UPDATED SEPTEMBER 11, 2024. Should you be worried about lead and other toxic metals in your tampons? That’s the question on everyone’s mind this week following the release of a new study that has users of the hygiene product on edge.
The study, published in the August edition of the journal Environment International, found that “several toxic metals, including lead” were detected in tampons that the researchers purchased from brick-and-mortar stores in New York City, Athens, Greece, and London, plus from two “major online retailers.” Researchers studied the concentrations of 16 metalloids in 30 tampons across 18 product lines from 14 unnamed brands (both brand-name and “store-brand”). Their report states that they found “elevated mean concentrations” of lead, cadmium, and arsenic in all the tampons tested. They also found that “lead concentrations were higher in non-organic tampons,” while organic tampons had higher levels of arsenic. The highest concentration of any metalloid found in the tampons overall was zinc.
The results are alarming enough that they’ve prompted the Food and Drug Administration (FDA) to begin its own investigation into tampon safety. “While the study [published in Environment International] found metals in some tampons, the study did not test whether metals are released from tampons when used. It also did not test for metals being released, absorbed into the vaginal lining, and getting into the bloodstream during tampon use,” wrote the FDA in its September 10, 2024 statement. “The FDA’s laboratory study will measure the amount of metals that come out of tampons under conditions that more closely mimic normal use.” Based on their findings—and on an independent comprehensive review, commissioned by the FDA, of existing literature on the metals—the FDA explained that it will “complete a risk assessment of metals contained in tampons, based on a worst-case scenario of metal exposure.” The findings will be peer-reviewed, and then shared with the public. In the meantime, the FDA said it would “continue monitoring these devices [tampons]... We want the public to know that before tampons can be legally sold in the US, they must meet FDA requirements for safety and effectiveness. Manufacturers must test the product and its component materials before, during, and after manufacturing.”
So what does this all mean for tampon users right now? Should people immediately throw theirs away and switch to another type of menstruation product for good? It’s understandable that seeing the words “lead” and “arsenic” associated with something you put inside your body on a regular basis would set off alarm bells. Both of those metals can contribute to some very serious health issues—especially if you’re thinking about having or adding to a family—but it’s not necessarily worth freaking out just yet.
“Users should stay informed but not panic,” says Dr. Lucky Sekhon, M.D., a board-certified reproductive endocrinologist and OB-GYN at RMA New York. “The study found trace amounts of toxic metals in tampons, but the levels were generally low,” she explains. Until we have the results of the FDA's study, there is no indication that these metals at the detected levels can leach into the body. “Given the limited amount of exposure to tampons—generally used for four to seven days per month—and the small amounts of heavy metals detected, it is likely safe to continue using tampons,” says Dr. Sekhon.
While the summary findings seem alarming at first, it’s worth noting that there are a lot of “maybes” regarding this study. For one, researchers didn’t share which tampon varieties they studied, so, despite what you may have heard on social media in the past few days, users can’t know for sure whether their specific brand was impacted. And without knowing which companies are making said tampons, “it is difficult to identify… if there is a specific country or source of where the contaminants are from,” explains Dr. Meleen Chuang, MD, chief of obstetrics and gynecology at NYU Langone Hospital Brooklyn. Dr. Chuang points out that some of the metalloids the study calls out are being added intentionally during production. “The study notes that metals such as calcium and zinc are intentionally added to help with odor control,” she says. The FDA notes that lead present in food often occurs because the lead that was once commonly used in paint, gasoline, and other products has leached into the soil, which in turn shows up in crops. It’s possible (though, again, we can’t know for sure) that the same is happening to the cotton that’s used to make many tampons.
Though there has been your typical round of people on social media screaming into their front-facing camera about how this “proves” that tampons are unsafe, the study actually concludes that there is a need for further research to “replicate our findings and determine whether metals can leach out of tampons and cross the vaginal epithelium into systemic circulation.” The FDA’s pending study will shed more light on the situation. And for now, it’s important to note that these findings are not related to toxic shock syndrome, a potentially life-threatening bacterial infection associated with some tampons.)
If the metals were to enter your body via a tampon, could they impact reproductive or general health? “Potential health impacts could include neurobehavioral issues from lead exposure,” says Dr. Sekhon. “However, there’s currently no evidence that these metals leach out or are absorbed by the body and the levels of exposure are very low relative to what is considered safe exposure.” Dr. Sekhon says that the average amount of lead found in tampons was “actually very small,” and far lower than what is considered “concerning levels of exposure” in food or water.
“This doesn’t invalidate the study’s findings, but it’s an important point to consider as people decide if they are comfortable to continue using tampons or not,” she says. “Even if trace metals are present in tampons, they are not necessarily released or absorbed into the bloodstream through the vaginal wall.” What we don’t know for sure for now is whether the metals are absorbed by the vaginal wall mucosa. Dr. Sekhon says that overall, exposure is minimal because tampons are only used for a few days each month.
That’s not to say you should brush off the results of the study entirely. After all, we do have evidence that the metals mentioned cause harm in other contexts: People are exposed to lead frequently throughout an average day, as it can be found in water, air, and products like paint, pipes, and batteries. If that lead is inhaled or ingested, as noted by the World Health Organization, it can lead to high blood pressure, kidney damage, and cardiovascular problems in adults. Children and pregnant people are particularly vulnerable to lead, as exposure to lead in childhood can lead to a host of side effects, including permanent brain damage and death. In other words, as the WHO puts it, there is “no level of exposure to lead that is known to be without harmful effects.” Arsenic, on the other hand, is most frequently found in contaminated water, which can then contaminate food as well as tobacco. Long-term exposure can lead to skin lesions that may develop into skin cancer, bladder and lung cancer, and diabetes.
Charalampos Chatzicharalampous, MD, PhD, a reproductive endocrinologist and clinical geneticist at Kofinas Fertility Group, cautions that “some of these metals have no safe level threshold,” which means that any potential exposure could impact your health. “We should be worried about contaminants,” he shares. “Environmental exposures are extremely important in female health and fertility. How much? No exposure is safe.” Dr. Chatzicharalampous says that unless there are strict regulations laying out safe limits that were created after rigorous research, there is “no safe level of exposure.”
The FDA classifies both scented and unscented tampons as a class II medical device, meaning they require special regulatory controls. What’s known as biocompatibility testing—including biological evaluation and toxicological risk assessment— has to be undertaken by the manufacturer, and reviewed by the FDA before tampons can be sold in the US. “All studies have limitations. While the chemical method used indicates these metals are present in the tampons tested in the laboratory, the study does not assess whether any metals are released from tampons when used in the body,” an FDA spokesperson told Allure. “It also does not address whether any metal, if released, can be absorbed into the vaginal lining or, subsequently, into the bloodstream.”
If these findings stress you out regardless, Dr. Chuang recommends finding an alternative to tampons (like a menstrual cup or disk or period underwear, for example). “It is very reasonable to reduce exposure as much as possible,” she says. When in doubt, talk to your doctor about your concerns.
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