Sanitary pads, menstrual cups, menstrual underwear, sponges, tampons – there are several alternatives for menstrual hygiene. Many women opt for tampons, disposable products that are thrown away after use. On average, each woman uses up to four tampons a day during her period, each of which remains in the vagina for several hours. In her lifetime, she made about 7,400 tampons. The results are even more intriguing University of California, Berkeley study [externer Link]according to which toxic metals could be detected in tampons.
Tampons are made of cotton and/or rayon and are inserted into the vagina to absorb and retain menstrual blood. They have an absorbent core, non-woven outer covering, recovery thread and may also have an applicator (cardboard or plastic) for insertion.
Toxic metals and non-metals in all tampons
In total, scientists measured the concentrations of 16 metals and metalloids (arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, manganese, mercury, nickel, lead, selenium, strontium, vanadium and zinc) in 30 tampons. 14 brands of tampons and 18 product lines were examined and the concentrations compared.
The researchers found more metals and metalloids in all tampons. Only the two toxic metals, chromium and mercury, were either absent or found in only a small percentage, says Kathrin Schilling, an assistant professor of environmental health sciences at Columbia University in New York City and a co-author of the study. It’s an interesting study result, because a previous study found a correlation between tampon use and slightly higher blood mercury levels, though not statistically significant; that prompted the research team for the current study to look for metals in tampons as a whole.
Lead, cadmium and arsenic in all tampon samples
Lead, cadmium and arsenic were found in all samples. The concentrations of the metals differed depending on the region in which the tampons were purchased (US, EU or UK), whether they were organic or non-organic and whether they were branded tampons. Lead concentrations were higher in non-organic tampons, while arsenic concentrations were higher in organic tampons. “We wanted to get an overview of how much of each metal was in the tampons. What was surprising or shocking to us was that we found lead,” says Schilling.
According to Schilling, lead is toxic in any concentration and is particularly problematic with frequent contact: lead has a half-life in the body of 10 to 30 years. Therefore, you should avoid any avoidable contact. This is often not possible because the toxic heavy metal is found in the environment – for example in water. In Germany, there are limit values for lead in drinking water. One liter may contain a maximum of 0.010 mg/l, so the Federal Environment Agency [externer Link]. A buffer dissolved in one liter of water released significantly more lead.
Although tampons are not a daily food item and are used only a few days a month, a woman will use more than 7,000 tampons in her lifetime if she uses them regularly. “That’s a lot of lead that you could theoretically be exposed to,” says Schilling, but adds: “Don’t panic, we don’t yet know whether all the lead from this tampon can actually pass into the body.” The extent to which substances are absorbed through the vagina, other than through drinking or eating, for example, and how quickly they can be metabolized is a complex interplay of several factors, such as the woman’s age, the pH value of the mucous membrane, the duration of menstruation, etc. This requires even more detailed investigations.
The same applies to arsenic – it is always poisonous. It is not just about people like metalworkers, who are severely exposed to higher doses and where higher concentrations can be detected. “It has now been proven that even low, chronic doses can eventually lead to cardiovascular disease or diabetes,” says Schilling. And that is why the limits for arsenic in water are being revised in the USA. One problem is that reducing the limit values is always a question of money, because more intensive filtration costs more money.
However, for Elisabeth Mertl, a researcher at the Austrian Institute for Chemical and Technological Research (OFI), the results of the study are not surprising. She has been researching the composition of menstrual products for some time and how they could be better regulated. For her, however, the amounts of metals are very small and: “If I want to find something in minute quantities, I will find it in almost all products.” Mertl works in Technical Committee 338 of the so-called ISO group, an international working group working to develop a standard for menstrual products. The goal is to have such a standard published by the end of 2026.
Should I continue using tampons or not?
It is currently difficult to estimate how high the health risks really are. This requires further study. “I would not advise you to stop using tampons. If you want to use them, feel free to do so,” says Schilling. This is the first study in this direction and it will then be necessary to see how much metals and non-metals actually dissolve during use.
Mertl also advises not to panic about this study, as the concentrations found in tampons were “very, very low.” In Mertl’s opinion, the results are not really significant in terms of risk to women using such products. With pads or menstrual cups as an alternative to tampons, other risks may arise.
With a menstrual cup, for example, “you tend to have less chance of consuming certain substances,” says Mertl, because you’re using the same cup for a longer period of time. “But on the other hand, there may be a lot more microbiological aspects that I need to pay attention to. How well can I clean it? Do I tend to get infections in the intimate area more often? These are different aspects that you should consider for yourself when making your selection.”
What is important for the end consumer is to observe yourself. If problems arise, you should question whether the product in question is the right one and try a different one. There are a variety of menstrual products: “Maybe you can try a different product? How does your body react to it and so on? That is certainly something you can do as a consumer. And of course, what is also possible is for the manufacturer or the manufacturers to impose more labeling requirements and require more information.”
Where do the toxic metals in tampons come from?
Scientists can only speculate as to why tampons are contaminated with toxic metals. One possible explanation is that the cotton plants came into contact with contaminated soil and water during growth. Abrasion from machinery may also have occurred during the manufacturing process. Some metals may also have been added. Zinc, for example, has antibacterial effects. But researchers cannot say for sure because manufacturers are not required to publish the composition of these hygiene products.
The purpose of the study: rules and controls
The aim of the study is to highlight a lack of regulation and provide an impetus for closer scrutiny, Schilling says. Manufacturers could be required to make their products’ ingredients more transparent and to write more information on product packaging — for example, about the country of origin of raw materials like cotton. In India, for example, there is a higher concentration of arsenic in water.
In addition, products and raw materials must be tested for the presence of toxic substances. In addition, the production process must be examined to see where metals may enter the product.
The study is already leading to early action: The U.S. Food Drug Administration (FDA) and Health Canada have already taken a closer look at the study, Schilling says. Now they want to conduct a risk assessment and think about regulations.
The Federal Institute for Risk Assessment (BfR) in Germany assumes that no health problems are to be expected from the use of tampons. However, the following also applies here: “Although the intake is negligible compared to the total intake from other sources, the levels of heavy metals should be further reduced through responsible selection of raw materials and good manufacturing practices.” The ALARA principle (as low as reasonably achievable) applies to lead, writes the BfR at the request of Bayerischer Rundfunk.