Are Your Tampons a Medical Device?
Yes, your tampons are considered a Class II medical device by the US government and FDA since 1980. So what does this mean to the clinician whose average female patient will use between 11,000 – 16,000 of these medical devices in her lifetime? It might be helpful to include a question on your intake about feminine hygiene similar to the ones you might ask when it comes to food. Organic? Do you avoid the Dirty Dozen? Are the animal products you eat from grass-fed sources? Are you using organic pads and tampons? What type of products (or in this case; medical devices) a woman chooses to manage her period may serve as a significant source of exposure to chemicals.
Let’s step back a moment to the fact that tampons and pads are medical devices. In 1980, after hundreds of cases of Toxic Shock Syndrome (TSS), tampons were classified as medical devices which forced manufacturers to report adverse health effects to the end user. TSS was linked to the synthetic chemicals found in super-absorbent tampons. In 1982, the FDA required that manufacturers carry a warning label around tampon use and TSS. During this time, there were also requests from consumer groups that the FDA require companies to label the ingredients in their tampons due to safety concerns, with dioxin levels being of primary concern. Unfortunately, the FDA did not agree with these requests and still does not require companies to list the ingredients in their tampons or pads.
Here is the exact language the FDA uses to guide manufacturers on chemical residues:
FDA recommends that tampons be free of 2,3,7,8- tetrachlorodibenzo-p-dioxin (TCDD)/2,3,7,8-tetrachlorofuran dioxin (TCDF) and any pesticide and herbicide residues.
You should describe any assurances that chemical residues are not present or, if residues are present, the level present and the method used to assess it. These assurances may include, but are not limited to, test methods, tolerances, or acceptance criteria. For any materials bleached during processing, we recommend that you identify the bleaching process used, e.g., Elemental Chlorine-Free (ECF) or Totally Chlorine-Free (TCF).
It is worth noting the words ‘recommends’, ‘should’ and ‘may’ as this clearly lets the manufacturer know that the FDA is making suggestions and that is does not actually require even this small level of consumer protection or transparency.
So what is in tampons? It is a challenging question to fully discern depending on what type of tampons you purchase. Tampax lists the following ingredients in their tampons: cotton, rayon, polyester or polyethylene, and polypropylene as well as fragrance (only in versions that are labeled as scented). Personally, I don’t want to wear plastic clothes (aka polyester clothes) or eat plastics in my food supply let alone use them vaginally. No thank you!
Let’s not forget that 94% of the cotton in the United States is genetically modified and that cotton is a pesticide-intensive crop. The amount of pesticides and insecticides used in cotton agriculture is often 3 to 5 times greater per hectare than those used in other crops. As this is a short article and the harmful effects of pesticides and insecticides to humans is well established, I won’t go into further detail but suffice it to say, I don’t want any of these toxins in the tampons or pads used by woman across the globe. Finally, a brief comment about the use of fragrances in tampons and how ‘scented tampons’ and ‘fresh scent’ are on nearly half the boxes of tampons now. Synthetic fragrances contain a wide variety of chemicals with harmful effects on humans. Phthalates are a common ingredient in fragrance and plastics and have been shown to have the following effects: estrogenic activity, elevated levels found in autism spectrum disorder, endometriosis, diabetes, ADHD, pro-artherogenic and pro-senescence effects via severe lipoprotein modification. If companies would only disclose the ingredients, especially the ones in the ‘scented tampons’, this article would be able cite the specific effects on human health of each ingredient.
The take-away message is conventional tampons and pads are not anywhere in the ballpark of being well regulated. There is zero transparency in their ingredients used to make tampons and pads and they pose a significant source of toxicant exposure to the health of half your patients. “I want to put pesticides, GMO’s, plastics and phthalates in my vagina” said no woman ever! So if you aren’t already doing it, consider including an additional question on your patient intake about sanitary products. It can be part of the discussion with your patients when you discuss organic food and/or the impact of personal care products. In the office bathroom, consider stocking it with some organic tampons and pads and have a little note letting them know, “organic sanitary products”. Emerson Ecologics is proud to now offer two brands for you to choose from for your organic tampons and pads; Emerita and Dr. Mercola. You can also make these available to your patients in-office or via wellevate, your online dispensary.
By Tina Beaudoin, ND
Dr. Tina Beaudoin is a licensed Naturopathic Doctor and Senior Medical Educator with Emerson Ecologics. She enjoys seeing patients in her private practice in Manchester, NH, and has been serving as the President of the New Hampshire Association of Naturopathic Doctors since 2012.
 As cited on March 27 2017 at: https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm071781.htm#ft9
 As cited on March 27, 2017 at: https://toxics.usgs.gov/regional/cotton.html
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