The researchers found 16 different types of metals in the tampons they examined, including heavy metals like lead and arsenic.
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Researchers have found toxic metals, including arsenic and lead, in more than a dozen popular brands of tampons, raising questions about a menstrual hygiene product used by millions of Americans.
Their study, published last week in the scientific journal International Environmentadds to a growing body of research on chemicals in tampons, but is believed to be the first to specifically measure metals.
The negative health effects of heavy metals are well documented and far-reaching. They can include damage to the cardiovascular, nervous and endocrine systems, damage to the liver, kidneys and brain, increase the risk of dementia and cancer, and harm maternal health and fetal development.
“Despite this significant potential for public health concern, very little research has been conducted to measure the chemicals in tampons,” lead author Jenni Shearston, a postdoctoral researcher at the University of California, Berkeley, School of Public Health, said in a statement.
Shearston led a team of scientists from Columbia University and Michigan State University who examined 30 tampons from 14 brands and 18 product lines, which they did not name in the study.
The sample includes products of varying degrees of absorption, listed as “best sellers” by a major online retailer and purchased online and in stores in New York, London and Athens between September 2022 and March 2023.
The researchers detected “measurable concentrations” of all 16 metals they were looking for in the tampons, as well as “high average concentrations” of toxic metals, including lead, arsenic and cadmium.
The study found that metals can end up in tampons in a number of ways. Raw materials like cotton and rayon can be contaminated by water, air or soil during production, while metals can in some cases be intentionally added during the manufacturing process, either to control odors, as a pigment or as an antibacterial agent.
According to the study, the exact amount of metals varied among tampons, depending on the region of purchase, whether they were organic or inorganic, and whether they were branded.
“Lead concentrations were higher in non-organic buffers, while arsenic concentrations were higher in organic buffers,” he added. “No category had consistently lower concentrations of all or most metals.”
Researchers say the study marks an important first step in confirming the presence of toxic metals in tampons, which are used by an estimated 52 to 86 percent of menstruating people in the United States.
But that doesn’t give them enough information to make a definitive link between the metals and negative health effects.
They say more studies are needed to determine the extent to which these metals can “leak out of tampons” and enter people’s bodies. They are calling not only for more research, but also for stricter regulation.
“I really hope that manufacturers will be required to test their products for metals, especially toxic metals,” Shearston said. “It would be interesting to see the public demand for that or better labeling of tampons and other menstrual products.”
In the United States, the Food and Drug Administration (FDA) classifies tampons as medical devices and regulates their safety. However, there is no requirement to test tampons for chemical contaminants, and the FDA only recommends that tampons not contain pesticide or dioxin residues.
FDA spokeswoman Amanda Hils told NPR that “all studies have limitations,” noting outstanding questions about whether tampons release metals into the bloodstream. Still, she said the agency is reviewing the research.
“We plan to evaluate the study closely and take all necessary steps to protect the health of consumers who use these products,” Hils added.
NPR has reached out to the Baby and Adult Hygiene Products Industry Center (BAHP) and its British counterpart, the Absorbent Hygiene Product Manufacturers Association, for comment.
BAHP defended the safety of its member companies’ menstrual products in a 2022 statement, acknowledging media coverage about the presence of chemicals and saying that “if present, these are not intentionally added by manufacturers.”
“Some of these impurities are present in the environment or naturally present at much higher levels in common fruits and vegetables or even manufactured by the human body,” she said, adding that its members use “rigorous quality and hygiene criteria.”
The big question: How harmful are these metals?
Several experts told NPR they weren’t surprised by the researchers’ findings, since other studies over the years have detected potentially harmful chemicals in tampons and other menstrual products, including menstrual underwear.
Catherine Roberts, health and science journalist at Consumer Reports who wrote about tampons, says it is more surprising that the issue was not studied earlier.
“It’s the most sensitive part of the human body. It’s so close to us,” she says. “We use so many tampons in our lifetime. It’s just amazing that this topic is so under-researched and under-regulated.”
People who menstruate may use more than 7,400 tampons during their reproductive years, the study authors calculated, with each tampon remaining in the vagina for several hours at a time.
According to Dr. Nathaniel DeNicola, an ob-gyn and environmental health expert with the American College of Obstetricians and Gynecologists, the most pressing question isn’t whether there are chemicals in tampons, but rather “when does it become dangerous?”
Some of the metals in tampons, including copper, calcium, iron and zinc, are not only considered safe but recommended by many doctors, he notes. They wouldn’t be harmful in small amounts, but a cumulative amount could have a lasting effect on a person’s endocrine functions.
Arsenic, for example, is sometimes present in trace amounts in foods and is not considered toxic, but high levels can be deadly. In contrast, as the study points out, “there is no safe level of exposure” for lead.
The study doesn’t tell us whether people are consuming harmful amounts of each metal from tampons, DeNicola says.
“When you start looking at the kinds of chemicals that are in our bodies, the reality is that in modern life, we’re kind of swimming in them,” he adds. “And that’s not to say that we shouldn’t be concerned about them. I mean, I don’t think most people hear this and think, ‘Oh, good, I have more plastic in me.’ But we have to recognize that small amounts of these chemicals are everywhere.”
What to do if you are worried
For Roberts, one of the study’s key findings is that “the organic label clearly does not guarantee that these products are free of heavy metals.” So what should concerned consumers do?
Ideally, she said, regulators should mandate heavy metal testing of tampons to take some of the pressure off consumers.
In the meantime, she said, there are some steps tampon users can take to try to reduce their exposure to chemicals in general.
This includes choosing products that do not contain plastic (including polyester and polypropylene) and avoiding those that contain fragrances and dyes.
“What people who look at this tend to say is look for periodic product labels that have fewer ingredients and simpler ingredients,” Roberts adds.
DeNicola recommends relying on a combination of “third-party testing and personal verification.” He says there are apps shoppers can use to scan product barcodes and see what chemicals they contain, which could be helpful for personal care and feminine hygiene products.
In some cases, women may consider using alternatives to tampons, such as sanitary towels or menstrual cups. Reusable cups have become increasingly popular in recent years, particularly due to their lower environmental impact compared to tampons.
Some disadvantages of tampons were evident long before this study.
DeNicola points out that tampon plastic is one of the largest sources of waste in the world (and some brands are more environmentally friendly than others). Roberts points out that even if they didn’t contain chemicals, tampons would still pose a risk of toxic shock syndrome, a rare but potentially fatal condition (users can reduce this risk by changing tampons frequently).
But DeNicola stresses that this study doesn’t prompt him to rush to tell his patients not to use tampons at all.
“I don’t think we’ve established that risk yet,” he says. “I think it’s more of a wake-up call for consumers and the general public: Most of the products you use are not rigorously tested for safety, and most of them have chemicals in them somewhere.”
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