Period 37: I hate tampons (derogatory)
I hate tampons.
No, really. I hate them.
I tend to be menstrual product agnostic in that I think people need to use whatever works best for them given their anatomy, comfort level, pain, bleeding level, and socioeconomic status. I have shared information over the years about the history of toxic shock syndrome and tampons, on how variable menstrual cup quality can be, and regarding the endocrine disrupting chemicals found in most disposable menstrual pads (and infant diapers by the way).
There is no single solution that will work for all, even most people. Your favorite period underwear are not pure, nor is your favorite menstrual cup. There is some group of people – because of chronic pain, pelvic prolapse, menorrhagia, endometriosis, limb differences, or more – for whom whatever you want to evangelize about, does not work. Yes there are independent, small companies testing their products on consenting adults not lab animals; devoted to avoiding bleach and PFAS; etc etc. You will need to pay up front to buy them online, they will cost a lot, and then they still may not work for you, an individual with unique anatomy. Or they may work for you today, but not after your second child, or not after you hit perimenopause.
I don’t say this to say give up! I’m saying this to say – all choices are compromised and things change over time. As Alexis Shotwell has said in Against Purity, it is from a place of compromise that our most radical acts are possible.1 Compromise does not have to cause us to freeze, it’s liberating to recognize there is no purity and that we are still obligated to do our best.
Which is why I’m going to finally say there is one single menstrual product that I cannot in good conscience recommend even though I find myself using it once or twice a year when pool time and my period just happen to conflict, and it’s tampons.
Let me explain why I am anti-tampon, even though I can identify at least one more point this summer where I will probably have to wear one (in about eight to ten days).
The vagina
While colloquially vagina is the term people use for the entire external anatomy, or for the vulva (the opening to the vagina), I want to talk about the actual vagina for a moment. This is the tube, or canal, that leads to the cervix – when we’re speaking about vaginas across species it’s the terminal section of the oviduct that. The tissue is very elastic and in humans it’s anywhere from six to ten centimeters long. The vagina has a mucosal membrane where any substance that comes into contact with it can go straight into the bloodstream, bypassing metabolic pathways. It has a very high surface area because it is full of folds (rugae), another reason to suspect high uptake of anything with which it comes into contact.2,3 While some species have thick vaginal walls to account for copulatory harm from spiny penises, we humans have no such protection, given that the human penis is, well, not spiny.4
The vagina is massively understudied, and I kept coming up against the same handful of citations to try and learn more about it. Much of what can be learned about within and between species variation in vaginas is thanks to Dr. Patricia Brennan and her lab at Mount Holyoke.4 Brennan’s lab is the one that published about corkscrew penises (and vaginas) in ducks several years back, and they published the first definitive evidence that dolphins have clitorises… in 2022.5
So like I said – not a lot in the way of research, and what we have from a broader comparative context, it’s largely thanks to Patty and her team.
So the vagina is a place where the body does all sorts of brilliant things to protect itself from immune assaults, physical assaults, and it has the capability to heal itself. It’s super duper cool. Despite these things, we need to understand that the vagina is still a place that is vulnerable because it is permeable: it is a place where substances get into the bloodstream more easily in part because of some of the adaptations that make it cool.
Therefore, if you put something up in the vagina that has, say endocrine disrupting chemicals (chemicals that in some way mimic, block, or interfere with hormones), you are increasing the risk that those chemicals go directly in the bloodstream. Additionally, you are putting those endocrine disrupting chemicals into the reproductive tract, and very close to reproductive organs. You know, all things that are very responsive to changes to the endocrine system – to hormones.
Tampons
Tampons are typically made of cotton or of a cotton blend. As such they are made of plant matter and sometimes fossil fuel products. Various endocrine disrupting chemicals, and other chemicals known to impact human health, have been found in tampons over the years, from dioxin, to glyphosate, to flame retardants, to phthalates, parabens, and bisphenols.6 The uptake of these chemicals into our bloodstream may be likely greater when it occurs through the vaginal wall than when we put it onto our skin or into our mouths.
Which brings me to why I am talking about why I hate tampons today – a new study came out about a month ago testing for the presence of heavy metals in tampons. Heavy metals – lead, cadmium, mercury, zinc, and others – are endocrine disrupting chemicals. Because of various public health emergencies like mercury in fish, leaded gas, lead paint, and lead in the water of Flint, Michigan, there is decent public awareness that these exposures tend to be harmful. And, well, as it turns out there are heavy metals in our tampons too.
The researchers in this study measured for the presence of sixteen heavy metals across twenty four different types of tampons (sometimes multiple varieties from the same brand). They were able to extent the presence of all sixteen heavy metals. Buying organic did not save you: some metals were lower in organic samples, some were higher. Some metals were lower in the UK/EU samples compared to the US samples. Plastic applicators had no particular effect on heavy metal concentrations. And brand name tampons were lower in some metals, but higher in others.7
The moral of the story: can we live ethically in compromised times?
I’m not going to tell you to never use tampons, especially since I’m not going to stop my very occasional usage of maybe three tampons a year. But if you are someone who relies on tampons as your main menstrual product and you haven’t tried anything else in a while and have the bandwidth to do so… maybe give something else a go? Aired out disposable pads and Aisle/Dear Kate period underwear are my go-tos but if you think your anatomy and wallet could handle a cup or disc, give it a go.
References
1. Shotwell, A. Against Purity: Living Ethically in Compromised Times. (U of Minnesota Press, 2016).
2. Hussain, A. & Ahsan, F. The vagina as a route for systemic drug delivery. Journal of Controlled Release 103, 301–313 (2005).
3. Srikrishna, S. & Cardozo, L. The vagina as a route for drug delivery: a review. Int Urogynecol J 24, 537–543 (2013).
4. Keeffe, R. M. & Brennan, P. L. R. Vaginas. Current Biology 33, R670–R674 (2023).
5. Brennan, P. L. R., Cowart, J. R. & Orbach, D. N. Evidence of a functional clitoris in dolphins. Current Biology 32, R24–R26 (2022).
6. Upson, K., Shearston, J. A. & Kioumourtzoglou, M.-A. Menstrual Products as a Source of Environmental Chemical Exposure: A Review from the Epidemiologic Perspective. Curr Envir Health Rpt 9, 38–52 (2022).
7. Shearston, J. A. et al. Tampons as a source of exposure to metal(loid)s. Environment International 190, 108849 (2024).