Have you ever thought about what's actually in condoms, tampons, and other sexual health products that you use and put inside the most intimate part of your body? For a while, I didn't either. Until I learned that the vagina is one of the most absorbent parts of the body. One study published in the American Journal of Obstetrics and Gynecology even found that the vagina can secrete and absorb fluids at a higher rate than skin.
It's estimated that the average woman will use about 12,000 to 16,000 tampons in one lifetime. Given the amount of time one tampon sits in a vagina, it could matter what's in the ones we use.
What's in your tampons and pads?
Most conventional tampons and pads are made from a mix of cotton, rayon, and other synthetic fibers. According to the USDA, 94 percent of cotton is sprayed with an herbicide called glyphosate. In 2015, the International Agency for Research on Cancer (IARC), a branch of the World Health Organization, classified glyphosate in group 2A as "probably carcinogenic to humans."
Because conventional tampons are made with non-organic cotton, this has led some to question the safety of glyphosate being absorbed in the vagina through tampons.
Occurring as a by-product of rayon, dioxins are also of concern. According to the Environmental Protection Agency, "dioxins are highly toxic and can cause cancer, reproductive and developmental problems, damage to the immune system, and can interfere with hormones."
The FDA says that the levels of these by-products such as glyphosate and dioxins in menstrual products are so small that they pose no risk.
Non-profits, such as Women's Voices for the Earth, say that because the mucous membrane of the vagina is so permeable, even trace amounts of carcinogenic agents could be a concern and that the levels of these toxins should be regulated.
Currently, there's been no long-term research on the effect of these compounds ending up inside a women's vagina and being absorbed there.
At this time, the FDA does not require manufacturers to list the ingredients in menstrual products. Currently, there are many NGOs and activist organizations trying to change this policy, with politicians leading the charge. New York congresswoman Grace Meng introduced the Menstrual Products Right to Know Act of 2017 (Bill H.R.2416), which would mandate that the manufacturers of menstrual products list their ingredients. Women's Voices for the Earth is also working to push this legislation through.
Sustain Natural is one company trying to make a difference in the space. Sustain makes 100 percent organic, all-natural condoms, tampons, pads, lubricant, and other vagina-friendly essentials. Founder Meika Hollender is on a mission to empower women to take control of their sexual and reproductive health.
"We're just all about clean ingredients and full transparency," Hollender said. "And also just having a very real conversation about sex and periods."
The "Tampon Tax"
One thing that Hollender is also working with organizations to change, is the "tampon tax," as it's often referred to. In 36 states in the US, feminine hygiene products are taxed as "non-essential luxury items." Period Equity, a law and policy organization working for affordable menstrual products, recently released this parody ad featuring Amber Rose to highlight the irony of tampons being taxed as "luxury" items.
This tax on menstrual products also means that women in poverty cannot use food stamps to purchase feminine hygiene care. According to Sustain's website, more than 20 million women lack access to reproductive healthcare, which is why the company donates 10 percent of its profits to family planning and reproductive healthcare services for low-income communities.
What about condoms?
Condoms are the most effective method of reducing the risk of STDs. So, let's begin by saying that all condoms are a fantastic thing. According to the CDC, STDs are on the rise with more than two million cases reported of chlamydia, gonorrhea, and syphilis in 2016, the highest number to date. Any condom is better than no condom!
FDA-approved condoms may be made from latex, nitrile (a synthetic latex), polyisoprene, polyurethane, or natural lambskin. While lambskin condoms are effective at preventing pregnancy, they are not effective at preventing STDs, as the small pores in natural animal skin allow bacteria and viruses to pass through.
What seems to fly under the radar is that most conventional condoms contain variations of a group of chemical compounds called nitrosamines. Nitrosamines are generally recognized as carcinogenic.
In 2010 the WHO and the United Nations Population Fund recommended that manufacturers reduce the levels of nitrosamines in condoms.
Since then, no mandate has been enacted by the FDA to regulate this.
Nitrosamine levels are regulated in products like baby bottle tops and pacifiers. In 2014, the Reproductive Health Technologies Project tested 23 condom brands for nitrosamines and found that seven of the 23 condoms tested, "released enough nitrosamines to exceed the level set by the EU for toys intended for use by the mouth or by children under the age of three."
According to this review published in the International Journal of Hygiene and Environmental Health, the level of absorption of nitrosamines through the use of condoms is so low that it's a non-issue. The FDA agrees. The review also concludes, "humans are regularly exposed to nitrosamines from food and tobacco smoke at a dose which is 1,000 to 10,000 fold higher than expected from condom use."
Hollender believes that either way, nitrosamine levels should be regulated in condoms.
"Because there is a way to manufacture condoms without nitrosamines occurring, I think every manufacturer should be doing that," she said. "Demand transparency."
Support the "Menstrual Products Right to Know Act," pushing for legislation that would require all manufacturers to disclose ingredients in feminine hygiene products.