If you're on the internet too often (guilty), you're probably aware that there's an ongoing conversation about tampon ingredient transparency. The discussion of what exactly is in your tampons has developed over the years, but it all started with a 2013 report revealing that ingredients like dioxides, furans, unidentified fragrance chemicals, and pesticide residues may be used in the manufacturing of some tampons and pads.
None of that sounds exactly warm and fuzzy, but what makes it extra concerning to a lot of folks is that the FDA has regulations around menstrual products that many advocates consider far too loose. The situation is certainly murky, but is it actually worth stressing over? Here's what you need to know.
How are tampons regulated?
Tampons are classified by the FDA as "medical devices," which means that companies aren't legally required to divulge the ingredients in the tampons they sell. Tampons are typically made of cotton, rayon, or polyester, but beyond that, consumers aren't always privy to info about which materials go into the manufacturing process. This lack of required transparency is at the center of many people's concerns about the issue.
While ingredient lists are voluntary, the FDA does suggest that tampon manufacturers include some basic details about what the product is made of, which is why you'll see lots of tampon boxes including phrases like "may contain" followed by a nebulous list of chemicals.
That said, tampons are subject to an FDA review "to determine whether they are substantially equivalent to, including as safe and effective as, a legally marketed tampon."
Which ingredients in tampons have people worried?
A handful of ingredients are on advocates' radars, but few have caused more discussion than dioxins. These persistent organic pollutants are thought to be left behind as a byproduct of the bleaching or purifying process during tampon manufacturing.
Research on whether dioxins in tampons might be harmful is somewhat conflicting. A study that directly focused on the effect dioxins in tampons and diapers has on humans found that the concentration was too low to be worth worrying over. Humans have a daily limit of how many dioxins is "too many" to be exposed to, and this study reported that the trace amounts in a tampon are so low that they hardly make a blip. (In fact, the study noted that we're exposed to many dioxins via the foods we eat.)
On the other hand, research on nonhuman primates has found a connection between dioxin exposure and endometriosis. This link hasn't yet been found in humans, but it's still worth keeping in mind.
How concerned do we need to be?
Some experts have argued that while the concentration of dioxins in a single tampon may be inconsequential, the scale looks different when you consider just how many thousands of tampons a menstruating person uses throughout their life—basically, that exposure can add up. At this point, it's tough to say if that's a genuine risk, but it's something to consider.
Up until the 90s, the tampon manufacturing process involved bleaching the materials used in tampons with chlorine gas. That was halted in an attempt to reduce dioxin risks (clearly, we've been worried about them for quite a while now). These days, big tampon brands claim to use chlorine-free bleaching processes instead.
The jury is still out, but based on where the research stands right now, remaining cautiously aware is the important thing. There's no need to panic or throw all your tampons in the trash. That said, it's worth paying close attention to any new research as it develops.
Just as with household cleaning products, the clothes we buy, and the foods we eat, concern about ingredients is all relative. There are so many chemicals involved in the making of our products and our food, and most of them are not linked to health issues by any evidence. (Of course, that can always change in the future, so it's important to keep an eye on research.)
What are the alternatives?
At the end of the day, it's up to you to do a gut check on how comfortable you are with what you're buying. If the murkiness surrounding major tampon brands makes you uneasy, there are plenty of organic tampons on the market you can opt for instead. (LOLA, Cora, and Seventh Generation are a few organic brands to use as a jumping-off point).
There are also menstrual discs, like FLEX, and cups, like Saalt, Lena, and Lunette, which are great alternatives since they vastly reduce your (already very small) risk of contracting toxic shock syndrome.
However, there's also a real learning curve using these, so it's a good idea to have a backup method for the first couple of cycles, like panty liners or a pair of Thinx period underwear (which can also just be your method, especially if your cycle is pretty light or you're getting toward the end of your cycle).
In an ideal world, we'd have a lot more transparency about what goes into tampons. But until that day comes, the best we can do is stay aware and continue to put pressure on tampon brands to be more forthcoming. In the meantime, there's no need to panic: Go forth, find a menstrual product that works for you, and don't lose any sleep over it.