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From the onset of menstruation until menopause, women rely on menstrual hygiene products. Among these, tampons and sanitary pads are the most commonly used disposable items. In the United States, 52%-86% of menstruators use tampons, primarily due to cultural preferences. Historically, there has been no clear distinction in the safety between tampons and sanitary pads.

However, a study titled "Tampons as a Source of Exposure to Metal(loid)s," published in the journal Environment International, raises concerns. The researchers tested tampons purchased from the US, EU, and UK, covering 14 brands, 18 product lines, and 30 types of tampons.

Should Tampons Be Tested for Metals?

Prior to this study, tampon safety assessments focused on 15 chemical substances, excluding metals. Research indicates that plants used in tampon production can accumulate metals over time. Moreover, manufacturers may add metals during production for purposes such as whitening, antibacterial properties, odor reduction, lubrication, and as pigments for applicators. These factors suggest that tampons could potentially exceed safe metal limits.

Tampons, designed to be inserted into the vagina to absorb menstrual blood, consist of cotton and/or rayon fibers, an absorbent core, an external non-woven cover, a withdrawal string, and sometimes an applicator (made of cardboard or plastic). A menstruator might use over 7,400 tampons in a lifetime. Due to the high permeability and vascularization of the vaginal mucosa, chemicals, including metals, can be efficiently absorbed into the bloodstream. This was notably highlighted in the 1980s when toxic shock syndrome outbreaks were linked to tampon use. Given the global prevalence of heavy metal poisoning incidents, it is clear that excluding metals from tampon safety assessments is not in the best interest of women. Testing tampons for metal content is necessary.

A tampon separated into its components, including the (A) non-woven outer covering, (B) withdrawal string, (C) inner absorbent core, (D) applicator, and (E) wrapper

Credit:Tampons as a source of exposure to metal(loid)s

What Metals Were Found in Tampons?

The study detected 16 metals in tampons, including arsenic [As], barium [Ba], calcium [Ca], cadmium [Cd], cobalt [Co], chromium [Cr], copper [Cu], iron [Fe], mercury [Hg], manganese [Mn], nickel [Ni], lead [Pb], selenium [Se], strontium [Sr], vanadium [V], and zinc [Zn]. Except for chromium and mercury, the concentrations of these metals were significant, with calcium and zinc being the highest. Among these, lead, cadmium, and arsenic are particularly harmful. Low levels of lead can cause neurobehavioral abnormalities in both adults and children. Arsenic is a known carcinogen, while cadmium can lead to kidney damage and cardiovascular issues.

Given the frequent use of tampons, it is crucial to investigate whether these heavy metals are absorbed into the body through the vaginal route. This will be a focus of future research by the team. As this research continues, it raises immediate questions: Should women continue using tampons? Should governments mandate metal testing in tampons? These are questions that demand careful consideration by all stakeholders.

Reference:

enni A. Shearston, Kristen Upson, Milo Gordon, Vivian Do, Olgica Balac, Khue Nguyen, Beizhan Yan, Marianthi-Anna Kioumourtzoglou, Kathrin Schilling,Tampons as a source of exposure to metal(loid)s,Environment International,Volume190,2024,108849,ISSN:0160-4120,https://doi.org/10.1016/j.envint.2024.108849.