampons are discarded each year in North America alone, adding the equivalent to 180 billion plastic bags to our waste stream every year. In 2009, The Ocean Conservancy’s International Coastal Cleanup project collected 20,000 tampon applicators out of 4 million total pieces of reclaimed plastic waste.
It can take applicators 25 years to break down in the ocean. Once they are broken down, they are often ingested by marine life causing digestion blockage and death.
Don’t flush plastic tampon applicators. They end up in the ocean. It even says right there in the directions not to flush the plastic applicators.
Every tampon and pad has an environmental impact, whether it’s the waste of the product itself, or the packaging, the plastic or cardboard applicators, or the less visible costs of transportation and production.
Almost all conventional sanitary pads and tampon applicators are made with crude oil plastic. Tampons themselves are made from chlorine-bleached wood pulp, synthetic fibers, and a small amount of heavily-sprayed, GMO cotton. The pollution created from the toxic chemicals that are needed to make these fibers and grow/process the cotton is devastating to the water, air, soil and natural habitats nearby.
This doesn’t even begin to take into account the vast amount of oil, water, trees, soil and gasoline that are depleted in the manufacture, packaging, delivery and disposal of these single-use products.
They found that the main environmental impact of the products was caused by the processing of raw materials, particularly LDPE (low density polyethelene)—or the plastics used in pads and tampon applicators, and cellulose production.
As production of these plastics requires a lot of energy and creates non-biodegradable waste, the main impact from the life cycle of these products is fossil fuel use, though the waste produced is significant in its own right.
Indeed, any product we make that is mostly plastic and put in the landfill after a single usage is, by definition, unsustainable.
What’s Really in Those Sanitary Pads and Tampons?
Many well-known, nationally-advertised brands of tampons, pads and panty liners are made mostly of synthetics like rayon, and sometimes contain a small amount of cotton.
Sanitary pads made by many of the best known brands also contain something called SAPs, or Super Absorbent Powders. SAPs are made from polymers that are derived from crude oil. Think about where those SAPs will be touching.
According to a groundbreaking scientific report on feminine hygiene products by Women’s Voices for the Earth, test results show dioxins, furans, and pesticide residues in tampons and pads, which have been linked to cancer, reproductive harm, and endocrine disruption.
In testing, Always menstrual pads and pantyliners in particular were found to contain several chemicals of concern, including the following:
- Styrene: carcinogen
- Chloromethane: reproductive toxicant
- Chloroethane: carcinogen
- Chloroform: carcinogen, reproductive toxicant, neurotoxin
- Acetone: irritant.
- Glyphosate (Round-up): carcinogen
You can assume that Always is not alone in containing these ingredients.
This video by Andrea Donsky demonstrates what happens when an organic vs. conventional sanitary pad is burned. The 100 percent organic cotton pad, made by Natracare, burns slowly and cleanly, leaving virtually no residue.
But the Always Infinity pad with its mostly undisclosed ingredients creates black smoke and thick residue, indicating the pad contains synthetic fibers, plastics, and petrochemical additives.
In fact, most conventional sanitary pads and tampons can contain a lot of plastic, which is made from crude oil. With everything we now know about the hazardous nature of plastic, this alone is cause for concern.
These chemicals include Bisphenol A (BPA), found in most sanitary pads, which has been found by many health researchers to disrupt the function of hormone-releasing endocrine glands, particularly in fetuses and babies. BPA has also been linked to cancer and heart disease. (In July 2012, the United States Food and Drug Administration banned the use of BPA in baby bottles and sippy cups.)
Phthalates, which give paper tampon applicators a smooth finish, are known to disrupt hormones and disregulate gene expression. Pre-natal exposure to phthalates has been linked to premature birth and low birth weight. Exposure to phthalates has also been linked to breast cancer, childhood obesity and type-2 diabetes.
The synthetic fibers and plastic in tampons and pads also restrict air flow and trap heat and dampness, potentially promoting yeast and bacteria growth in your vaginal area (including the bacteria that causes TSS).
Besides BPA and phthalates, conventional sanitary pads and tampons can also contain other potentially hazardous ingredients, such as odor neutralizers and fragrances, artificial colors, polyester, adhesives, polyethylene (PET), polypropylene and propylene glycol (PEG), which are contaminants linked to hormone disruption, cancer, birth defects, dryness and infertility.
Yikes! Do you really want these chemicals against your most sensitive bits?
GMOs in Tampons and Pads
In her book, Label Lessons, Andrea Donsky points out some scary facts, such as:
- Cotton is known as the world’s “dirtiest crop.” Approximately 84 million pounds of pesticides and herbicides are sprayed on 14.4 million acres of conventional cotton grown each year in the U.S. These chemicals are some of the most toxic used in agriculture, and the Environmental Protection Agency has declared seven of the top 15 to be possible, likely, probable, or known human carcinogens.
- Conventional tampons and pads contain genetically-modified organisms (GMOs). According the USDA, 94 percent of all U.S. cotton is genetically engineered.
In a preliminary study from the University of La Plata in Argentina, glyphosate (Round-up), a widely popular herbicide used on GMOs that has been linked to cancer, was detected in 85 percent of cotton hygiene products tested!
Sixty-two percent of the samples also tested positive for AMPA (or aminomethylphosphonic acid), a derivative of glyphosate.
In some ways, inserting a GMO-cotton tampon several times every month is no different than eating GMO food. It might even be worse, considering the vaginal wall is highly permeable and allows toxins like pesticide residues and GMO proteins direct access into the bloodstream.
Dioxin in Tampons and Pads
The rayon/viscose used in tampons and pads is made from wood pulp, and hundreds of chemicals are used during the process of converting wood to rayon. The chlorine dioxide bleaching (known as elemental chlorine free or ECF bleaching) of wood pulp is where the greatest danger lies.
While safer than regular bleaching, the ECF process creates chlorinated hydrocarbons, a hazardous group of chemicals with byproducts that includes dioxins, some of the most toxic substances known.
Studies have shown that the manufacturing of chlorine dioxide does not produce a pure product, as tampon manufacturers claim. Most are contaminated with a certain amount of elemental chlorine. In commercial production of these products, chemical reactions that take place during the bleaching process liberate elemental chlorine atoms from some of the chlorine dioxide molecules. This increases the burden of elemental chlorine in the bleaching process, which can create and release dioxin.
The FDA has acknowledged that chlorine dioxide, though elemental chlorine free, can still generate dioxins at extremely low levels. It’s for this reason that the Worldwatch Institute has referred to ECF bleaching as a “low-tar cigarette strategy.” Basically, the new EFC bleaching method lowers the amount of dioxins created, but does not eliminate them completely.
A 2002 study published in Environmental Health Perspectives found low levels of dioxin in four different brands of tampons. This is concerning because the US Environmental Protection Agency released an in-depth report on dioxins in 2012 that concluded that dioxins could have “potentially serious [health] effects at ultra-low levels of exposure,” and that “…no safe level for dioxin exposure exists.”
Given that dioxin is cumulative and slow to disintegrate, the real danger comes from repeated contact. I think it’s safe to say that five days a month, 12 months a year, for nearly 40 years could be considered repeated contact.
Tampons and Toxic Shock Syndrome
TSS, which got its name in 1978, is basically a complication of an infection of staph bacteria (or Staphylococcus aureus). It doesn’t only happen to women, but there’s been a link between TSS and tampon usage for decades, due largely to a spike in TSS-related deaths when new brands of synthetic fiber tampons were introduced in the 1980s.
Though not prominently displayed, there are warnings about the risk of TSS printed on every box of tampons. (Did you know?) This is basically a “Get out of jail free” card for tampon manufacturers to avoid liability and responsibility for making a safer product.
A tampon alone is not enough to cause TSS—a person must already have Staphylococcus aureus present in his or her body. About 20 percent of the general population carries the bacteria.
The tampons with the highest risk of leading to TSS are the ones made with synthetic fibers—which includes all of the mainstream brands. It is the combination of carrying Staphylococcus aureus bacteria in the vagina and using a synthetic fiber tampon that can cause tragedies like what happened to Lauren Wasser, and thousands of women before and since.
Dr. Philip M. Tierno, a professor of microbiology and pathology at the NYU School of Medicine who has done serious research into the link between tampons and Toxic Shock Syndrome, agrees that cotton would be safer:
“Most major tampon manufacturers make tampons with either mixes of viscose rayon and cotton, or pure viscose rayon, and in either case those tampons provide the optimal physical-chemical conditions necessary to cause the production of the [TSS toxin] if a toxigenic strain of Staphylococcus aureus is part of the normal vaginal flora in a woman… Therefore the synthetic ingredients of a tampon are a problem, whereas 100 percent cotton tampons provide the lowest risk, if any risk at all.”
How to Reduce Your Risk of Exposure to Toxins in Tampons and Sanitary Pads
Current regulations on the chemicals used in feminine care products are too weak protect public health, according to WVE’s report. Tampons and sanitary pads are regulated as medical devices, which means that companies are not required to disclose the ingredients, nor do they have to prove the chemicals they are using in these products are safe. That means companies are legally allowed to use ingredients linked to cancer, birth defects, and other chronic diseases.
The only thing you can do to avoid these toxins is to choose alternatives you can be sure do not contain them. Here are the best choices, in order of environmental value and cost…
Organic Tampons and Pads
All natural, organic tampons are made from non-GMO certified, organic cotton. They are free of irritating dyes, fragrances, rayon and all the risks that come with rayon. Choosing certified organic cotton, chlorine-free tampons reduces the amount of dangerous toxins and pesticide pollution in our environment and in your body.
These tampons function in the exact same manner as conventional tampons and come in a variety of absorbencies with or without an applicator. Even though they contain more natural ingredients, there is a lot of waste and water usage associated with these products. However the waste is less toxic, and if you use the tampons without the applicator, there will be less to throw away.
It is advised to use the lowest absorbency needed to avoid any potential risk of TSS. Organic tampons are only marginally more expensive than conventional tampons, but you are worth it.
Sea Sponge Tampons
Sea sponges are small creatures that grow in colonies on the ocean floor. When sea sponges are harvested, millions of egg and sperm cells are released into the surrounding water, which makes the sponge a renewable resource and an ecologically sound product for menstrual use. They are completely biodegradable and are not treated with chemicals or bleach.
Natural sea sponges are worn internally to absorb the menstrual flow, just like a tampon. As with tampons, they need to be changed every few hours, but, unlike tampons, the sea sponge is not thrown away. Another dry sponge may be inserted or the used one can be rinsed and reinserted.
Sponges need to be boiled before use, and must be washed between uses with natural cleaning methods solutions, such as vinegar and water, or baking soda and water. They last 6-8 months. (Where to find sea sponge tampons.)
Reusable pads are cloth pads that work just like disposable sanitary pads. They usually snap or velcro around your panties, and are made from soft 100% organic cottons and flannels that can be washed by hand or in the washing machine.
Washing pads every month does take some water and energy, but far less than the water and energy that goes into making, transporting and disposing of disposable pads.
You can find sewing patterns to make a reusable pads at home here. You can also find ready-made reusable pads by Gladrags, Lunapads, Sckoon and other brands here.
Menstrual cups do put you into closer contact with your body and your blood, and they have a bit of a learning curve to initially using them, but they are also the most risk free, maintenance free, environmentally-friendly and cost-effective choice.
Menstrual cups generally hold twice as much liquid as tampons, and as there is zero risk in TSS (no cases reported), the cup can be left in twice as long. Most women only need to empty them twice a day, in the morning and evening. They can essentially be inserted and forgotten. Many women also say that they experience fewer menstrual cramps when using menstrual cups.
Menstrual cups have a life expectancy of ten years. They come in two sizes: one for before childbirth and one for after childbirth, and each brand is a little different in size and shape. Because they have no harmful chemicals or residues, they can be inserted when you’re expecting your period to avoid any accidents.
The most popular brands of menstrual cup include the Keeper, the Mooncup and the Diva Cup, though more brands are entering the market as menstrual cups become more popular. Both the Mooncup and the Diva Cup are made from medical grade silicone, and the Keeper is made from natural gum rubber (latex).
The upfront cost for these reusable products is high at about $35-40, but when compared to the ten year cost for tampons, the value is clear:
- Tampons: $5.00 monthly x 120 months = $6000.00
- Reusable Menstrual Cup: 0.32 monthly x 120 months = $38.00
If the menstrual cup works for you, it is far and away your most sustainable, least toxic and most affordable option. You can find a wide selection of menstrual cups online here.
Choosing a non-toxic, less wasteful option for one’s menstrual cycle can make a big difference for your wallet, your health, the health of all women, and for the planet. Thank you for making a difference!