People started to worry tampons might be linked to cancer after a 2024 study found that several tampon brands contained toxic metals like arsenic, lead, and cadmium.
But there hasn’t been any research to date showing that wearing tampons increases your chances of getting cancer, including endometrial or cervical cancer.
“There are contaminants, such as heavy metals and PFAS (per- and polyfluoroalkyl substances) in [tampons] that may be linked to adverse health effects, including cancer,” says Jeffrey How, MD, assistant professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center. “We are exposed to these heavy metals and PFAS in our environment (e.g., tap water and food), and the amount of the substance determines whether it is toxic or not.”
The most common health-related issues linked to using tampons include:
Toxic shock syndrome (TSS). This rare, potentially deadly condition happens when certain bacteria in your body make poisons that damage your organs. Wearing tampons can trap bacteria in your vagina, especially if you don’t change them enough.
Vaginal irritation. You feel itching or pain when you insert a tampon, particularly a tampon with deodorant.
Bacterial vaginosis. This is a bacterial infection that leaves you with a gray discharge and fishy smell in your vagina. Tampons can cause this condition by changing the normal balance between “good” and “bad” bacteria in your vagina.
Yeast infections. Tampons don’t cause yeast infections but may worsen them, especially if they’re scented tampons.
Allergic reactions. Some people are allergic to the materials, scents, or dyes in tampons.
Foreign body retention. Part or all of your tampon can get stuck inside your body. Sometimes you can remove it, but if your tampon gets beyond your cervix, see your doctor right away.
What Are Tampons Made Of?
In the U.S., tampons are regulated by the FDA as medical devices. The agency requires tampons to be made of cotton, rayon, or a blend of the two. It also requires that they be made with a bleaching process without elemental chlorine. Elemental chlorine leaves traces of dioxin, a chemical that may cause cancer in people.
You can find a list of ingredients in your tampons on the box or by going to the company’s website. For instance, Tampax, which is one of the most recognized brands on the market, says its tampons are made from a mix of rayon and cotton (for absorption), plus a number of chemicals. The exact ingredients in your tampons will depend on the brand.
If your tampon has a cardboard applicator, it’s usually made of paper and adhesive. If it has a plastic applicator, it may be made of polyethylene. Some tampons have no applicator.
Chemicals in tampons
Studies have found chemicals like PFAS, phthalates, and volatile organic compounds (VOCs) may be present in tampons from the manufacturing process, added as fragrances, or emitted as gas.
PFAS are considered “forever chemicals” because they don’t break down and they make their way into the food and water we consume, and into our bodies. Some studies show that higher levels of PFAS can increase the risk of cancer and infertility.
Phthalates are a group of chemicals used to make plastics softer. They're found in cosmetics, like deodorant, as well as in all kinds of plastics, like children’s toys or food containers. You can absorb phthalates by inhaling them or through your skin. Phthalates can disrupt your body’s endocrine system, which regulates your hormones.
VOCs are emitted as gases in products like paints, cleaning supplies, and office printers and cartridges. They may cause liver and kidney damage, headaches, loss of coordination, and ear, nose, and throat irritation. They may also cause cancer.
Since these chemicals are so widespread and found in so many products, it’s difficult to know how much exposure we have to them and if that exposure could be harmful from tampons and other feminine hygiene products.
Heavy Metals in Tampons
A 2024 study found that tampons contained small amounts of the following heavy metals:
- Arsenic
- Barium
- Calcium
- Cadmium
- Cobalt
- Copper
- Iron
- Manganese
- Nickel
- Lead
- Selenium
- Strontium
- Vanadium
- Zinc
The highest concentrations were for lead, cadmium, and arsenic. Lead was higher in non-organic tampons than in organic tampons, while arsenic was higher in organic tampons.
Where did these metals come from? The study suggests they may have been:
- In plants (like cotton) growing in contaminated soil
- In water used during the manufacturing process
- Intentionally added during manufacturing for odor control or as antimicrobial agents
Some of these metals (like arsenic and lead) are also naturally present in the earth.
The concern is that these heavy metals and other chemicals could be absorbed in your vagina and expose you to harm. Vaginal skin is at higher risk for chemical absorption than skin in other parts of the body because it is thin and lined with many blood vessels and small folds. Exposure to metal has been found to damage the liver, kidneys, and brain as well as increase the risks of infertility, dementia, and cancer, among other conditions.
“To be able to leach out the heavy metals, the authors [of the study] had to place the tampons in a concentrated acid solution and heat the tampon at very high temperatures in a microwave system,” says How. “Since the vaginal environment does not have those same conditions, it is unclear whether these heavy metals would ultimately leach into the body. Even if these heavy metals do leach out of the tampon, it is not clear that the levels present in tampons would pose any negative health risk. However, these are important questions that should be the focus of future research.”
In light of this research, the FDA commissioned a literature review and a lab study on metals in tampon materials. In December 2024, the literature review was published, which “did not identify safety concerns associated with tampon use and contaminant exposure,” the FDA said. The lab study is still going on.
“The amounts that were found in this particular study are not so alarming, other than for lead ... because it can be toxic, even in relatively small amounts,” says Nathaniel DeNicola, MD, an environmental health expert. “There's another consideration here, though, which is the cumulative body burden, the amount that is getting into you, and that is something that you have to think about. … I give dozens of interviews per year on these kinds of environmental questions on women's health, and most do not trigger an FDA investigation. So the fact that this one did is a signal that there's something important to explore here.”
Organic Tampons
The FDA doesn’t regulate the use of the term “organic” on personal care products. But in order to use the USDA organic seal, the cotton used in tampons labeled as organic must be grown to certain standards and without the use of synthetic pesticides and fertilizers.
Because even tampons made with organic cotton may have other materials (like a plastic applicator or whitening chemical), they may not be labeled as “organic tampons” but rather as “tampons made with organic cotton.”
Are organic tampons better?
There’s no evidence that organic tampons are better for you than non-organic ones. The heavy metals study found that organic tampons also had both arsenic and lead. A separate study found that all-cotton tampons promoted the growth of bacteria that could lead to TSS more than tampons mixed with cotton and rayon or cotton and viscose.
And although some users swear that their cramps lessened when they switched to organic cotton tampons (because fewer chemicals were going into their vaginas), there’s no scientific evidence to back this up.
As of now, the choice to use organic tampons over non-organic seems to be based on environmental or personal reasons, rather than health benefits.
Bearing all this information in mind, should you stop using tampons altogether?
“I don't tell [people] to stop using them because that hasn't been demonstrated yet [that they’re unsafe],” says DeNicola. “But the fact that they contain lead, the fact that things are absorbed vaginally, is enough to give people pause and just consider.”
Organic tampon ingredients
Organic tampons are made of 100% cotton and generally have no bleaches, dyes, fragrances, and added synthetic ingredients and no pesticides were used while growing the cotton. These ingredients will vary depending on the tampon brand.
Tampon Alternatives
If you’re thinking about switching from tampons, there are many alternatives to choose from. These include:
Menstrual pads
The FDA also regulates menstrual pads and menstrual cups as medical devices.
Menstrual pads are used to absorb your menstrual blood outside of your body. A pad has three layers:
- A soft top layer made of non-woven polypropylene/polyethylene to absorb the fluid and feel comfortable against your vulva
- A middle absorbent core usually made of cotton to hold the menstrual fluid
- A bottom layer to prevent leaks that has adhesive to stick to your underwear
Studies have found that most sanitary pads have VOCs and phthalates. As of now, it’s not clear that there is any danger from having these chemicals in your sanitary pads where they can potentially be absorbed into your vagina. More research is needed.
Menstrual cups
These are usually made of medical-grade silicone, rubber, or latex and are designed to collect and keep blood in your vagina. Most cups are designed for reuse, though some disposable cups are available.
A review of 43 studies on menstrual cup safety, comprising 3,319 women, didn’t find any major health problems. There were just five reports of toxic shock syndrome, six of allergies or rashes, and five of pain. Some 49 women needed professional help to remove the cup.
Look for a cup that’s hypoallergenic, nonabsorbent, and without harmful additives or chemicals. A menstrual cup is better for the environment than pads and tampons because it can be reused after each period for up to 10 years, preventing a lot of waste from going into the landfill.
It’s very important to wash your cup thoroughly after each use and to sterilize it at the end of your period to prevent infection.
Menstrual sponges
These are synthetic or natural sea sponges you insert into your vagina to absorb menstrual blood, similar to a tampon. But the FDA considers them a health risk because they can contain “sand, grit, bacteria, and various other materials. They’re no longer available for sale in the U.S. as a menstrual product.
Reusable menstrual disc
Menstrual discs are similar to menstrual cups; both are designed to collect menstrual flow inside your body and are usually made of medical-grade silicone. Like menstrual cups, discs can be left in place for up to 12 hours and reused. Discs are also available in disposable options.
Discs are flat and round and placed at the base of your cervix instead of in your vaginal canal. You may find a disc harder to insert, too, and they’re messier to remove than a menstrual cup. They can also be left in place during sex, unlike cups.
Discs haven’t been studied very much, but there seems to be a low chance of getting toxic shock syndrome when using them. The materials used to make discs also seem to be safe. As with cups, you must wash and sterilize the reusable versions.
Period underwear
These look like regular panties and are available in a variety of styles. They’re marketed as able to hold as much as 12 tampons or to last up to 12 hours. If you have a heavy period, you may want to combine period underwear with a pad or tampon.
Period underwear is usually made from layers of polyester to wick moisture away, along with an outer layer of nylon and Lycra to prevent liquid leaking onto your clothes.
Can an IUD stop your period?
An IUD (intrauterine device) is a T-shaped device used to stop you from getting pregnant. Both kinds of IUDs are inserted into your uterus by a doctor and can last between five up to 10 years. There are two different kinds.
Copper IUD. This device is made of copper and doesn’t have any hormones, although some people report they get irregular or heavier bleeding after it’s inserted.
Hormonal IUD. This IUD has the hormone progestin that it releases into your uterus. Progestin thickens mucus in the cervix to stop sperm from reaching an egg. Progestin also thins the lining of the uterus and partially stops the release of eggs from your ovaries.
One review of studies on hormonal IUDs found that almost half the participants reported their periods stopped (amenorrhea) during their first year on the device. Since progestin thins out the lining of your uterus, you’ll have less tissue available to shed during menstruation. Another study showed that women with heavy periods were less likely to report amenorrhea than women with light periods when using a hormonal IUD.
Takeaways
Though there’s no hard evidence that you can get cancer from tampons, most health issues associated with tampons (like toxic shock syndrome) can be lessened by following some basic guidelines. Wash your hands before and after inserting a tampon or other menstrual product in your vagina. Don’t leave it there longer than recommended by the manufacturer (for tampons, don’t leave it longer than eight hours). If the product is reusable, be sure to wash and sterilize it properly. See your doctor if you experience pain, discomfort, or an unusual discharge.