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Approximately 43 million women in the United States use tampons. Millions more use sanitary napkins. These feminine hygiene products are usually made of cotton or a blend of cotton and rayon for absorbency. Rayon is a cellulose fiber made from wood pulp.

Until the late 1990s, the cotton and/or rayon used to make the tampons were bleached with elemental chlorine gas which was known to leave dioxin residues. Dioxin is a pervasive environmental contaminant and a known human carcinogen. It accumulates in body fat over time with repeated exposure.

The use of these dioxin laced fibers in the manufacture of disposable feminine hygiene products caused millions of women and girls to unwittingly allow carcinogenic toxins to come into contact with the thin and delicate tissues of their female reproductive organs, month after month, year after year.

In response to fears of dioxin residues in feminine hygiene products, bleaching with elemental chlorine gas is no longer used. According to the FDA, sanitary products are now bleached via one of the following methods:

  • Elemental chlorine-free bleaching These methods include the use of chlorine dioxide gas as the bleaching agent as well as totally chlorine-free processes. Some elemental chlorine-free bleaching processes can still generate dioxins at extremely low levels.   In practice, however, this method is considered to be dioxin free by the FDA.
  • Totally chlorine-free bleaching These methods are completely dioxin-free. Totally chlorine-free methods include, for example, the use of hydrogen peroxide as the bleaching agent.

Is the dioxin really and truly gone with these new bleaching methods?  The FDA reports that dioxin can “theoretically” be created with chlorine-free bleaching.  In practice, however, it appears dioxin is still very much present. A study sponsored by the FDA Office of Women’s Health published in 2005, found “detectable levels of dioxin in seven brands of tampons,” including at least one 100 percent cotton brand.

Dioxin Exposure and Endometriosis

Endometriosis was found to be directly correlated with dioxin exposure in a colony of rhesus monkeys chronically exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD or dioxin) for a period of 4 years. Ten years after the termination of dioxin treatment, the presence of endometriosis was documented by surgical laparoscopy.

With endometriosis rates soaring in young women, one has to wonder if chronic exposure to low levels of dioxin residues from sanitary products could partly be to blame?

Chlorine Dioxide is a Pesticide

Even if dioxin is mostly gone using these newer bleaching methods, another problem emerges in the manufacturing process for tampons and sanitary napkins.

While totally chlorine-free bleaching with oxygen or hydrogen peroxide (H2O2) appears safe, the use of chlorine dioxide is likely not. While chlorine dioxide smells somewhat like chlorine bleach, it should not be confused with elemental chlorine gas.  They are two distinct chemicals that react differently and produce by-products that have little in common.

Chlorine dioxide is an antimicrobial pesticide that has been used for its disinfectant properties since the early 1900s. Microbes are killed by chlorine dioxide via the disruption of nutrients across the cell wall.

Chlorine dioxide was one of the pesticides used as part of the federal decontamination response to the anthrax spore bioterrorism attacks of October 2001.

So, while dioxin residue may potentially no longer be a problem for sanitary products, pesticide residues are.

One problem replaced with another as is frequently the case with industrially manufactured products!

Is exposure to chlorine dioxide residue dangerous?

No one knows for sure.  While chlorine dioxide itself is toxic, the effects of long term, low-level exposure such as would occur for women and girls using conventional sanitary products several days each month for decades on end is unknown.  According to a 2002 World Health Organization report on long term exposure to chlorine dioxide:

There are no chronic inhalation or dermal studies available and no conventional carcinogenicity studies are available.

Cotton: The Most Highly Sprayed Crop

Besides the concern for chlorine dioxide residue, commercial sanitary products made with cotton or a cotton/rayon blend would contain other pesticide residues from the cultivation of the cotton itself.

According to the Pesticide Action Network:

Conventionally grown cotton uses more insecticides than any other single crop. Nearly $2.6 billion worth of pesticides are sprayed on cotton fields each year – accounting for more than 10% of total pesticide use and nearly 25% of insecticides use worldwide.

Unlike cotton clothing that can be washed before coming into contact with the skin, feminine hygiene products are used right out of the package, immediately coming in contact with delicate and thin tissues of the female reproductive system.

Between the bleaching process and pesticide-laced cotton cultivation practices, disposable feminine hygiene products like sanitary pads and tampons are likely some of the most toxic personal care items women and girls use on a regular basis.

Rumor Control: Asbestos in Tampons?

Internet rumors in recent months have claimed that there is asbestos in commercial tampons. These claims suggest that asbestos is purposefully added to tampons by manufacturers to promote excess bleeding and hence, sell more products and increase profits.

You will be relieved to know that testing of commercial tampons has not indicated this to be true. According to an FDA report:

Asbestos is not an ingredient in any U.S. brand of tampon, nor is it associated with the fibers used in making tampons. Moreover, tampon manufacturing sites are subject to inspection by FDA to assure that good manufacturing practices are being followed. Therefore, these inspections would likely identify any procedures that would expose tampons products to asbestos. If any tampon product was contaminated with asbestos, it would be as a result of tampering, which is a crime. Thus far, FDA has received no reports of tampering. Anyone having knowledge of tampon tampering is urged to notify FDA or a law enforcement officer.

Safe, Green Choices to Toxic Feminine Hygiene Products

The data is ominous regarding the health and safety of repeated use and exposure to commercially produced feminine hygiene products like tampons and sanitary napkins. Pesticide and dioxin residues are a very clear and present danger to the health of women of all ages and these products should be avoided if at all possible.

For women and mothers of newly pubescent girls who wish to choose a safer route, fortunately, many options are available.

First of all, organic feminine hygiene products could be used. While these products may avoid the pesticide residues from commercially grown cotton and the chlorine dioxide gas used in bleaching, other problems emerge with disposal.

The book Flow: The Cultural History of Menstruation, estimates that the average woman throws away up to 300 pounds of feminine hygiene-related products in a lifetime.  While this may not be huge (.5% of personal landfill waste), considering the astronomical amount of garbage produced, it all ads up particularly when there are greener options available.

One option for safe and reusable sanitary items would be organic, cloth pads made with cotton, hemp or even bamboo.  For heavier days or when water sports or other sports-related activities are involved, however, pads just don’t cut it.

For active women and girls, a reusable menstrual cup made with natural, non-toxic materials like gum rubber or medical grade silicone is an excellent choice. A good quality cup will set you back about $30 upfront, but you will likely never have to buy another one and will save hundreds in the coming years compared with purchasing disposable organic sanitary tampons.

Menstrual cups are easy to use and in most cases, you don’t even need a pad when wearing one. The female scientists in the Biosphere 2 used menstrual cups as their sole form of feminine protection.  Just be sure to get the correct size: one size for girls and women who have not given birth and one for women who have.

There is no doubt that ditching commercial feminine hygiene products is one of the smartest personal care changes a woman can make to assure her current and ongoing reproductive health.  Choosing organic disposable products or even better, a reusable, natural materials menstrual cup that is safe, convenient, effective, easy to use and good for the planet is a wise practice not just for ourselves but for our developmentally vulnerable young daughters as well.


World Health Organization, Chlorine Dioxide
Anthrax spore decontamination using chlorine dioxide
Dioxin Facts
Tampons and Asbestos, Dioxin, & Toxic Shock Syndrome
Pesticide Action Network: Cotton
Endometriosis in rhesus monkeys following chronic exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin
Biosphere 2