Tampons - and cancer?
What’s the myth?
That some tampons contain harmful chemicals that leach from the product, increasing the risk of various health issues including breast and ovarian cancers, endometriosis and infertility.
And that organic tampons are safer than conventional tampons, which may be made up of combinations of natural and synthetic materials.
These broad claims were based on the findings of one small NZ study [1] that measured the levels of oestrogen activity of four tampon brands. (Oestrogen is one of the main sex hormones, particularly in women, and is responsible for a range of essential human health and development functions.)
Some mainstream and social media contained statements that went well beyond the study’s findings and may have caused undue alarm.
Synthetic, organic…what??
Synthetic means man-made. For chemicals, this means chemicals made in a laboratory.
For ‘organic’, there is no universal definition. Generally, it means a product that has been produced without any contact with synthetic chemicals. For example, organic cotton should have been grown without the use of synthetic pesticides or genetically modified seeds. ‘Certified organic’ is clearer, meaning products that have been independently assessed as meeting an organic standard.
In Australia, products don't need to meet a particular standard to be labelled as ‘organic’ but, under the Australian Consumer Law, there must be evidence to back up the claim.
See ‘Is natural – is good?’ for more related to this topic.
FACT: Some media claims went far beyond what the study found
Some mainstream and social media claims were alarming and went far beyond the study’s actual findings. For example:
But there is no basis for concern. The study did not establish any link between the use of conventional tampons and any health effects. And no evidence of a difference in the safety of organic and conventional tampons was provided.
This ABC Media Watch clip succinctly and comprehensively slams the false claims made.
FACT: The study did not even look for a link between tampon use and adverse health effects
The study was commissioned by an organic tampons manufacturer in New Zealand. Its aim was to determine if there were endocrine-disrupting chemicals present in tampons available on the New Zealand market.
To do this, the study measured the level of oestrogen activity of four tampon brands, one of which was organic and three that were conventional. ‘Measurable oestrogen activity’ was found in just one non-organic tampon brand. However, the chemical or chemical/s responsible for this activity were not identified, nor the levels present, and certainly not the impact of these undetermined chemical/s in the context of the route of exposure and frequency of product use.
The study’s lead author Dr Alison Heather was reported in New Zealand media as follows: ‘Dr Heather says researchers don’t know what this particular chemical is yet or if it is able to leach out of the tampon, cross the tissue of the vagina, get into a woman’s bloodstream and cause a physiological effect’.
Dr Heather also told Media Watch that ‘our pilot study did not establish a direct link between tampons and an increased risk of cancer’.
The study had not (at the time of the media reports) been reviewed by qualified peers.
Other studies have looked for and found certain chemicals—such as fragrances, volatile organic compounds, dioxins and phthalates—in menstrual products. A 2023 review [2] considered all these studies and said that more research was needed, rather than claiming any link to adverse health effects.
FACT: Experts say the detected level of oestrogen activity are negligible
Following the alarmist media on this topic in November 2023, experts weighed in on what conclusions could be drawn from the study.
For example, regarding the study’s conclusion of ‘significant’ endocrine-disrupting activity, University of Adelaide molecular pharmacologist Dr Ian Musgrave said that the amounts of oestrogen that were detected in the one brand were so small they would have no impact: ‘Even if all this “oestrogenic material” was released at once, this would have no biological effect.’[3]
University of Melbourne gynaecologist Alex Polyakov said ‘no meaningful conclusions’ could be drawn from the research.
Fact: There is no evidence that organic tampons are ‘safer’ than conventional tampons
Some of the media arising from this report suggested that organic tampons are a safer option. This was not supported by the study’s findings and the study authors made no such claims.
First, two of the conventional brands showed no oestrogenic activity. Second, as explained above, no link to any adverse health effects were found for the one conventional brand that did show oestrogenic activity.
The study was commissioned by an organic tampons manufacturer, which requested a study on the prevalence of endocrine disrupting chemicals, with xenoestrogenic potential, in feminine hygiene products. (Xenoestrogens are estrogen-mimicking compounds that are not produced by the human body.) The study report is up-front about this affiliation. This manufacturer was featured in some media reports advocating the use of certified organic products (like theirs).
The media is often sceptical of studies by companies or industry groups but, in this case, the findings of a non-peer-reviewed study funded by one tampon company were not only drastically overblown but the very company behind the study was given airtime on mainstream media to promote their product type.
FACT: Tampons are regulated for safety in Australia
In Australia, all tampons are regulated by the Therapeutic Goods Administration and are required to comply with Therapeutic Goods (Standards for Tampons) (TGO 103) Order 2019. This order states that menstrual tampons must meet the Australian Standard (AS) 2869:2022 Tampons - Menstrual. This standard ensures that tampons are manufactured to minimise recognised health risks associated with the use of these products.
See more on tampon regulation here: www.tga.gov.au/resources/resource/guidance/guidance-regulation-tampons-australia
FACT: Tampons should be used safely to minimise known risks
The use of tampons has been associated with an increased risk of toxic shock syndrome (TSS), although they are not the direct cause and tampon-associated TSS is rare. TSS is a serious condition. But some sensible precautions can minimise your risk. See http://www.healthdirect.gov.au/toxic-shock-syndrome for more information.
The bottom line: When used correctly, you can continue to use tampons with confidence. There is no new evidence that trace levels of chemicals that may be present increase your risk of cancer, or other adverse health effects.
Sources
[1] Schack, D, Campbell, Sutherland, E, Heather, A, A Collaboration between Zestt Wellness and Insitugen. Assessment of Endocrine Disrupting Activity of Commercially Available Sanitary Products – A Pilot Study Report for Organic Initiative. https://cdn.shopify.com/s/files/1/0609/2043/0843/files/Organic_Initiative_-_Tampon_Report_August_2023.pdf?v=1698044821
[2] Marroquin, J, Kiomourtzoglou, M-A, Scranton, A, Pollack, AZ. Chemicals in menstrual products: A systematic review. BJOG. 2023; 00: 1–10. https://doi.org/10.1111/1471-0528.17668
[3] Paige Cockburn, ABC Health and Wellbeing, 30 November 2023, Your guide to what's in tampons, pads and whether 'organic' is better than not. www.abc.net.au/news/health/2023-11-30/are-the-chemicals-in-tampons-and-pads-actually-harmful/103091914
That some tampons contain harmful chemicals that leach from the product, increasing the risk of various health issues including breast and ovarian cancers, endometriosis and infertility.
And that organic tampons are safer than conventional tampons, which may be made up of combinations of natural and synthetic materials.
These broad claims were based on the findings of one small NZ study [1] that measured the levels of oestrogen activity of four tampon brands. (Oestrogen is one of the main sex hormones, particularly in women, and is responsible for a range of essential human health and development functions.)
Some mainstream and social media contained statements that went well beyond the study’s findings and may have caused undue alarm.
Synthetic, organic…what??
Synthetic means man-made. For chemicals, this means chemicals made in a laboratory.
For ‘organic’, there is no universal definition. Generally, it means a product that has been produced without any contact with synthetic chemicals. For example, organic cotton should have been grown without the use of synthetic pesticides or genetically modified seeds. ‘Certified organic’ is clearer, meaning products that have been independently assessed as meeting an organic standard.
In Australia, products don't need to meet a particular standard to be labelled as ‘organic’ but, under the Australian Consumer Law, there must be evidence to back up the claim.
See ‘Is natural – is good?’ for more related to this topic.
FACT: Some media claims went far beyond what the study found
Some mainstream and social media claims were alarming and went far beyond the study’s actual findings. For example:
- ‘chemicals found in some synthetic tampons disrupt hormone regulation and are associated with breast and ovarian cancers’
- ‘cancer link’ (with picture of tampons)
- ‘increased risk of cancer’
But there is no basis for concern. The study did not establish any link between the use of conventional tampons and any health effects. And no evidence of a difference in the safety of organic and conventional tampons was provided.
This ABC Media Watch clip succinctly and comprehensively slams the false claims made.
FACT: The study did not even look for a link between tampon use and adverse health effects
The study was commissioned by an organic tampons manufacturer in New Zealand. Its aim was to determine if there were endocrine-disrupting chemicals present in tampons available on the New Zealand market.
To do this, the study measured the level of oestrogen activity of four tampon brands, one of which was organic and three that were conventional. ‘Measurable oestrogen activity’ was found in just one non-organic tampon brand. However, the chemical or chemical/s responsible for this activity were not identified, nor the levels present, and certainly not the impact of these undetermined chemical/s in the context of the route of exposure and frequency of product use.
The study’s lead author Dr Alison Heather was reported in New Zealand media as follows: ‘Dr Heather says researchers don’t know what this particular chemical is yet or if it is able to leach out of the tampon, cross the tissue of the vagina, get into a woman’s bloodstream and cause a physiological effect’.
Dr Heather also told Media Watch that ‘our pilot study did not establish a direct link between tampons and an increased risk of cancer’.
The study had not (at the time of the media reports) been reviewed by qualified peers.
Other studies have looked for and found certain chemicals—such as fragrances, volatile organic compounds, dioxins and phthalates—in menstrual products. A 2023 review [2] considered all these studies and said that more research was needed, rather than claiming any link to adverse health effects.
FACT: Experts say the detected level of oestrogen activity are negligible
Following the alarmist media on this topic in November 2023, experts weighed in on what conclusions could be drawn from the study.
For example, regarding the study’s conclusion of ‘significant’ endocrine-disrupting activity, University of Adelaide molecular pharmacologist Dr Ian Musgrave said that the amounts of oestrogen that were detected in the one brand were so small they would have no impact: ‘Even if all this “oestrogenic material” was released at once, this would have no biological effect.’[3]
University of Melbourne gynaecologist Alex Polyakov said ‘no meaningful conclusions’ could be drawn from the research.
Fact: There is no evidence that organic tampons are ‘safer’ than conventional tampons
Some of the media arising from this report suggested that organic tampons are a safer option. This was not supported by the study’s findings and the study authors made no such claims.
First, two of the conventional brands showed no oestrogenic activity. Second, as explained above, no link to any adverse health effects were found for the one conventional brand that did show oestrogenic activity.
The study was commissioned by an organic tampons manufacturer, which requested a study on the prevalence of endocrine disrupting chemicals, with xenoestrogenic potential, in feminine hygiene products. (Xenoestrogens are estrogen-mimicking compounds that are not produced by the human body.) The study report is up-front about this affiliation. This manufacturer was featured in some media reports advocating the use of certified organic products (like theirs).
The media is often sceptical of studies by companies or industry groups but, in this case, the findings of a non-peer-reviewed study funded by one tampon company were not only drastically overblown but the very company behind the study was given airtime on mainstream media to promote their product type.
FACT: Tampons are regulated for safety in Australia
In Australia, all tampons are regulated by the Therapeutic Goods Administration and are required to comply with Therapeutic Goods (Standards for Tampons) (TGO 103) Order 2019. This order states that menstrual tampons must meet the Australian Standard (AS) 2869:2022 Tampons - Menstrual. This standard ensures that tampons are manufactured to minimise recognised health risks associated with the use of these products.
See more on tampon regulation here: www.tga.gov.au/resources/resource/guidance/guidance-regulation-tampons-australia
FACT: Tampons should be used safely to minimise known risks
The use of tampons has been associated with an increased risk of toxic shock syndrome (TSS), although they are not the direct cause and tampon-associated TSS is rare. TSS is a serious condition. But some sensible precautions can minimise your risk. See http://www.healthdirect.gov.au/toxic-shock-syndrome for more information.
The bottom line: When used correctly, you can continue to use tampons with confidence. There is no new evidence that trace levels of chemicals that may be present increase your risk of cancer, or other adverse health effects.
Sources
[1] Schack, D, Campbell, Sutherland, E, Heather, A, A Collaboration between Zestt Wellness and Insitugen. Assessment of Endocrine Disrupting Activity of Commercially Available Sanitary Products – A Pilot Study Report for Organic Initiative. https://cdn.shopify.com/s/files/1/0609/2043/0843/files/Organic_Initiative_-_Tampon_Report_August_2023.pdf?v=1698044821
[2] Marroquin, J, Kiomourtzoglou, M-A, Scranton, A, Pollack, AZ. Chemicals in menstrual products: A systematic review. BJOG. 2023; 00: 1–10. https://doi.org/10.1111/1471-0528.17668
[3] Paige Cockburn, ABC Health and Wellbeing, 30 November 2023, Your guide to what's in tampons, pads and whether 'organic' is better than not. www.abc.net.au/news/health/2023-11-30/are-the-chemicals-in-tampons-and-pads-actually-harmful/103091914
